Update 20201224 I’m in the process of updating/completing this page, check back in a few days. We are also in the process of making cards with this information on – they will be available to buy as credit card sized , like the cards with the OTP generator, as well as pdf downloads for Patrons.
Depending on the first aid or medical courses you might have taken you will have come across a number of different ways to do an assessment. The type of assessment you do may vary depending on the situation.
The introduction of the use of tourniquets as the first line treatment for arterial bleeding, introduced and tested by the military during the Gulf War, significantly changed the survivability of victims of trauma. The use of tourniquets and the “STOP THE BLEED” campaign has become main stream in the civilian world. Many places have STOP THE BLEED kits (must like an IFAK) with AED kits in facilities and many public places.
This also required a re-evaluation of the way we do assessments. It used to be A-B-C – Airway – Breathing – Circulation (stopping bleeding) but now it is recognized that stopping massive hemorrhaging (bleeding) is the first priority, especially when a tourniquet can be applied in less than a minute, even by the victim if they are conscious.
Massive Hemorrhage
Airway
Respiration
Circulation
Hypothermia
Scene Safety – Is It Safe?
Before you begin any assessment or treatment you must make sure it is safe for you.
LOOK AROUND – CHECK FOR HAZARDS
- Active Shooters
- Wires
- Fuel
- Other vehicles
Wear appropriate personal protective equipment
- Gloves
- Eye protection
GET OFF THE X
If it is an active shooter situation or other instance where it is not safe to stay and treat at that location, i.e., middle of an interstate in fog, snow, ice etc.
MOVE!
MASSIVE HEMORRHAGE
- Look from head to toe for any signs of bleeding
- Run you (gloved) hands around and under the head and back of the neck
- Run down the sides of the patient and under the back as far as you can get your hands
- Run down along the sides of the hips
- Run down the outside the legs and underneath as far as you can get
If the patient is wearing heavy clothing get your hands inside as best you can – heavy clothing can hide blood.
IF IT IS WET, RED AND SQUIRTING
If it is a limb (arm or leg) place a tourniquet about 2 inches above the wound and tighten it as much as you can (warn the patient that it WILL hurt). DO NOT APPLY OVER JOINTS i.e. knee or elbow
If you can’t see where it is coming from, or the situation is not stable, place it HIGH AND TIGHT. As high as you can get it, as tight as you can get it.
Only use a tourniquet if it is bright red and squirting
If you can’t apply a tourniquet use hemostatic gauze and apply direct pressure TO THE SOURCE OF THE BLEED. This means stick your finger in the hole so you are putting pressure on the artery. If you apply to the surface you are not stopping the bleed, you are allowing it to fill the cavity.
With hemostatic dressing pack the wound and hold pressure for at least 2 minutes then use gauze, an elasticated bandage or something similar to wrap over the area to keep the hemostatic dressing in place.
If you do not have a hemostatic dressing use regular gauze and keep direct pressure for at least 10 minutes.
Once you have taken care of any massive hemorrhaging i.e., bright red squirty stuff, quickly re-check head to to for any other massive bleeding.