"A person can bleed out in three minutes," said Dr. Andrew Gaugler, trauma surgeon at Lakeland Regional Health. "It takes on average five to eight minutes for an ambulance to arrive in a big city, and that is not (the response time) in a large county like Polk."
Lakeland Regional Health has been sponsoring Stop the Bleed classes for the past several weeks, mostly for those who work at the hospital or for emergency medical services workers, said Diana DeGroot, trauma-program manager. But the health system will start offering the classes to the general public in January, she said.
"Although terrorist attacks and mass casualties are in the news, you are much more likely to encounter an accident on the road, at home, the workplace, or if a sportsman, out in the field or on the water," Gaugler said.
Knowing what to do can save lives, he said.
The genesis of Stop the Bleed dates to 2013, following the mass shooting at Sandy Hook Elementary, when the American College of Surgeons and an array of federal agencies, nongovernmental agencies and emergency responders gathered at Hartford, Conn., to create a protocol that would increase survivability during active shootings and other mass-casualty events. The idea was to expand beyond first responders the number of people who know what to do when faced with traumatic bleeding injuries.
That course is now streamlined and simplified and is aimed at the general public.
Breanna Campion, a training captain with Polk County Fire Rescue who was among 16 people attending an hour-long training session Tuesday evening, said the county is in the research phase before offering Stop the Bleed classes through its own public-outreach and education program, probably starting within a few months.
Dr. Paul Banerjee, medical director of Polk County Fire Rescue, brought his children, Roland, 14, and Anjali – who turns 12 next week – to the Tuesday night session because "this is at a level you can teach it to kids and they can teach their schools, their teachers, how to do this," he said.
Two registered nurses from the hospital trauma team, Ashley Young and Tiana Binxhiu, led the session with added support from Gaugler.
"I work in the emergency department, but we can work as a team to save a life," Binxhiu said, then explained the simple step.
• Call 9-1-1 and make sure you are safe.
• Check where the bleeding is coming from – remove clothing from the victim to find the source of the bleeding.
• Determine if the bleed is life-threatening? Is bllod spurting out, won't stop, pooling on the ground or soaking the clothing or bandages? Is part or all of a limb missing? Is a seriously bleeding victim confused or unconscious?
• Apply firm steady pressure to stop the bleeding. Cover the wound with a cloth (gauze if it is available or a shirt or jacket or whatever is on hand) and press hard and steadily with both hands.
• If the wound is deep or gaping, pack the cloth or gauze into the wound using your fingers until the wound is filled with cloth and then press hard on top.
• If the wound is to an arm or leg and a ready-made tourniquet is available, use it, slipping it two or three inches above the wound and tightening. If no tourniquet is available, apply pressure.
All the trainers at the session emphasized that putting strong, hard pressure on the wound will be painful to the patient and the patient may tell you to stop, but don't stop until the paramedics or trauma team takes over.
Resist any temptation to ease up on the pressure to check if the bleeding has slowed, Young said.
"If you let go, you will let the hemorrhages start again," she said."Talk to the patient. Tell them you have to keep pushing to save their life."
"When the paramedics arrive, they will give the patient something to take care of the pain," Gaugler said.
Improvising a tourniquet with a belt and stick is not recommended, but it will work, Gaugler said. If an approved tourniquet with Velcro band and windlass is not available, the best thing is to apply pressure, he said.
While a tourniquet is suitable for limbs, it does not work on shoulders, armpits, the neck or groin area, Binxhiu said. Apply pressure, she said.
And if the wounds are to the chest, abdominal area or back, leave them to the trauma team, Gaugler said. "We can stop the bleed at the trauma center," he said.
Still, there is plenty a trained bystander can do, Binxhiu said.
Lessons from live-saving efforts in Iraq and Afghanistan, where explosive devices have caused mass casualties and limb losses, have vastly expanded what the medical profession now knows about tourniquets and bleeding control, Gaugler said.
"The most preventable cause of death from injury is life-threatening bleeding from an arm or leg," Gaugler said. "From the last 15 years of war, we have learned that a properly applied tourniquet saves lives and does it with a minimal risk for disability."
Bleeding-control kits are available online that include the approved Combat Application Tourniquet, gauze with coating to promote clotting, latex gloves and more. A personal kit approved by the American College of Surgeons costs $69 to $99 through controlledbleedingkits.com
But suitable items, military-approved tourniquets carrying the C-A-T designation and clot-promoting dressing, is also available online as single items for lesser amounts. The tourniquets are one-use items and should be taken off by a medical professional within two hours of being applied.
While wearing gloves is preferable when handling a bleeding patient, the chances of being exposed to a blood-borne pathogen while trying to stop a bleed are almost negligible, Gaugler said. Be sure to wash well and tell the EMTs that you have been exposed to blood, he said.
"You don't need to be a nurse or doctor to save a life," Gaugler said. "All you need is a little knowledge well placed. We make it very simple for the general public to replicate and digest."
Starting in January, classes will be on the last Tuesday of the month from 5:30 to 7:30 p.m. and the third Saturday from 9 to 11 a.m.
To register for a class, go to https://www.eventbrite.com/e/bleeding-control-basics-b-con-course-registration-40877882848.
Marilyn Meyer can be reached at marilyn.meyer@theledger.com or 863-802-7558. Follow her on Twitter @marilyn_ledger.
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