By Douglas F. Kupas, MD, FAEMS, FACEP
Dr. Kupas is board certified in EMS and emergency medicine. He is an EMS physician, emergency physician, and director of Resuscitation Programs for Geisinger in Danville. Dr. Kupas serves as the EMS medical director at the Bloomsburg Fair, and volunteered as a physician EMS medical director at the 2017 National Boy Scout Jamboree.
Las Vegas, Charlottesville, New York City, Boston … Our world has changed dramatically in the last 17 years, and we now live with a constant threat in our schools, streets, movie theaters, and outdoor events.
We expect that physicians specializing in EMS, emergency medicine, trauma surgery, and critical care medicine are part of our hospital preparedness and mass casualty incident (MCI) planning, and nearly every member of a hospital staff is included in the plans for an MCI.
Beyond that, all physicians have special skills and a moral duty to be prepared, to help prepare the public, and to react to violence and injury in our communities.
In October 2015, the White House began the Stop the Bleed campaign to teach bleeding control to the public. Stop the Bleed is supported by Homeland Security, the American College of Surgeons, the American College of Emergency Physicians, and other physician organizations.
Stop the Bleed endeavors to teach lay providers, medical professionals, and first responders the most recent strategies to stop serious bleeding and to save lives.
You may have already seen Stop the Bleed kits hanging next to AEDs in airports or shopping malls. Whether used in a hostile event (like a shooting or bombing) or for an individual who puts an arm through a plate glass window, everyone should have the skills to stop bleeding.
A recent report from the National Academy of Sciences suggests that we should aim for “zero preventable deaths from injury.” Yet in Pennsylvania, people still die from external bleeding that can be controlled with simple techniques.
Stop the Bleed courses are short and include hands-on skills sessions. The courses focus on:
- Use of tourniquets without hesitation for severe bleeding from an extremity. Commercial tourniquets are included in Stop the Bleed kits, and we should all know how to use them.
- Packing of other seriously bleeding wounds and then application of direct pressure. Packing with sterile dressing impregnated with a hemostatic agent is ideal, but any clean cloth at hand is also fine. Wound packing to control bleeding is a relatively new concept in first aid skills. Direct pressure over the packed wound is important.
Stop the Bleed Checklist
PAMED's checklist can help physician practices, hospitals, and communities start their own Stop the Bleed training program. You'll find items to consider when planning your own training such as budget, manpower/materials, venue, and marketing.
Recent events have shown the need for military-style bleeding control in our communities, and all physicians should know these skills for the same reasons that all physicians should be able and willing to start chest compressions/CPR for cardiac arrest. Health care workers are the most helpful medical immediate responders in our communities.
Severe bleeding and cardiac arrest are immediately life-threatening, and many individuals die from these before EMS can arrive. Bystander physicians are important immediate responders who can save lives through Stop the Bleed and CPR training. Get Stop the Bleed training now, and participate with your hospital/health system in National Stop the Bleed Day activities on March 31, 2018, and beyond.
A version of this article appeared in the winter 2018 issue of Pennsylvania Physician Magazine, PAMED’s print magazine, and was reprinted with permission.