Jenny Harvey remembers some first aid training from not so long ago that stressed never use a tourniquet. Yet here she was, learning how to properly place a tourniquet on a mannequin with a bad leg wound. Members of the trauma service at the University of Alabama at Birmingham were teaching bleeding control techniques to teachers like Harvey at Homewood High School, as part of the national Stop the Bleed campaign.
“We used to be told that tourniquets were dangerous,” Harvey said.
That thinking has changed in the past few years. Military battlefield medicine and, more poignantly, mass shooting events in America have resulted in tourniquets’ returning to favor in cases of severe bleeding, especially in the absence of quick professional medical response.
“In the aftermath of mass shootings such as at Sandy Hook or the Pulse nightclub, we have learned two important things,” said Jeffrey Kerby, M.D., Ph.D., director of the UAB Division of Acute Care Surgery in the School of Medicine. “First responders can’t get to all the victims to provide first aid if a shooter is still loose and the scene is on lockdown. And after-action reports indicate that some of the victims of shooting events might survive if bleeding-control techniques are performed quickly. In the absence of first responders, that responsibility may fall on bystanders.”
The Stop the Bleed campaign, organized by the American College of Surgeons and Hartford Consensus, points out that victims can quickly die from uncontrolled bleeding, as soon as five or 10 minutes after injury. The campaign aims to provide the general public with the knowledge and tools to respond quickly in the event of an emergency, even before trained professionals can arrive. Stop the Bleed is modeled after the very successful efforts to place AEDs — automated external defibrillators — in public places.
“Ideally, we’d like to see Stop the Bleed kits in courthouses, schools, theaters, stadiums and other public places just as we are now accustomed to seeing AEDs,” Kerby said. “And we need to provide training to the general public in the use of bleeding-control techniques.”
|“We feel safe at school; but it’s comforting to know that we have this training and have acquired these skills should we ever need them in school, at an athletic event or just anywhere in our community.”|
Homewood High School was the launching site for UAB’s public efforts. The Division of Acute Care Surgery trained about 100 teachers, and provided enough tourniquet kits for every classroom. Teachers in groups of 10-15 underwent the one-hour training. Members of the UAB trauma team taught bleeding-control techniques, including the use of tourniquets, and gave the teachers hands-on practice on realistic mannequins.
“It was eye-opening,” said Lars Porter, a teacher at Homewood High. “We feel safe at school; but it’s comforting to know that we have this training and have acquired these skills should we ever need them in school, at an athletic event or just anywhere in our community.”
The tourniquet kits consist of a web and Velcro tourniquet with a windlass for tightening, along with gauze to pack a wound, gloves and basic instructions on bleeding control. The kits cost about $60. Kerby says he has trauma surgeons, nurses and emergency medical technicians ready to provide training; but he is missing one thing: more kits.
“We need a funding source to purchase more kits,” he said. “The first thing we are told to do in an active shooter situation is lock the door and shelter in place; but if you’ve got an injured person in the room with you, you can’t wait for the all-clear. If the survivors in the room are prepared and equipped to respond, they may be able to keep a victim alive until other resources are available. So we need kits in classrooms, offices, stores, anywhere where people may seek shelter.”
Kerby says his team is also teaching proper bleeding control to first responders from area police and fire departments. He hopes to offer the training to additional schools or businesses as kits become available.
“Unfortunately, there will be another mass shooting event,” Kerby said. “Civic and community leadership, the medical community, and the public need to take action now if we are to be prepared for the next tragedy.”