Stop the Bleed

Stop the Bleed

Stop the Bleed

A couple of weeks ago, I wrote about opportunistic gun grabbers who just happen to be doctors doing a literal blood dance in the aftermath of mass shootings to promote their gun control agenda. These doctors began angrily tweeting shots of bloodied clothing and hospital floors in response to an NRA tweet telling them to stay in their lane after the American College of Physicians published a policy paper to “fight gun violence.” Today I want to acknowledge something I only briefly mentioned in my last post and draw your attention to a legitimate, serious effort to stop the bleed.

Problem is, doctors – like many others – are influenced by the carnage they see. It’s agonizing to work on a blood-soaked kid who was shot and even more so to have to tell the parents of that kid that they will not see their child grow up. I get it. Doctors see a problem, and it is in their nature to work to fix it and take the most direct route to do so. See a gun shot? Eliminate the gun.

I can understand these physicians. Their first priority is to save lives. Unfortunately, they’re conflating their expertise in the emergency room with expertise in public policy, but an initiative by the American College of Surgeons aims to accomplish exactly what these doctors, who are no doubt traumatized by the blood and gore they see every day, endeavor to do every time they step foot into an emergency room: stop the bleed.


This is a national preparedness effort that works to actually save lives. This is not a political project that aims to disarm law-abiding citizens. It is an effort to educate the populace about how to save lives should the worst happen. Because anyone can become a first responder and save a life.

Massive bleeding from any cause, but particularly from an active shooter or explosive event where a response is delayed can result in death. Similar to how the general public learns and performs CPR, the public must learn proper bleeding control techniques, including how to use their hands, dressings, and tourniquets. Victims can quickly die from uncontrolled bleeding, within five to 10 minutes.

I first became aware of this effort through a video by ZDoggMD – otherwise known as Dr. Zubin Damania. ZDoggMD is Damania’s alter ego who does hilarious videos addressing popular misconceptions about US healthcare. If you haven’t seen ZDogg’s video critiquing the new medical drama “New Amsterdam,” you need to see it. I unfortunately watched the pilot episode of this trainwreck before I saw ZDoggMD had already watched it so I didn’t have to, and by the time I was done, my eyes were permanently embedded in the back of my head and I needed a crowbar and WD-40 to retrieve them.

This video, however, was different, and I would urge you to watch it all the way through before getting pissed off and pulling the “eject” handle. It’s not what you think.

Stopping the bleeding is critical to saving lives.

When I was in Army basic training, we spent a lot of time learning how to stop bleeding on the battlefield – pressure bandage, makeshift tourniquets, Combat Application Tourniquets (CAT), QuikClot powder… you name it, we learned about it. Because when seconds count, a bystander can be a lifesaver.

Courtesy of the Hartford Consensus

To this day, I have a First Aid kit in my car. It includes several CATs, sterile pressure bandages, QuikClot powder, hemostats, a scalpel, adhesive tape rolls, iodine wipes, burn cream, gauze, some sterile IV sets, and a bag of saline, among other things. I certified as a Combat Lifesaver on my last deployment, but I make an effort to remember my training.

Stopping bleeding is certainly a priority, but I would submit that treating for shock is also critical.

These vital skills that I learned in the military have found their use in the civilian world, and the Stop the Bleed has educated thousands of people about the steps they should take to stop bleeding before the victim ever enters an ambulance or an emergency room – especially in the uses of a tourniquet. The initiative appears to be working.

During 6 years, 1,026 patients with peripheral vascular injuries were admitted. Prehospital tourniquets were used in 181 (17.6%) patients. Tourniquet time averaged 77.3 ± 63.3 minutes (interquartile range 39.0 to 92.3 minutes). Traumatic amputations occurred in 98 patients (35.7% had a tourniquet). Mortality was 5.2% in the non-tourniquet group compared with 3.9% in the tourniquet group (odds ratio 1.36; 95% CI 0.60 to 1.65; p = 0.452). After multivariable analysis, the use of tourniquets was found to be independently associated with survival (adjusted odds ratio 5.86; 95% CI 1.41 to 24.47; adjusted p = 0.015). Delayed amputation rates were not significantly different between the 2 groups (1.1% vs 1.1%; adjusted odds ratio 1.82; 95% CI 0.36 to 9.99; adjusted p = 0.473).

No one ever hopes that they will be able to use the resources provided by the initiative, but these are critical skills we all should have if we ever find ourselves in an active shooter situation or even a car accident.

These skills helped save several lives during the recent Tree of Life Synagogue massacre, according to a trauma surgeon who cared for multiple victims that day.

We encourage people to learn CPR and the Heimlich maneuver to save lives. We should also encourage the general public to learn how to stop the bleed.

This is not a political initiative, but an effort to help save lives, which is exactly what doctors work to do. It allows doctors to stay in their lane by educating the public and helping bystanders become lifesavers.

The NRA was right – albeit not particularly tactful or sensitive – when it tweeted out that “self-important anti-gun doctors” need to stay in their lane, but I can also understand why doctors – many of whom have held a human heart in their hands when it stopped beating – would have a visceral reaction to that tweet.

Most doctors become doctors because they want to save lives. The Stop the Bleed effort allows doctors to do just that without getting mired in politics and advocating policies they, for the most part, don’t understand.

Written by

Marta Hernandez is an immigrant, writer, editor, science fiction fan (especially military sci-fi), and a lover of freedom, her children, her husband and her pets. She loves to shoot, and range time is sacred, as is her hiking obsession, especially if we’re talking the European Alps. She is an avid caffeine and TWD addict, and wants to own otters, sloths, wallabies, koalas, and wombats when she grows up.

  • scott says:

    Stop the bleed is a great program Marta, thanks for highlighting it! I have put together both first aid kits, and stop the bleed kits for all our vehicles, and educated my wife and son on use of tourniquets. Yes, i did say two kits, and here’s why..
    1 The first aid kits have small bandages / bandaids, NSAIDS (ibuprofen), saline bullets for eye wash, tape, and other items for minor injuries / ailments. While important and helpful, I don’t want any of this stuff getting in the way during a real emergency. In general, these are kept under the back seat / in the trunk.
    2. Stop the bleed kits. These contain two tourniquets, Israeli bandages, duct tape (it’s not pretty but it works well when wet, and gets the job done), 4×4 gauze pads, wound packing gauze and quick clot. In short, stuff that can stop life threatening bleeding. These are kept in center consoles, or the storage pocket on the drivers door, where they can be reached in an emergency, without leaving the drivers seat.
    To make an already long post even longer (my apologies) to anyone getting a stop the bleed kit, buy an extra tourniquet of the type you have in it, and use it just for practice! They have to be applied correctly to be effective. Forget the old “2 inches above an injury”.. the new rule is “High and tight” in the armpit, or the groin area of the effected limb (empty pants pocket on that side contents can keep it fro working right), and tighten it till it’s very uncomfortable / borderline painful. The intent is to STOP bleeding, not just slow it.
    Once you keep the blood in, you can take other steps to prevent shock, but all the other stuff doesn’t mean anything if you run out of blood.
    Sorry for the soap box, but as you said, this stuff is important!

    • GWB says:

      I prefer calling the band-aid first aid kits “boo-boo kits”. They’re for run-of-the-mill I-don’t-feel-good or I-cut-myself sorts of things. Not the honey-where’s-thefirst-aid-kit-and-the-mop or we’ll-talk-about-running-with-scissors-after-the-doctor-finishes-stitching-dear moments.

      On those kits, do make sure you rotate out all the ingredients regularly. Pain killers eventually go blecch, and even those moist towlette packages eventually dry out. (But, I guarantee there’s at least one kind of band-aid in your kit that you will never run out of. Probably whichever one the maker thought most important – and you never use.)

  • GWB says:

    many of whom have held a human heart in their hands when it stopped beating
    Well, duh! That’s not where the heart is supposed to be! Put it back!
    /dark humor

    One of the things that has always bugged me is “automobile first aid kits” that are full of tiny little band-aids, a couple of disinfectant wipes (moist towlette style), one 2×3 gauze pad, and a pair of blunt gauze scissors. I’ve always been “Whut?!?” If I need actual first aid material in my car it’s going to be because someone had their feet on the dash during the crash and has both legs with compound fractures and compromised arteries! If I need real first aid during a camping trip it’s going to be because one of the kids didn’t watch where he was walking and took an axe to the arm. I need REAL equipment to handle that!

    So, after Instapundit prompted me (he mentions it regularly), I went and got this for my car. It still has little moist wipes for sterilizing *eyeroll* but it’s got some quick-clot and real bandages. (And duct tape for holding bandages on – ’cause nothing says you’re f*ed up like being held together with duct tape!)

    I pondered getting one with a splint, but I don’t really need to pay big bucks for a piece of plastic you can roll up to store. Splints are easily improvised. I will probably get a bottle of merthiolate or iodine – trust me when I say that the ability to pour your antiseptic into the wound is helpful. (Yes, there’s a story for that. Buy me a beer and I’ll share it.)

    Oh, and make sure you have a Leatherman or Gerber in your kit, too. Some day you just might need to snip that fishhook, or take the head off an arrow so you can secure the wound. And, yes, first aid sometimes entails mechanical work (for the screwdriver and such).

    As to the doctors….
    Again, I don’t mind if they ask me to help them stop the gunshot wounds. But don’t think that because you graduated medical school, therefore we should all shut up and listen to your (often short-sighted) policy pronouncements outside the actual practice of medicine. (And don’t think I won’t double-check you on those, too!)
    (BTW, you want to reduce the most gunshot wounds? Step up aggressive policing in the violent places, and allow the good citizens there to carry for self-protection. Go arrest the evil folks running the place with their gangs, and put them away for the rest of their lives – though many probably deserve the death penalty.)

    • GWB says:

      Oh, and I need to get some burn ointment. That’s something else no one ever puts in a first-aid kit. (Is it a fear of someone using it inappropriately, then being sued?)

      • scott says:

        GWB, it is misuse that keeps burn ointment out of the kits. That stuff works great for smaller burns, but for the kind of burn that buys you some time in a burn unit, it does more harm than good. Because of the risk of misuse is why the stuff is no longer in most first aid kits.

        I guess I might have mentioned in my overly long post that I was an Army medic back in the 80’s, and have been a Paramedic since the early 90’s.

        • GWB says:

          What’s proper trauma treatment, then, for a bad burn (while you are waiting on an ambulance or getting them in the car)? Say the romaine lettuce bumped the lighter fluid while you were starting the grill and you ignited your arm….

          (And, of course, I’m wondering really about things like burns from a car fire or falling in the campfire, etc. Uses for a small trauma kit.)

          • Pretty limited. Put any actual fire out, then cover with a damp cool cloth, or any clean cloth if clean water isn’t available. After that, pretty much the same as first aid for shock. (If it’s a liquid fuel burn, it is helpful to irrigate the area – IF you have clean water, that is cool, not cold, and do it gently.)

            • scott says:

              Spot on W.O., you want to stop the burning process which involves cooling the area.. cool clean water is the best way. Not ice / ice water, that will make the burn worse. a clean sheet or similar will protect the area not just from contaminants, but also from the air.. the slightest breeze can feel like a thousand needles on a serious burn. A good dose of Ibuprofen or similar won’t hurt, reduces pain and inflammation.

              • GWB says:

                Thanks, WO and scott.
                I’m looking at buying a sealed wound irrigation pack (saline, basically) to go with the trauma kit. And some burn ointment (pain reliever and antiseptic) for the boo-boo kit.

                Now that I’m thinking about it, I should probably replace my fire extinguishers, too. 🙂

            • Marta Hernandez says:

              I adore this discussion, you guys! Please spread the message too. This is a terrific program aimed at saving lives, and it does!! Now I need to buy more CATs. 🙂

              • scott says:

                For those on a budget, Recon Medical has a good lower cost version. It isn’t American made, but it also isn’t cheap chinese crap, and it’s about $17. I also keep a couple SWAT-T’s, they’re just a big stretchy band basically, and they’re not my first line for adults, but for kiddos, they work great (CAT’s can be too big sometimes), and you can use what you need, cut off the rest, and take care of a second kid..

              • Click says:

                Marta or commenters, it would be very helpful if you would post URLs for those of us who are interested in following up and equipping ourselves. I went to the site, but no pointers to car or home kits. Maybe I’m missing something here or there….thanks in advance for any help!

    • That Alabama shooting was stopped cold by a person with a firearm. (Police officer in this case, who happened to be WHERE he was needed WHEN he was needed. Not a frequent thing.)

      Two wounded and one dead in that incident – not dozens. (And the perp was the dead one – which nobody SANE regrets.)

    • Click says:

      Your “this” link does not work. You will need to edit and insert the URL, I suspect, if you want folks to check the kit you’ve recommended.

  • Theo Moore says:

    Bleeding (blood) Beating (heart) Breathing are my first checks. If shock is there these will still need to be treated first.

  • Mac says:

    Excellent article! The best way to make sure you won’t ever have to deal with this type of life-threatening problem is to have both the knowledge and the equipment on hand and ready to handle it immediately should it arise. You’ll have a DIFFERENT problem, but it almost certainly won’t be the one you prepared for. Murphy usually doesn’t waste his time screwing up the stuff you’re all primed and ready to sort out.

  • CSMBigBird says:

    Medical malpractice kills many more thousands of people than guns. And that is 100% their lane.

  • AnneG says:

    A comment about doctors, especially surgeons. They are very involved in their work, but otherwise, tend to be low information. They have an opinion but they don’t take time to think it through. Slometime their solutions to problems outside the OR ortheir office are not practical or just won’t work.

  • J Bond says:

    Unfortunately the incident at the Alabama mall may have ended up with the police shooting an innocent black man who had nothing to do with the shooting in the mall but had pulled out his own handgun while running away.
    I do not know if a stop the bleeding effort was made in this case.
    I am a retired ER doctor and gunshot wounds are no fun to deal with. I think the Stop The Bleeding advice is great.

  • Chuck Pelto says:

    Bullet and other puncture wounds….

    A tampon!

  • Chuck says:

    Your local Community Emergency Response Team (C.E.R.T.) provides this kind of emergency first aid training fo free.

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