With the increase in intentional mass-casualty events and the rise in gun and knife crimes on individuals, the injuries seen in the civilian world have become all too similar to those suffered on the field of combat.
One such tragic event was the Sandy Hook Elementary School shooting in 2012. The shocking loss of life led Lenworth Jacobs, the head trauma surgeon at Hartford Hospital, Connecticut, to examine what could be done to reduce the fatalities in such an incident.
As a trauma surgeon, Jacobs was all too aware that the primary cause of preventable death, post-trauma, is hemorrhage. But if addressed quickly enough, even with the traumatic amputation of a limb, bleeding from an extremity wound can always be controlled: no one should bleed to death from such an injury.
How quickly is quickly enough?
A person can bleed out in as little as 3 to 5 minutes—often quicker than emergency responders can attend the scene.
So Jacobs realized that equipping bystanders with the skills to prevent catastrophic blood loss—such as applying a tourniquet or packing a wound—would empower them to make a significant impact on casualty survivability in such emergencies.
He convened a group known as the Hartford Consensus: physicians, military leaders, FBI representatives, and members of the Department of Defense, who devised the Stop the Bleed® protocol. This program intends to encourage the general public to become as comfortable with the principles of hemorrhage control as they are becoming with lifesaving CPR and the use of AED devices.
The impact of this is illustrated in an article by Matthew D Neal, after the Tree of Life synagogue shooting. A recent study in Kuwait also highlighted that even amongst health professionals, many have not acquired life-supporting first aid skills.
The study found that a Stop the Bleed training course improved the pass rate from 2% to 96% post-course among 5th-year medical students.
Key Factors in Training
There is a chasm of difference between knowing how to do something in principle and being able to apply that knowledge in the heat of the moment, especially in terms of the shocking scenarios referred to. As mentioned in the Kuwait study, even medical personnel may not have been trained on how to pack a wound or where/how to apply a tourniquet correctly.
For any organization providing tactical emergency care training—whether to professional emergency responders or potential bystanders, realism in training can help to overcome some of the five “Fs” of the typical stress responses—freeze, faint, flight, fright, fight—by exposing the participant to acute trauma in a safe, supportive learning environment.
For hemorrhage control training, tactical simulation has several other key advantages. A tourniquet must be tight enough to control the bleeding, which is painful and difficult to demonstrate effectively on a volunteer ‘patient’. The pressure required to stop bleeding when packing a wound can also be underestimated. Therefore, training aids such as the Tactical Hemorrhage Control Trainer that realistically simulate the volume and speed of blood loss, better prepare the potential responder for the reality of a situation they may, unfortunately, find themselves in.
The Tactical Hemorrhage Control Trainer Pro is a fully-modular, wireless simulator with interchangeable trauma limbs and wounds designed for point-of-injury, tactical medicine training for law enforcement and first responders. Ultra-realistic and fully mobile, it is ideally suited for training rapid assessment and treatment of trauma injuries associated with active shooter, disaster, and terrorist incidents. To find out more about Stop the Bleed programs visit stopthebleed.org
