York County residents learn how to Stop the Bleed at WellSpan event
An individual can happen upon a victim of life-threatening bleeding at any time, local medical professionals told a group of York County residents, and their prompt action could save that person's life.
That's why the public was invited to participate in a "Stop the Bleed" event, in which they learned how to treat hemorrhage victims in emergency situations via a hands-on training offered by WellSpan York Hospital trauma staff.
The free session was held at the York Jewish Community Center on Wednesday, March 28, in conjunction with National Stop the Bleed Day, which was March 31. The event offered a nationwide, free course designed to educate the public about controlling bleeding until the arrival of first responders at a trauma scene.
During the session, Dr. Shawn Terry, a WellSpan York Hospital trauma surgeon, and Dr. Jordan Kirsch, a WellSpan surgical resident, spoke about the importance of mitigating blood loss in trauma situations and demonstrated the proper use of tourniquets, wound packing and simple hand pressure to stem blood loss.
Participants were then given the opportunity to experiment with the techniques themselves using mannequins.
Emergency: National Stop Bleed the Day is part of a larger Stop the Bleed campaign established by the U.S. Department of Homeland Security in 2015.
"You never know when you're going to find someone in an emergency," Terry told the crowd.
According to Terry, 35 percent of hospital trauma deaths are a result of a hemorrhage.
"We could cut that by one third by training the public," he said.
It takes police on average three minutes to arrive at the scene of an emergency, and it's even longer for medical personnel, according to the Stop the Bleeding Coalition's website.
That window of time is critical, as the adult heart pumps several liters per minute in a body that holds four or five liters of blood. This can lead to massive blood loss within minutes, according to the website.
In addition to educational sessions, Terry said the campaign is advocating for the greater availability of onsite bleeding kits for law enforcement and schools. The kits typically contain tourniquets, gauze, gloves and a marker to write the time of placement on the tourniquet.
The ABCs: The doctors said the first thought a bystander should have at a trauma incident is ABC: A for alert (call 911), B for bleeding (find the source of the bleeding) and C for compress (applying pressure to stop the bleeding).
The doctors said that identifying the source of the bleeding is vital because it determines the proper place to apply pressure and halt the bleeding.
A cloth or piece of gauze can be applied to the wound, and pressure can be applied by pushing directly with both hands, using a tourniquet or packing the wound with gauze, and then applying pressure.
The doctors demonstrated how to apply pressure to a wound by using the heel of the hand, rather than the whole hand, and leaning into the wound, using one's body weight to exert pressure.
However, tourniquets are even more effective, Kirsch said.
"If you think you should put a tourniquet on, you probably should. Don't talk yourself out of it. Talk yourself into it," he said.
If a tourniquet is unavailable, one can improvise with other objects, such as belts, Kirsch said.
A third option for small wounds that are located in a part of the body where a tourniquet is less effective is to pack the wound with hemostatic gauze.
This type of gauze encourages blood coagulation, Kirsch said, and was developed in 2003 to treat soldiers in Iraq and Afghanistan.
He said it doesn't matter if the gauze or cloth is sterile, as the wound is already filled with contaminants and it's the job of the surgeon to clean it out.
Encouraging tourniquet use: Kirsch said tourniquets became controversial after World War II and were almost banned in the medical community for decades. In the past, tourniquets were used improperly, often being applied too loosely or tightly, leading to limb loss and even death.
However, tourniquet technology improved in the 2000s, and the military began using them in Afghanistan and Iraq to great effect, Terry said. According to a 2008 Journal of Trauma study, an injured soldier's survival rate with a tourniquet was 87 percent.
The tourniquets soon became standard in the military and are now being phased back into civilian medical treatment, Kirsch said.
There have been no documented instances of a patient losing a limb when a tourniquet was applied for two hours or less, Kirsch said. However, he also noted that when a person is rapidly bleeding out, they are losing blood to vital organs, and the decision must be made between saving a patient's limb or saving their life.
Now, protocol regarding tourniquet use is simple: Put it on and keep it on until the professionals arrive.
"Tourniquets are not just safe, but they're extremely effective," he said.
Local sessions: WellSpan has trained 429 individuals in bleeding control since they began holding local sessions last June, according to Reda Willis, injury prevention coordinator for WellSpan Trauma Service.
Presentations have been given to state police, EMS crews and administrators and teachers at local schools, Willis said. The organization plans to hold demonstrations for the students in local schools this fall, and it has received a multitude of requests from churches and civic organizations.
"We're willing to go anyplace," she said.
Good Samaritan: The doctors emphasized that individuals who intervene in trauma situations are protected by Pennsylvania's Good Samaritan law, which protects them from liability if unintended consequences occur from their efforts to save a life.
One of the biggest hurdles average people with no medical training have to overcome is the disgust and fear factor associated with treating the victim of a gory wound, Terry said.
However, their assistance can make all the difference in what surgeons see when the patient arrives in the emergency room.
"You're looking at someone who is alive and breathing, but they won't be bleeding because of that tourniquet," Terry said.