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Music.

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Hello and welcome to another episode of the Self-Initiative Project Podcast.

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I’m your host, Jim O’Brien.

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In our third podcast, we’re going to be talking about Stop the Bleed.

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You can learn more about Stop the Bleed at bleedingcontrol.org.

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Today, we’re talking to Gina Solomon, the Trauma Program Manager at Gwinnett

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Medical Center in Lawrenceville, Georgia. How are you, Gina?

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I am good. How are you? Good. And we’re here to talk about the Stop the Bleed program.

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But before we get started on that, I want you to tell our audience a little

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bit about yourself and who you are and what your background is.

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Sure. As you said, I am the trauma program manager at Gwinnett Medical Center.

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And kind of what that is in a nutshell is I oversee the level two trauma program here at our facility.

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I’m a nurse. I’ve been a nurse for 25 years.

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Worked in critical care areas in the emergency department with a focus on the

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care of trauma patients, has kind of been my background.

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Sure, sure. So a nurse for a long time, I gather.

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Yes. Seen a lot of action, I’m sure, doing what it is you do.

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Yes, sir. Yes, sir, for sure. Well, I want to thank you for all that work that you do for us.

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So Stop the Bleed, what is this all about?

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What is this all about? Great question. It’s really this initiative that it

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has just snowballed and for good reason because it’s really life-saving and it’s very easy to learn.

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I put it in the, you know, category with CPR, you know, that we’ve just,

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you know, we’ve really pushed that out to the public that we,

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you know, anybody can learn how to do CPR and you can really make a difference.

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So Stop the Bleed is a program that’s along those lines, but it’s really about controlling bleeding.

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Back in around 2012, the program came out and unfortunately,

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it was born out of a group that got together called the Hartford Consensus that

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came together after the Sandy Hook shooting.

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Okay. So this was a group.

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Emergency management folks, EMS,

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trauma surgeons, law enforcement, to really sit down and look at not only Sandy

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Hook, but some of the other mass shooting scenarios that we had had in our country, unfortunately.

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And how could we make a difference?

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How could we decrease the loss of life in these scenarios.

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Yeah. No, I was just going to say, it’s unfortunate that, you know,

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tragedies, you know, get you to make you have to think about these sorts of things. Right.

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But the good news is, is that tragedy, sometimes a lot of good come from them.

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And I would say this is one of those things.

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Absolutely. And, you know, sometimes that’s all you, you can do is,

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is, you know, we can’t go back and undo this situation, but what can we learn

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from it? And that’s really what this group did.

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So when they sat and went back and looked at a lot of these,

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what they realized is it takes a little while for the pre-hospital responders

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to get on scene and render aid.

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There’s a lot of factors that involve that if you still have somebody who’s

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actively shooting on the scene or, you know, you don’t know what’s going on.

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The first present there is typically law enforcement and their job is to get the bad guy.

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Not necessarily to help bleeding people. You know, and that’s a good point that

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you make, because I don’t think that many people realize that when first responders

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come on the scene, at least as far as law enforcement goes or otherwise,

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they’re not there necessarily to take care of the injured. They’re there first

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to clear out the bad people.

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And so you’re left to your own demise there for a little while until they can

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get things under control and then let those pre-hospital folks in.

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And that’s the first time I’ve ever heard that said that way as well. Pre-hospital folks.

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Pre-hospital, yeah. Well, and you don’t, and you wouldn’t think about that,

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that they have to neutralize that threat.

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That is the first goal, you know, is to stop that person from injuring anybody else.

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Absolutely. So they have to neutralize that threat before they let the medical

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pre-hospital responders in.

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So there was lag time before people came in that could render aid to these folks.

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And sometimes a very long time, like with Columbine, it was hours before there

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were medical personnel allowed in the building to begin to render aid.

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And what they found was that the people that were injured,

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some of them died from just acute blood loss that could have been controlled

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by some simple maneuvers that’s easily passed on to lay people.

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So this is kind of where Stop the Bleed came out of.

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And it’s really meant it started out with law enforcement was a target for it.

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And we do teach this to law enforcement and law enforcement as well as.

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Pre-hospital medical personnel have really began to change the way that they

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respond to these events.

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And they almost do it more as a team approach.

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And that’s been one piece of it. But the other piece of it is the Stop the Bleed

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program. And that’s teaching lay people how to control hemorrhage.

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Because if you can stop the blood from coming out, you can buy folks some time

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until those pre-hospital medical responders can come in and get you out.

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And they truly believe that that can save lives in the long run. Yeah, absolutely.

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And do I remember somewhere hearing that in, you know, trauma events that bleeding

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is one of the number one causes of death?

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Am I making that up or have I heard that somewhere? Yeah, well,

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no. And actually uncontrolled hemorrhage is the leading cause of preventable death.

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Okay. You know, there are things that we cannot prevent, but if we can keep

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the blood in your body, you know, then it can buy us some time to potentially

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fix that. Kind of important.

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Right. And a lot of what we do in trauma care, we learn from the military and

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we learn from conflicts. We learn from war.

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So the use of tourniquets and all are coming out of the conflicts in the Middle

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East and they’ve learned that and they have saved numerous lives.

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You know, you can live without part of an arm or a leg, but you can’t live without your blood volume.

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So, you know, learning on ways to control that has really been important and has been huge.

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Sure. And I assume that, you know, part of this stop the bleed program is the

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use of tourniquets, right? And that’s gotta be a pretty big part.

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It is, it is a big part. It’s for arm and leg wounds. Um, it’s a large part of that.

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And then the other part of it just being, you know, compression,

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good old holding pressure and not being afraid to do that and how to do it properly.

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Yeah. Well, I, I asked about the the tourniquet thing, because I’m a big proponent

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of tourniquets and I carry at any given time, I probably have two to three in

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my bags that I have with me at any time.

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And, you know, because it’s the go-to. And, you know, having quite a bit of

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interaction with law enforcement locally lately,

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I think it’s great that most all, if not every officer now carries a tourniquet

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on their utility belt all the time just for such incidents.

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But I wanted to talk about tourniquets for a minute specifically just to dispel

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some of the rumors about tourniquets, because I think in the past,

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and I think even still now,

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there are some individuals and entities that think that tourniquets are bad

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or dangerous because it kills the local cells or, you know, you can’t get filling

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back where the tourniquet’s been applied and they’re just not ideal to use.

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Can we talk about that for a minute and maybe help dispel some of the bad juju

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and myths about tourniquets? Right.

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Absolutely. Well, you know, when when Turk is first born.

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Were used, and again, it was in a military conflict and don’t,

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you know, it was the Korea-Vietnam era type, and they were seeing a lot of amputations.

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And unfortunately, they kind of correlated the amputation rate to the tourniquet

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use that, you know, this was bad.

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And the tourniquet itself was causing the need for these amputations.

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But with the Operation Desert Storm and all this, we began back into another

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conflict and they really began to study that.

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And what they found is the complete opposite.

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Sometimes those amputations happen, but it’s really related to the damage to

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the extremity, not the use of the tourniquet.

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So tourniquets have been used in the hospital for many, many years.

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Folks that have orthopedic surgery, knee replacements, those such,

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you’ve had a tourniquet placed on your extremity for a prolonged period of time

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for them to be able to do that.

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So they’re not unusual to the hospital and haven’t been, but changing that thought

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process that the tourniquet itself causes that extreme damage and causes amputations.

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The studies have shown that no amputations have occurred due to a tourniquet

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being left on two hours or less.

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So you do with prolonged period of time with a tourniquet, you’re shutting off

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blood flow to your tissues can cause some local damage.

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But if you truly need that tourniquet, You know, we can deal with the tissue damage, but you cannot.

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Deal with extreme blood loss. So that becomes the caveat there.

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And if you see any video from,

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over in the Middle East and our military in combat situations,

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you will often see tourniquets that are already placed on their arms and legs,

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and all they have to do is tighten them because they’ve,

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really shown that they make a difference and they save lives if they can control

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that hemorrhage until they can get them to definitive care and somebody who can fix that.

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Yeah, and I had heard that as far as any type of tissue damage that might occur

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after prolonged use of a tourniquet could pretty much be fully reversed with

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medication that we have today anyway.

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It depends, and if we know, you know, we know ahead of time,

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you know, that we’ve had this tissue, there are ways that we can take the tourniquet down,

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and yes, there are medications that we can do to kind of help mitigate the return

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of blood flow to that extremity.

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Because what happens is you shut off the blood flow to that tissue and the tissue

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starts to metabolize things that are not necessarily good for the body because

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it doesn’t have its usual routes.

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You know, it’s not good enough. And then the good things that,

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you know, it needs to function.

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So there will be toxins that build up because of that.

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But there are ways to let it go, be prepared for those toxins,

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you know, when you return flow back to that extremity, you know, and if you,

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you know, heaven forbid, have an extreme case where it was left on an extremely

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long period of time, you know, they would be able to mitigate that,

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you know, with surgery, amputation, or knowing that’s going to happen as a possibility.

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But again, loss of limb is much better than loss of life, especially where we

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have come Um, technology wise with prosthetics are just absolutely amazing,

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you know, so people are returning to almost normal functioning with prosthetics.

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So, so they’re, you know, not ideal, but certainly manageable and again,

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better than the overall loss of life.

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Yeah. I think the alternative is a lot worse in the overall scheme of things.

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So tourniquets are good and they can definitely go a long way towards stopping

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severe hemorrhaging and hopefully and most likely helping to save that life.

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Absolutely. So back to Stop the Bleed. And for folks wanting to know more,

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you can learn more at bleedingcontrol.org.

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I think I got that right.

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Correct. So let’s talk about just kind of going through the outline that I have for it.

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Let’s talk about the primary principles of trauma care response.

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Yeah. Well, you know, it’s, you want to find the bleeding and control it.

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And we talk about, we like ABCs in the medical world.

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We do a lot of things based on the alphabet.

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Because people remember that they can recognize that and, you know,

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mnemonics are really easy.

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So, So, you know, it’s, hey, I noticed something is wrong. So, A, let’s alert.

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Let’s get, call 911 and get the help that we need.

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And then B is for bleeding. We need to find it. Okay, where is it coming from?

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And that may be tearing clothes, cutting clothes, because you really need to

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see where it’s coming from to be able to stop it.

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Sometimes you’ll just see somebody, you know, covered head to toe with blood.

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And that’s not really helpful because you’ve got to get to the site that it’s

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coming from. You got to find it.

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You got to find it. And then C is compress.

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And we talk about three different ways to compress. And first off is just direct

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pressure, good old direct pressure that we learn works most of the time.

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And then we have wound packing. So if you have a deep wound,

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it’s the same principle except for you’re taking that gauze or that towel or

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T-shirt and actually stuffing it into a larger wound and then holding pressure.

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And then the tourniquets is the third way to compress. So if you have uncontrolled

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hemorrhage on an arm or a leg,

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you can utilize a tourniquet to stop the flow of blood to that extremity and

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it’s not coming out of the wound at that point in time.

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So those are really the three major principles.

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They’ve kept Stop the Bleed very simple because the goal is,

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you know, that lay people can learn how to do this, you know,

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and we want to train as many people as possible.

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Absolutely. You know, like one of my coworkers says, you know,

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I want the person behind me in Walmart to know how to do this.

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You know, if if I need it, you know, if something happens, you want the person

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next to you to be able to to understand the principles and be able to render

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aid until help can arrive.

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Yeah. And, you know, it’s an important point to make because at the end of the

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day, and I think that what you were getting at earlier, too,

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we kind of wind up being or needing to be our own first responders at the end

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of the day, especially in these situations where we may be a long way away from help,

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getting help, or it takes some time to get the help that we need,

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right? We’re first on the scene.

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And really, we have a responsibility to ourselves and our loved ones to kind

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of know these sorts of things and be able to render that level of help to ourselves and those.

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00:15:37,319 –> 00:15:41,879
Absolutely. And the other key piece of it is, you know, unfortunately,

212
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you know, all we have to do is turn on the news to hear of, you know,

213
00:15:46,059 –> 00:15:50,359
some unfortunate situation, you know, just another one today in Texas.

214
00:15:50,359 –> 00:15:58,959
But we see tourniquets often coming into the emergency room that have been used outside the hospital.

215
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And you know here in Gwinnett County there’s been

216
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no news report of mass shootings or bombings that people or

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motor vehicle crashes work injuries home

218
00:16:08,699 –> 00:16:11,639
injuries you know the principles of this

219
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we are training teachers in schools and there was just a school teacher in the

220
00:16:15,639 –> 00:16:20,719
neighboring county who used one on a on a child who fell off playground equipment

221
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and severely broke her arm and it cut an artery in her arm the bone bit so she

222
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was able to control that bleeding.

223
00:16:29,459 –> 00:16:33,739
Yeah, you know, like we were talking about earlier, this program was born out

224
00:16:33,739 –> 00:16:37,619
of, you know, active shooter scenarios, tragedy at Sandy Hook.

225
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But the reality of it is an accident to cause severe hemorrhaging can happen

226
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any place, anytime. I saw a fantastic meme on one of the social media outlets

227
00:16:48,039 –> 00:16:52,279
earlier just this week, and it was a picture of a big chainsaw.

228
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And it was to remind you that, you know, tourniquets don’t just have use on

229
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the battlefield or in these tragic scenarios.

230
00:17:00,159 –> 00:17:03,719
It could be in your backyard, you know? Absolutely.

231
00:17:03,959 –> 00:17:08,379
Absolutely. One of the places that I carry my trauma kits is in the gun range

232
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because I’ve worked up until recently. I’ve done some work as a range safety

233
00:17:12,219 –> 00:17:15,239
officer and I, I shoot fairly regularly.

234
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So I always am sure to have a kit in there if nowhere else, because even if

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something doesn’t happen to you, you see sometimes some pretty silly,

236
00:17:24,839 –> 00:17:28,639
unsafe things going on. So it can happen anywhere.

237
00:17:29,259 –> 00:17:33,819
Correct. And we have, we have trained one of our local gun clubs on,

238
00:17:33,839 –> 00:17:38,199
on stop the bleed, you know, the personnel that work there. So it is certainly

239
00:17:38,199 –> 00:17:43,239
useful outside of, you know, those obvious horrible tragedies that we see.

240
00:17:43,579 –> 00:17:47,699
Yeah. And keeping it simple, something like the ABCs of bleeding just makes

241
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it all the more easier for the masses to get the information and to learn it.

242
00:17:52,579 –> 00:17:54,299
Because it’s really not that hard, to your point.

243
00:17:54,679 –> 00:18:02,199
Right. So let’s talk about compression and what to do with that and what not to do with that.

244
00:18:02,339 –> 00:18:06,019
Okay. I think a lot of times I know I’ve done it with injuries to myself.

245
00:18:06,199 –> 00:18:09,699
You know, has it stopped bleeding? I want to lift it up and look and see if

246
00:18:09,699 –> 00:18:11,199
it’s still gushing or not.

247
00:18:11,259 –> 00:18:14,079
And then go, oh, shoot, I got to get another bandage to put back on there.

248
00:18:14,899 –> 00:18:16,339
Exactly. Things not to do.

249
00:18:17,359 –> 00:18:21,999
Right. Right. Those are things. And yes, compression, holding, direct pressure.

250
00:18:22,039 –> 00:18:26,399
That is, you know, most of the time will control most hemorrhage.

251
00:18:26,599 –> 00:18:32,039
But if you have somebody who has severe hemorrhage, you’re going to want to take medication.

252
00:18:32,539 –> 00:18:37,799
You know, of course, gauze, nice, clean gauze is great if you have it readily available.

253
00:18:38,219 –> 00:18:42,219
But if you don’t, use what you’ve got. I have a great T-shirt from the American

254
00:18:42,219 –> 00:18:45,139
College of Surgeons that says this shirt can save your life, you know.

255
00:18:45,159 –> 00:18:48,399
And the whole guise behind that is, you know, use what you have.

256
00:18:48,479 –> 00:18:52,699
It doesn’t have to be medical gauze. It can be a towel out of your car or the

257
00:18:52,699 –> 00:18:53,919
T-shirt that you have on.

258
00:18:54,239 –> 00:18:57,699
You’ve just got to get something on the wound and hold pressure.

259
00:18:57,699 –> 00:19:02,739
The best way to hold pressure is with the heel of your hand and then on a firm

260
00:19:02,739 –> 00:19:07,239
surface, because then you’re able to get, you know, good compression of the

261
00:19:07,239 –> 00:19:10,079
vessels, which is what you’re trying to do to stop the bleeding.

262
00:19:10,379 –> 00:19:11,559
And then you don’t want to peek.

263
00:19:11,959 –> 00:19:15,459
It’s very tempting. Don’t peek. I know, right? You know, it’s not Christmas.

264
00:19:15,939 –> 00:19:19,139
You know, you don’t want to peek because once you let off that compression,

265
00:19:19,379 –> 00:19:23,999
you allow it to begin to bleed again. So if you have severe hemorrhage and you

266
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hold pressure on it and you’re going to hold it until you’re relieved by the

267
00:19:28,659 –> 00:19:30,419
medical responders to get there.

268
00:19:30,499 –> 00:19:35,819
And it’s also really important not to, hey, the ambulance is pulled up so I can let go and walk away.

269
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You want to keep holding pressure until somebody takes over for you from that standpoint.

270
00:19:41,039 –> 00:19:49,239
But firm, constant pressure without looking is the best way to compress.

271
00:19:49,239 –> 00:19:53,099
Press yeah to your point you don’t have to have medical equipment either like

272
00:19:53,099 –> 00:19:56,759
we’re talking about you can use a towel out of your trunk or t-shirt off your

273
00:19:56,759 –> 00:20:01,239
back i ideally clean but again if it’s a life-threatening hemorrhage it doesn’t

274
00:20:01,239 –> 00:20:03,419
really matter just get something on there and hold it.

275
00:20:03,899 –> 00:20:08,759
Exactly we have antibiotics so we’ll take care of whatever you know we’ll figure

276
00:20:08,759 –> 00:20:12,359
all that dirty in the in the trunk of your car we’ll deal with the funk later

277
00:20:12,359 –> 00:20:18,679
yeah exactly yeah so this tourniquet versus packing, you know, sometimes,

278
00:20:18,959 –> 00:20:24,519
especially being lay person, I don’t really know when to use a tourniquet versus

279
00:20:24,519 –> 00:20:30,899
when I need to stuff a hole that’s inordinate amount of liquid that I need coming out.

280
00:20:30,999 –> 00:20:36,719
Let’s talk about when to use a tourniquet or where to use a tourniquet versus packing a wound.

281
00:20:37,019 –> 00:20:41,859
Right. Well, and it really may be an escalation for you.

282
00:20:41,899 –> 00:20:47,819
Now, obviously, the tourniquets, you need a wound that’s on an arm or a leg to be able to use that.

283
00:20:48,059 –> 00:20:51,159
So it’s really nice that that is an option.

284
00:20:51,399 –> 00:20:57,959
So, you know, if the wound is on the neck or at the shoulder or the groin,

285
00:20:58,099 –> 00:21:02,539
obviously that takes tourniquet out and wound packing, you know, may be your only option.

286
00:21:03,059 –> 00:21:10,379
But if you see loss of all or part of an arm or a leg, if you have blood spurting

287
00:21:10,379 –> 00:21:12,979
out of a wound, And that’s exactly what it looks like.

288
00:21:12,999 –> 00:21:16,519
If you cut an artery, it’s like getting a split in a garden hose.

289
00:21:16,999 –> 00:21:21,199
That’s exactly what it’s like. You know, it’s a geyser. So when I say spurting,

290
00:21:21,219 –> 00:21:22,459
that’s exactly what it does.

291
00:21:22,599 –> 00:21:27,299
Or you have blood that is constantly coming out of a wound that will not stop.

292
00:21:27,379 –> 00:21:31,059
And it’s, you know, soaking the clothes and the ground.

293
00:21:32,170 –> 00:21:36,750
So those are kind of what we consider that life-threatening hemorrhage.

294
00:21:36,970 –> 00:21:41,950
So if it’s on an arm or leg and you have a tourniquet available and it meets

295
00:21:41,950 –> 00:21:46,290
some of those things, then you can go straight to the use of the tourniquet for that.

296
00:21:47,090 –> 00:21:51,730
It’s just a Velcro band. So when you take it out of the packaging,

297
00:21:51,970 –> 00:21:57,450
you just unfold it, put it two to three inches above the site of the bleeding.

298
00:21:57,570 –> 00:21:59,310
You just want to make sure you don’t go on a joint.

299
00:21:59,670 –> 00:22:03,210
So it should be above a joint. You can put it on top of clothing.

300
00:22:03,350 –> 00:22:07,410
You just don’t want to put it on top of something bulky in a pocket or such

301
00:22:07,410 –> 00:22:11,370
as that because you want to get it snug next to the skin.

302
00:22:11,710 –> 00:22:17,130
It doesn’t even have to be extremely tight with the Velcro because you’re going

303
00:22:17,130 –> 00:22:19,570
to notice it’s a Velcro band. There’s a rod.

304
00:22:20,270 –> 00:22:25,450
We call it a windlass rod and a clip. Those are really the three parts to the tourniquet. up.

305
00:22:25,630 –> 00:22:31,590
So you use the Velcro snugly around the arm or leg, and then you take the rod

306
00:22:31,590 –> 00:22:33,910
and you turn it, and it doesn’t matter which way.

307
00:22:35,050 –> 00:22:38,630
Clockwise, counterclockwise, either way works. And you’re just going to turn

308
00:22:38,630 –> 00:22:43,650
that rod, and it’s probably going to take both hands until you can’t turn it

309
00:22:43,650 –> 00:22:48,730
anymore or you see the blood stopping from coming out of the wound.

310
00:22:48,930 –> 00:22:52,870
And then the clip is just to hold that rod that you’ve tightened in place,

311
00:22:53,030 –> 00:22:55,090
and it doesn’t allow it to unwind.

312
00:22:55,530 –> 00:22:59,830
And those are really the three key pieces to the tourniquet itself.

313
00:23:00,510 –> 00:23:05,370
So it’s quick, it’s easy to use, you can do it one-handed, so you could do it on yourself.

314
00:23:06,890 –> 00:23:13,210
And it’s designed that way to be easy to use, because you want to be able to do it quickly.

315
00:23:14,630 –> 00:23:17,190
And aren’t the tourniquets, at least the ones I’m thinking of,

316
00:23:17,190 –> 00:23:20,810
of the, what is it, the combat application tourniquet, the CATS,

317
00:23:20,810 –> 00:23:25,590
which seemed to be the go-to for everyone, the one that seems to be recommended,

318
00:23:25,890 –> 00:23:28,050
there’s a way to write the time on there.

319
00:23:28,170 –> 00:23:32,190
So first responders have some sense of when the tourniquet got applied.

320
00:23:32,230 –> 00:23:35,650
So, you know, better how you might need to.

321
00:23:36,070 –> 00:23:42,490
Yes, they do. There is a little piece of Velcro right at the clip where you can put over the clip.

322
00:23:42,570 –> 00:23:45,790
And, you know, if you had something available, Right. What time that you put it on.

323
00:23:45,810 –> 00:23:49,070
And that just lets us know at the trauma center, you know, what time it got

324
00:23:49,070 –> 00:23:51,670
put on, how long it’s been on from that standpoint.

325
00:23:51,870 –> 00:23:57,130
And it’s really important. I mean, they are very useful tools and they work

326
00:23:57,130 –> 00:23:58,230
well, but they’re painful.

327
00:23:58,710 –> 00:24:02,590
So when you’re putting a tourniquet on somebody, you’re also explaining,

328
00:24:02,650 –> 00:24:04,430
I know this hurts really, really bad.

329
00:24:05,767 –> 00:24:09,747
But, you know, I’m trying to save your life here. I’ve got to get this bleeding under control.

330
00:24:09,827 –> 00:24:13,947
But knowing that it’s painful for the person that you’re putting it on. But you can’t be afraid.

331
00:24:14,227 –> 00:24:19,607
You’ve got to tighten it, know it’s going to hurt, and just try to explain that to the patient.

332
00:24:19,687 –> 00:24:22,327
Know that your goal is to save a life.

333
00:24:22,647 –> 00:24:26,367
At least the pain lets you know that you’re alive. So let’s get through this, right?

334
00:24:27,227 –> 00:24:32,287
Exactly, exactly. Exactly. So some of the kind of pitfalls with the use of tourniquets

335
00:24:32,287 –> 00:24:38,947
is not using one, you know, being afraid to use one, not making it tight enough

336
00:24:38,947 –> 00:24:41,147
because you’re afraid you’re going to hurt somebody.

337
00:24:41,247 –> 00:24:46,547
So you really have to make it tight enough that you’re stopping all blood flow to that extremity.

338
00:24:47,167 –> 00:24:50,047
You can actually use two tourniquets if need be.

339
00:24:50,107 –> 00:24:53,547
So if you put one on and it doesn’t seem to be controlling it,

340
00:24:53,587 –> 00:24:58,887
you can put another tourniquet on above the first one so those are just some

341
00:24:58,887 –> 00:25:03,287
you know some common things that you know,

342
00:25:04,087 –> 00:25:06,927
yeah and much like lifting the compression off to look

343
00:25:06,927 –> 00:25:10,667
you don’t want to take if you do have to use two tourniquets because bleeding’s

344
00:25:10,667 –> 00:25:14,627
not slowing down to the degree that you were hoping you’d want to if you do

345
00:25:14,627 –> 00:25:18,347
get that second one on you want to go above the first one and then don’t mess

346
00:25:18,347 –> 00:25:23,007
with the first one right correct correct you don’t don’t take anything down

347
00:25:23,007 –> 00:25:24,407
and you don’t want to loosen it.

348
00:25:24,467 –> 00:25:28,547
Once you’ve put that tourniquet on, you just leave it. We’ll deal with it at the hospital.

349
00:25:28,727 –> 00:25:32,967
So, you know, you’re not going to take it down no matter if they tell you it’s

350
00:25:32,967 –> 00:25:34,707
killing them and beg you to.

351
00:25:34,807 –> 00:25:38,367
You’ve got, once you put it on, you just leave it alone. You don’t loosen it or take it off.

352
00:25:39,147 –> 00:25:42,587
And is, are the cat tourniquets really the go-to standard?

353
00:25:42,747 –> 00:25:47,307
I know there’s two or three types. It seems like I’ve seen recently there’s a newer one out.

354
00:25:47,427 –> 00:25:52,927
I know there’s the rat cat as well, rapid application, I think, is that what they call?

355
00:25:53,987 –> 00:26:00,127
What’s your preference? What do you tell folks? Yeah, there are other tourniquets out there.

356
00:26:00,267 –> 00:26:05,487
But the good thing about the cat or the combat application tourniquet is it’s

357
00:26:05,487 –> 00:26:06,867
not terribly expensive.

358
00:26:07,907 –> 00:26:09,967
It’s easy to use. Okay.

359
00:26:10,700 –> 00:26:14,780
And, you know, those are the two main things about that.

360
00:26:14,920 –> 00:26:18,720
So the cat tourniquet actually is the preferred military tourniquet.

361
00:26:19,200 –> 00:26:24,060
So, again, they’re the ones that, you know, that we’ve learned a lot about this

362
00:26:24,060 –> 00:26:25,620
tourniquet. So we know that it works.

363
00:26:26,280 –> 00:26:30,120
So that’s kind of what we see the most of is the cat tourniquet. Sure.

364
00:26:30,740 –> 00:26:33,540
Yeah. And you want to be careful. You can get them pretty easily.

365
00:26:33,580 –> 00:26:34,820
You can get them off Amazon.

366
00:26:35,040 –> 00:26:42,300
They run around $25, $26. I think the new Gen 7 is somewhere around $27,

367
00:26:42,480 –> 00:26:44,640
$28, but you can get them off of Amazon.

368
00:26:44,980 –> 00:26:48,760
But what you want to be careful of is some of the Chinese knockoffs where you’re

369
00:26:48,760 –> 00:26:50,760
getting a three-pack for $14.

370
00:26:50,980 –> 00:26:56,720
You want to save your pennies and spend the extra $10 and get an authentic cat.

371
00:26:57,060 –> 00:27:02,120
Absolutely, because North American Rescue is the only company making the authentic

372
00:27:02,120 –> 00:27:03,440
cat tourniquets right now.

373
00:27:03,760 –> 00:27:10,140
So, you know, they are ranging anywhere from $25 to $30. So if you’re not paying

374
00:27:10,140 –> 00:27:14,220
that, if you’re getting it for $9.99, it’s probably not real.

375
00:27:16,280 –> 00:27:21,620
Because understand that there are some role player and cost players who will

376
00:27:21,620 –> 00:27:25,140
wear just for looks. They’re not functional.

377
00:27:25,340 –> 00:27:29,440
And you may get something like that. And when you need it, it’s not the time

378
00:27:29,440 –> 00:27:33,000
to realize that yours is not really a real tourniquet.

379
00:27:33,420 –> 00:27:35,500
I have to ask. I’m sorry.

380
00:27:35,960 –> 00:27:40,480
Oh, no. No, I was just saying it is really important to make sure you’ve gotten an authentic one.

381
00:27:40,680 –> 00:27:44,700
I have to ask, I see these blue trainer tourniquets, and I know that’s just

382
00:27:44,700 –> 00:27:50,740
to differentiate them from the others, and probably because they get reused in training.

383
00:27:50,860 –> 00:27:54,160
You don’t want to reuse a tourniquet because it gets stretched out,

384
00:27:54,240 –> 00:27:57,080
but likely because it’s dirty and contaminated as well.

385
00:27:57,220 –> 00:28:02,900
But is there any real difference between the blue and a normal, let’s say?

386
00:28:02,900 –> 00:28:06,280
No, if you, if you had a blue tourniquet in a, in a package,

387
00:28:06,500 –> 00:28:11,120
you know, it works the same way, but they are just the, the blue is kind of

388
00:28:11,120 –> 00:28:14,700
hallmarks that this is a training tourniquet because you do,

389
00:28:14,740 –> 00:28:18,960
you know, we’ve all had Velcro that no longer Velcros, as I call it,

390
00:28:18,960 –> 00:28:21,080
you know, it’s just worn itself out.

391
00:28:21,080 –> 00:28:25,780
And that’s what happens after, you know, using a tourniquet repeatedly for training

392
00:28:25,780 –> 00:28:30,400
is you have the potential for failure there with the Velcro.

393
00:28:30,440 –> 00:28:34,200
So that’s why we recommend, you know, you don’t want a tourniquet that you might

394
00:28:34,200 –> 00:28:38,200
use on somebody you don’t want to utilize to train with or practice with or,

395
00:28:38,220 –> 00:28:43,300
you know, open and close too much because you run the risk of causing failure.

396
00:28:44,369 –> 00:28:49,049
Don’t want that. Defeats the purpose. So I think, you know, compression on a

397
00:28:49,049 –> 00:28:53,969
wound, holding constant, steady, good, solid pressure on a hemorrhage is easy

398
00:28:53,969 –> 00:28:55,009
enough and pretty straightforward.

399
00:28:55,069 –> 00:28:59,309
And even going back to first aid that I learned in the Boy Scouts, that was the go-to.

400
00:28:59,489 –> 00:29:05,089
Apply a direct, firm pressure, right? And I think with a little bit of familiarization

401
00:29:05,089 –> 00:29:11,809
with the tourniquet, folks can learn and figure out how to use one fairly easy

402
00:29:11,809 –> 00:29:13,349
because they are fairly straightforward.

403
00:29:13,349 –> 00:29:16,389
Forward and obviously it’s only appropriate for

404
00:29:16,389 –> 00:29:19,149
arms and legs but let’s talk about this

405
00:29:19,149 –> 00:29:23,269
next one because this one kind of i’m sure gives folks the heebie-jeebies where

406
00:29:23,269 –> 00:29:28,009
you got to get in there and you know we call it packing the wound but at the

407
00:29:28,009 –> 00:29:32,589
end of the day you got to get in there and stuff some stuff inside there so

408
00:29:32,589 –> 00:29:38,349
exactly if if you have a wound that’s that’s large and deep or,

409
00:29:38,549 –> 00:29:43,349
you know, a wound that may be on, like I said, the groin or the armpit or the neck.

410
00:29:43,469 –> 00:29:48,169
There are large vessels that run through there and you can’t use a tourniquet on it.

411
00:29:48,249 –> 00:29:53,749
So you may need to actually get in there because you want to get the site of the bleeding.

412
00:29:53,929 –> 00:29:58,949
And the most severe bleeding is maybe not those superficial vessels on top.

413
00:29:59,209 –> 00:30:02,329
So you want to be able to get down to the source of bleeding.

414
00:30:02,509 –> 00:30:05,429
So if you have a large, deep wound, you want to take your

415
00:30:05,429 –> 00:30:08,789
gauze or towel or t-shirt or whatever you’re using

416
00:30:08,789 –> 00:30:12,669
and actually stuff it into the wound because you really want to get down to

417
00:30:12,669 –> 00:30:17,989
the site of the bleeding so you’re just going to stuff your stuff and then you’re

418
00:30:17,989 –> 00:30:23,249
going to hold pressure on top of that if you still see bleeding coming through

419
00:30:23,249 –> 00:30:25,729
that packing you don’t want to.

420
00:30:26,446 –> 00:30:30,546
Take that packing out. You just want to add to it. So add another towel to it,

421
00:30:30,586 –> 00:30:33,966
add another roll of gauze, and again, just hold pressure.

422
00:30:34,226 –> 00:30:37,586
But it does, you know, people don’t want to, you know, non-medical people especially

423
00:30:37,586 –> 00:30:42,486
don’t want to stick their hands down or, you know, you’re worried about causing

424
00:30:42,486 –> 00:30:46,966
further damage, but you’ve got to get down in there to the main sources of bleeding.

425
00:30:47,146 –> 00:30:50,086
You know, and the deeper you go, the bigger the vessels are.

426
00:30:50,206 –> 00:30:53,566
So you’ve got to get control of those larger vessels.

427
00:30:54,506 –> 00:30:57,846
So that’s where the wing packing really comes in handy.

428
00:30:58,266 –> 00:31:03,586
Yeah. So it’s a good idea if you do have trauma kits to probably have yourself

429
00:31:03,586 –> 00:31:08,086
a set of gloves in the mix to, to protect yourself.

430
00:31:08,146 –> 00:31:13,206
But if not, if you got to go, you got to go and get that stuffing in there.

431
00:31:13,726 –> 00:31:20,886
So just to re go back over some of these again, in summary of the ABCs is after

432
00:31:20,886 –> 00:31:25,386
you’ve made sure the area is safe and you’re safe, alert, right?

433
00:31:25,486 –> 00:31:29,026
Call 911. That’s the first step. And if you can’t do it because you’ve already

434
00:31:29,026 –> 00:31:33,886
gone to work on whoever, have somebody nearby if they’re available, do it for you. Right.

435
00:31:33,986 –> 00:31:39,566
And one of the things we say about that is be bossy.

436
00:31:39,606 –> 00:31:44,306
You know, if you’re at a scene where there’s lots going on and you you have

437
00:31:44,306 –> 00:31:48,146
lots of people, you know, and you just yell, call 9-1-1, you know,

438
00:31:48,166 –> 00:31:49,846
one or two things going to happen.

439
00:31:49,886 –> 00:31:54,046
Either everybody’s going to do it and clog up 9-1-1 or nobody’s going to do

440
00:31:54,046 –> 00:31:56,666
it because they think that, you know, the next person is doing it.

441
00:31:56,746 –> 00:31:59,826
So, you know, being bossy and actually pointing somebody else,

442
00:31:59,926 –> 00:32:04,746
will you, you please call 9-1-1 can be very helpful in those kinds of scenarios.

443
00:32:05,126 –> 00:32:08,746
That’s a good point. Being very specific in those directions, those

444
00:32:08,746 –> 00:32:15,066
instructions you’re giving the next one during that chaos i think actually i

445
00:32:15,066 –> 00:32:21,506
appreciate you know somebody giving them direct instructions yeah so good point

446
00:32:21,506 –> 00:32:25,906
b obviously is for bleeding but not in the sense.

447
00:32:26,866 –> 00:32:31,886
Just finding where the bleeding the source of the bleeding is and to your point

448
00:32:31,886 –> 00:32:34,826
that could be you know if someone’s covered in blood that could be anywhere

449
00:32:34,826 –> 00:32:38,346
so you know you’re likely going to have to remove some clothing,

450
00:32:38,446 –> 00:32:41,686
lift up some clothing, or cut some clothing off to get to it.

451
00:32:42,146 –> 00:32:46,626
Correct. Great. You want to find out where it’s coming from because you can’t

452
00:32:46,626 –> 00:32:48,486
compress if you don’t know where it’s coming from.

453
00:32:48,726 –> 00:32:53,146
Yeah. And then, of course, C that we’ve spent some time on is for compression,

454
00:32:53,306 –> 00:32:57,526
applying that pressure to stop the bleeding, either by covering the wound and

455
00:32:57,526 –> 00:33:00,086
applying constant steady pressure,

456
00:33:00,426 –> 00:33:04,666
using a tourniquet if need be, or if you’ve got to get get in there and stuff

457
00:33:04,666 –> 00:33:08,146
that wound, pack that wound, in which case you’re actually still going to use

458
00:33:08,146 –> 00:33:10,646
compression when you get through packing on top of that.

459
00:33:10,786 –> 00:33:14,786
Correct. Correct. So it’s a twofold process. Great.

460
00:33:15,679 –> 00:33:18,919
Well, what can we do? What can we do to get involved? Where do I go to learn

461
00:33:18,919 –> 00:33:21,559
more and what do I need to do to sign up?

462
00:33:22,059 –> 00:33:29,399
Well, you can look at the bleedingcontrol.org has a place you can go there and

463
00:33:29,399 –> 00:33:32,219
look if people are having public classes.

464
00:33:32,379 –> 00:33:37,859
But you can reach out to your local trauma center if you know where that is.

465
00:33:37,919 –> 00:33:41,879
Just about every trauma center in the country is participating in this initiative,

466
00:33:41,959 –> 00:33:45,539
as well as our pre-hospital cohorts.

467
00:33:45,679 –> 00:33:49,599
So, you know, reach if you can get to somebody in a trauma program somewhere,

468
00:33:49,659 –> 00:33:52,859
they can usually point you to the direction to get training in.

469
00:33:52,879 –> 00:33:55,639
And, you know, like I said, we’ve trained schools.

470
00:33:55,919 –> 00:33:59,959
We’ve been to, you know, community outreach programs.

471
00:34:00,399 –> 00:34:04,799
We’ve done, you know, just drive by training, you know, here at the hospital,

472
00:34:04,919 –> 00:34:09,799
you know, set up a station and just train people as they, you know, come by.

473
00:34:09,939 –> 00:34:14,179
Because it is, you know, there’s a whole PowerPoint and everything that goes with it.

474
00:34:14,199 –> 00:34:19,039
And that’s great. But you can also train people, you know, on on the skills very quickly.

475
00:34:19,139 –> 00:34:25,799
It doesn’t take that long to do. We’ve set up at the one of the baseball fields

476
00:34:25,799 –> 00:34:28,079
in the area, train people as they come by.

477
00:34:28,139 –> 00:34:33,119
So, you know, if if you’re looking for a program, those are some suggestions

478
00:34:33,119 –> 00:34:36,579
to outreach to find people who could can come teach groups.

479
00:34:36,579 –> 00:34:40,919
Groups and and so bleedingcontrol.org has

480
00:34:40,919 –> 00:34:43,679
some information but your local trauma centers and your

481
00:34:43,679 –> 00:34:46,539
hospitals can get you hooked up with the program yes

482
00:34:46,539 –> 00:34:52,519
yes let’s talk about gear i know bleedingcontrol.org also sells some rescue

483
00:34:52,519 –> 00:34:58,559
trauma packs are there any other sources or entities that you recommend people

484
00:34:58,559 –> 00:35:06,159
looking to to get good gear from yes there there are a lot of yes bleeding Leadingcontrol.org,

485
00:35:06,179 –> 00:35:09,879
you know, has a little store on there, but there are a lot of companies,

486
00:35:10,019 –> 00:35:14,019
you know, Google can find you lots of things, you know, just make sure that

487
00:35:14,019 –> 00:35:17,659
it’s a reputable company that sells medical equipment.

488
00:35:17,879 –> 00:35:22,319
You can trust them pretty well. I know there’s a, you know, right here in Marshall,

489
00:35:22,399 –> 00:35:27,479
Georgia, there’s a local company that we’ve worked with that sell individual kits.

490
00:35:27,759 –> 00:35:31,839
And we’re also working on placing these kits like we place AEDs.

491
00:35:31,839 –> 00:35:37,879
So right in our area, we’ve placed kits at the local mall, one of the colleges.

492
00:35:38,199 –> 00:35:42,939
Minor league baseball stadium, you know, places where people may gather.

493
00:35:43,039 –> 00:35:48,299
We’ve put, we call them wall kits, where there’s actually 10 individual bleeding control kits in them.

494
00:35:48,359 –> 00:35:55,799
So the goal really is to make the tools needed to do this more readily accessible to people.

495
00:35:55,799 –> 00:36:01,619
Yeah, it’d be great if they’d make the excessive bleeding kits required like

496
00:36:01,619 –> 00:36:05,859
they do the first aid and AEDs in the corporate world as well.

497
00:36:06,039 –> 00:36:07,899
Right. And we’re working on that.

498
00:36:09,499 –> 00:36:11,319
Yeah, yeah. Baby steps.

499
00:36:13,879 –> 00:36:19,199
Well, this has been great. This is a lot of good information that I hope people can benefit from.

500
00:36:19,339 –> 00:36:22,179
It’s pretty straightforward. The ABCs of bleeding.

501
00:36:23,939 –> 00:36:28,239
Yeah, we appreciate you being on today with us. Well, I appreciate it.

502
00:36:29,680 –> 00:36:58,165
Music.