'Stop the Bleed' campaign continues outreach amid gun violence

In Chicago, more than 3,000 people have been shot this year, and the victim of a gunshot wound can bleed to death in only five minutes

By Robert McCoppin
Chicago Tribune

CHICAGO — Responding to a 911 call for a gunshot victim, Chicago police Officer David Watson followed a trail of blood into an apartment and found a teenager with blood streaming from a leg wound.

Using training he received as a Marine, Watson took the belt from the young man’s pants and wrapped it around his thigh. The officer placed a stick under the belt to tighten it by twisting, and his partner helped stem the blood by pressing down on the wound until paramedics arrived.

Doctors said that if Watson and his partner, Paul Moreno, hadn’t taken those steps after the October 2016 shooting, the teen probably would not have survived.

Medical experts say anyone can employ a few basic techniques to achieve the same results when confronted with a life-and-death scenario. And a public service campaign called “Stop the Bleed” aims to do just that: teach bystanders to save someone’s life by learning basic blood-stemming techniques.

Stop the Bleed is a national effort established by the White House in 2015 as one response to the Sandy Hook mass school shooting three years before. It aims to arm civilians with skills and bleeding control kits to provide crucial aid in an emergency until medical professionals can take over.

And each time there is a mass shooting or other violent event, like the massacre of more than 50 people in Las Vegas on Oct. 1, the campaign takes on greater urgency.

In Chicago, more than 3,000 people have been shot this year, and the victim of a gunshot wound can bleed to death in only five minutes.

Bystanders are on the scene before first responders, and experts say bleeding remains one of the leading preventable causes of death for such victims.

While street crime remains a common cause of severe injury, it is lessons learned from battlefield medicine that are the basis for training to stop blood loss. The military use of tourniquets in Iraq and Afghanistan saved an estimated 1,000 to 2,000 lives, according to the Journal of Trauma. Now, experts are hoping to translate that success into a civilian setting, and they have a precedent for such a program.

Thanks in large part to American Heart Association classes, more than 12 million people each year learn how to keep blood flowing through cardiopulmonary resuscitation, or CPR. Yet few nonprofessionals train in how to stop blood loss.

In the past two years, the American College of Surgeons, the primary group coordinating Stop the Bleed classes, has trained 165 people to be bleeding control instructors. They, in turn, have held more than 80 courses for more than 900 students, the group reports.

So far, only a few classes are offered each month by hospitals in the Chicago area, but sponsors like the Cook County Trauma and Burn Unit are hoping to ramp that up as people become more aware.

Audrey Robinson, a nurse practitioner for the county, began teaching classes on bleeding control there this summer.

She first taught surgeons so they could teach other students. She then provided the training to social workers at Stroger Hospital and is planning a free class each month for the general public.

While medical professionals have expertise in human anatomy, Robinson said anyone can be trained to recognize severe bleeding and try to stop it.

In case of a bleeding emergency, here are the main steps to follow, as described at bleedingcontrol.org:

  • Get yourself and the victim to a safe place, call 911, and assess the seriousness of the situation.
  • If blood from a wound is spurting, soaking clothing or pooling, the injury could be life-threatening.
  • Caregivers should first figure out the origin of the bleeding, then cover the wound or, if it’s large, stuff it with gauze, bandages or clean cloth, such as a T-shirt.
  • Apply pressure to the wound as hard as you can with both hands to keep blood from flowing out until help arrives.
  • If that doesn’t work, and the wound is in an arm or a leg, the next step is to make a tourniquet, using virtually anything that can be wrapped around a limb, such as a piece of clothing. It should be placed above the wound, or closer to the torso, and tightened until the bleeding stops.
  • A short stick called a windlass can then be inserted under the tourniquet next to the knot and used to tighten the tourniquet more if necessary. It should be tight enough to be uncomfortable. If the bleeding continues, a second tourniquet can be added.

These are the same kind of techniques paramedics use almost every day to save lives, Robinson said. Besides in regard to mass casualty events, these skills are also valuable for accidents that can occur at home, work or on the road. Officials say that keeping a first-aid kit with a tourniquet and blood-clotting gauze at home should be as routine as having a smoke detector.

Cook County sheriff’s deputies are among dozens of big-city departments that already carry tourniquets and get bleeding control training. The Chicago Police Foundation also is working to provide first-aid kits, including tourniquets, to Chicago police officers who undergo special training.

Yet not all medical authorities have full confidence in letting civilians cut off blood flow.

The Royal College of Surgeons of Edinburgh, in Scotland, released a position statement in July stating that tourniquets “must be used correctly or not at all,” warning of possible circulatory complications or even increased bleeding if used incorrectly.

The statement said it “could be argued that in a civilian setting,” the need to use a tourniquet is rare and that “most bleeds can be controlled with direct pressure successfully.” But it said there “remains a place for tourniquets” in cases of shootings, stabbings, industrial accidents or where a serious flesh wound occurs in a remote location.

Officials with the American College of Surgeons say they’re confident that properly trained civilians can be effective, citing real-life examples.

Dr. Kevin Chow, who has taught the Stop the Bleed course at the University of Illinois at Chicago, said someone used a ripped T-shirt, an apple and a pencil to make a tourniquet to save another person’s life. In a different case, two soccer players collided, leaving a large gash in one player’s leg. A friend packed the wound with a clean T-shirt to stop the bleeding until they could get to a hospital.

Hospital workers themselves often apply direct pressure to stop sudden bleeding until they can get in an operating room.

The long-term goal of the program is to hold classes at police stations, churches, community centers, offices and schools, and to make bleeding control kits as common as defibrillators in public places.

“A high school student can learn the same techniques I would use to hold pressure, pack a wound or apply a tourniquet,” Chow said. “These are skills that we are trying to get into everyone's hands so that it becomes common knowledge. … We tell people that they can make a huge difference and be the reason someone lives.”

Dr. James Doherty, trauma surgery director at Advocate Christ Medical Center in Oak Lawn, and education director for the College of Surgeons, taught the class to two Boy Scout troops, using an aquarium pump to simulate blood flow in a fake leg Halloween prop.

Since medical prosthetic models are expensive, Doherty is working in his basement to build his own models made of pool flotation noodles with a wooden rod inserted to simulate the bone, just to make lessons more available.

“This is a lifesaving maneuver,” he tells students. “Don’t be afraid to do it. The potential benefit far outweighs any harm.”

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