Reacting and Responding to the Unthinkable

Would you know what to do?

If the unthinkable happens and you find yourself in a situation where someone needs your help to stop life-threatening bleeding, would you know what to do?  Chaotic situations call for a cool head and quick action.  Whether it’s an on-the-job injury, a natural disaster, a home accident, vehicle accident or tragic public event, knowledge of how to stop bleeding could make you someone’s hero.  So what should you do?

Time is Critical

You want to locate the wound and get access to it. Cover the wound with a clean cloth (a shirt works if there is no sterile gauze available), and put as much pressure as you can on the wound with your hands and body weight until the bleeding slows or professional help arrives. This may take some time so enlist help of other bystanders if possible. In the case of a large open wound, you may need to pack cloth or gauze into the wound before applying pressure.

Acquiring an understanding of the basics on how to apply pressure and pack a bleeding wound could make you the difference between life and death to a victim. Educational opportunities are becoming more prevalent, and having more bleeding control kits available in public places is crucial if we are going to save lives during these kinds of events.

What’s Happening?

Uncontrolled bleeding is the number one cause of preventable death from trauma. In 2015 the White House, in conjunction with an interagency consensus, began the “Stop the Bleed” campaign to educate the general public in methods to stop life-threatening bleeding and save more lives. Unfortunately, the initiative was prompted by the increased prevalence and deadliness of active shooter and intentional mass casualty events.

The US Government’s Gun Violence Archive is self described as “a not for profit corporation formed in 2013 to provide free online public access to accurate information about gun-related violence in the United States.” According to their 2017 data, 15,533 people died as a result of gun violence, and 31,131 were injured. Included in these numbers are 732 children who were injured or killed.

These kinds of incidents, along with natural disasters, get all the media attention. More commonly, on-the-job and home injuries, as well as vehicle accidents, can result in life-threatening blood loss as well. We as a society have been increasingly confronted with the need to respond quickly to save lives, which means we as individuals must contemplate how we can prepare ourselves to act if we find ourselves in the midst of an unfolding tragedy.

How do we save more lives?

Like AEDs for patients suffering from sudden cardiac arrest, bleeding control kits offer better odds for someone suffering a life-threatening blood-loss injury. While there is no way to know how many lives could have been saved last year if bleeding control kits were available, they definitely would have given victims a better shot at survival.

Whether it is from a shooting, a vehicle accident, an on-the-job injury, or a natural disaster, someone who is bleeding profusely needs quick action to save their lives and their limbs. Most people keep a standard first aid kit in their car, but when faced with a situation where more than band-aids and gauze squares are needed, having a bleeding control kit or adding a basic tourniquet to an existing kit might be the answer.  

In its most basic configuration, a bleeding control kit contains gauze, tourniquets, scissors, and gloves. Just the gauze and tourniquets could mean the difference between bleeding out at the scene or going home from the hospital. The other very helpful item in these kits is a guide with step-by-step instructions on how to use the items inside. Some of the more advanced kits also include a dressing which is infused with kaolin, a hemostatic substance which helps blood clot. Sometimes just pressure isn’t enough to completely stop a bleed, and this type of dressing can significantly decrease the time it takes for the blood to clot.

The hope is as time goes on there will be fewer violent incidents. Even so, accidents happen, and the words of Louis Pasteur ring true when he said: “Luck favors the prepared mind.” We may think survivors of vehicle accidents, injuries, and mass casualty events are “lucky,” but more often it’s the knowledge and efforts of those around them who increased their luck substantially.

12 Responses to “Reacting and Responding to the Unthinkable”

January 16, 2018 at 10:40 am, melinda vose, RN said:

this is excellent thank you for sending this out


January 17, 2018 at 8:40 am, Eleanor Pelosi,RN said:

Excellent article.We all should be prepared for any emergency.


January 22, 2018 at 9:06 am, Sandy said:

A question: someone in cardiac arrest needs indeed CPR and an AED asap. What if this same person is bleeding massively? What goes first? a tourniquet or CPR/AED. Just had a discussion with a student about that. What is your opinion on that one?


January 22, 2018 at 2:43 pm, eileen said:

Hi Sandy – that’s an excellent question. Our training director has been an EMT for many many years and is one of our American Heart Association certified CPR/AED instructors, and this was his response: “In reality, if a person was in cardiac arrest potentially due to a massive bleed resuscitation efforts are going to be futile. As with any precipitating cause of cardiac arrest, we need to treat the cardiac arrest first; all other injuries are secondary. If additional rescuers were available a tourniquet could be applied simultaneously, but CPR needs to be the focused treatment in that situation.”


January 23, 2018 at 2:29 am, Sandy said:

Thank you very much for your answer


November 14, 2018 at 8:00 am, Tim Jamison said:

If a person is “massively bleeding,” their heart is still beating, so CPR is not needed. If there is no pulse, but you recognize that there is massive trauma, quickly address the wounds before starting CPR. Otherwise, you simply push blood out with each compression.


January 26, 2018 at 6:56 am, Cynda said:

conformation of what I was aware of this is great


March 13, 2018 at 9:36 am, J Taylor said:

Nice, short and to the point


November 14, 2018 at 9:50 am, Vince said:

In some cases, exsanguinating hemorrhage is treated before CPR. It depends on the source of the hemorrhage. If the bleeding is from an arterial source, death may only take 20 seconds to a couple of minutes. Keep in mind though that the particular artery involved will determine how quickly you bleed out and your immediate treatment. You can do CPR if you have someone to treat the bleed.

Santa Barbara County MRC (EMS/PHD) In-house Trainer
Allied 100 LLC, AHA & ECSI Instructor


November 14, 2018 at 1:02 pm, Prentice St Clair said:

Are pre-packaged “bleeding control kits” available to the general public, and from whom? Thank you.


November 14, 2018 at 1:11 pm, AED Superstore said:

Hello Prentice,
Yes! AED Superstore carries a line of bleeding control kits. You can find them here.


November 15, 2018 at 12:09 am, Manuel De los Santos said:

Great information brought to our attention n discussion. Another thing to use as a tourniquet is the new belts without holes.


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