Why Cities Must Train People in How to Stop Bleeding
By teaching ordinary people in how to stop bleeding and adding bleeding control kits to public spaces, cities may save more lives in mass casualty events.
Richard Hampton, a 71-year-old Kenny Rogers impersonator, was one of many people attending the Rte 91 Harvest Country Music Festival when Stephen Craig Paddock, a 64-year-old retired accountant from Mesquite, Nev., allegedly fired on the crowd killing 59 and injuring more than 515 people. The Las Vegas shooting behooves all cities that host public events to ask how to stop bleeding and save as many victims lives as possible when mass casualty events happen.
Las Vegas Became a Blood Bath in Seconds
Recounting his story for Esquire, Hampton and his wife fled the area they were standing in near the stage and ran to their minivan.
People were running. People were running over people. People were getting trampled. And bodies started falling around us. There was blood and chaos, and we needed to get out of there, fast," said Hampton.
In addition to opening their minivan to fellow concertgoers, they picked up a woman named Jennifer badly bleeding from many places. As Hampton drove her as fast as he could to the hospital, Jennifer said she was having a hard time breathing. The others in the car held her hand and her head, and tried to comfort her. It doesn't appear they were trained in how to stop bleeding.
Whether it's Run! Hide! Fight! or Move! Escape! or Attack! there will always be the ordinary people that try and help the wounded, dying and others. Like Hampton, who said he remained cool and calm as he purposely, and with police approval, drove up the wrong side of the Vegas Strip to an ambulance where he knew someone knew how to stop bleeding.
Initially, so much blood was needed at the five hospitals treating the upwards of 600 victims that Las Vegas Mayor Carolyn Goodman and Nevada Governor Brian Sandoval asked other cities to send blood donations at a briefing the following day.
Training in How to Stop Bleeding Must Be the New Norm
It's laypeople like Hampton -- and the others in his vehicle -- that are first on-scene and on-point to control the bleeding of victims of mass casualty events.
According to Greg Friese, editor-in-chief of EMS1, "every able-bodied person needs to be able to apply direct pressure, improvise a tourniquet and apply a tourniquet" in an incident where hundreds of victims have severe hemorrhage from penetrating trauma, or blunt trauma secondary to trampling.
According to Kenny Navarro, an assistant professor in the Department of Emergency Medicine at the University of Texas Southwestern Medical School at Dallas, hemorrhage is the second leading cause of death for patients before they make the hospital, accounting for 30-40 percent of all mortality.
Navarro's perspective is that bystanders that are trained to stop the bleeding can mean the difference between life and death for victims.
The EMS Education Department of the Denver Paramedic Division, in cooperation with the Prehospital Trauma Life Support committee of the National Association of EMTs (NAEMTs), developed a 2.5-hour Bleeding Control for the Injured Course, also known as B-Con, combining lecture with hands-on training that teaches the lay rescuer hemorrhage control and how to open an airway.
Bleedingcontrol.org, established by American College of Surgeons and other medical groups after the Sandy Hook Elementary School shooting, has information on how to stop bleeding designed for the public on its website and offers courses nationally.
Adding Bleeding Control Kits to Public Spaces is Critical
It's not just EMTs that believe ordinary people must be trained to stand-in for medics. Chief Rob Wylie, former fire chief of the Cottleville FPD in St. Charles County, Mo., quickly responded to the Las Vegas shootings for FireRescue1, writing:
We have to teach citizens wound packing, how to apply chest seals and how to evacuate victims to a safe area. Training needs to include the importance of public access trauma care kits and carrying your own emergency trauma supplies.
The fact is that with critical bleeding, people can lose the amount sufficient to cause death within three minutes, wrote Wylie as he called upon fire chiefs across the United States to empower citizens to become a part of the first responder system, "instead of hapless bystanders hoping help arrives in time."
Robert Smith, a cardiovascular technician at the University Medical Center of Southern Nevada, a level one trauma center, told The Guardian about trails of Las Vegas shooting victims blood leading to the emergency room.
Blood on the ground in the car park – trails of blood about 20 feet from the entrance. That’s where they were dropping off the people,” he said.
Dr. Jay Doucet, medical director of the Surgical Intensive Care Unit at UC San Diego Medical Center, told the The San Diego Tribune after the Las Vegas shooting that 20 percent of non-military deaths from extreme bleeding can be prevented through quick application of tourniquets and bandages by people nearby.
The Las Vegas shooting injuries were unusually large wounds compared to those normally seen in the local trauma wards, but "tourniquets applied to even huge, horrifying extremity wounds can still control bleeding and be lifesaving," according to Friese. Wounds to head, neck, torso, abdomen, pelvis can't be controlled with tourniquets and require other wound care methods, however.
Georgia funds a program that pays for bleeding control kits at public schools, and California bill, AB909, introduced this year would require the kits to be installed next to all automatic defibrillators throughout the state, according to the Tribune article. Such kits often contain dressings with hemostatic coatings that can help blood clot quicker. These dressings can be packed into a penetrating wound.
With planned events, leaders establishing safety plans and event security should not only consider best practices to prevent violence or neutralize active threats, but also how to best prepare to address injuries and minimize death. Teaching ordinary people how to stop bleeding has the potential to save more lives in mass casualty incidents, and trained citizens improve emergency response.
Review and download the booklet Stop the Bleed: