The 4th “R”

Direct Pressure on Bleeding Wound
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May is Stop The Bleed Month!

When you go to school you learn the three “R”s: Reading’, ‘Riting’, ‘Rithmetic. That’s all well and good, but in these days of school shootings and civil unrest, it might be time to add to the curriculum a fourth “R“: Reducing hemorrhage.

We’ve written a number of time about mass casualty incidents (also called MCIs). They’ve pretty much become part and parcel of the “New Normal”. A mass casualty incident is any event in which the medical resources available are inadequate for the number and severity of injuries incurred.

Look at images of any terrorist attack, and you’ll see a lot of blood. These events tend to be over very quickly, but during that time, death from bleeding wounds can easily occur. In a world where high level medical care is just minutes away, citizens has become awfully secure in the notion that help is forthcoming. Unfortunately, it is rarely immediately at hand; the actions of individuals at the scene, therefore, may make the difference between life and death. If aid isn’t administered in the first few minutes, hemorrhage can be fatal.

Despite the urgency of the situation, even members of law enforcement are taught not to approach wounded victims until the threat has been neutralized. This is, in reality, a wise move that avoids additional casualties, but adds a delay that may cost the wounded their lives. Therefore, the quick action needed may have to come from those involved but uninjured in the event.

How many know exactly how to stop a major hemorrhage? Just a few. Only those in the medical field or who take First Responder classes have been taught basic techniques, such as how to use a tourniquet. But although you can find fire extinguishers on wall cabinets with medical kits shoved inside. Is it time to teach our children how to stop bleeding as a subject in school and workplaces? As horrible as this sounds, I believe we have reached that point.

Disasters occur regularly, not just terrorist events but natural disasters such as tornadoes, as well. If hemorrhage first aid were a part of the curriculum, would it make a difference? Imagine a community full of people who learned to deal with injuries during their school years. Would there be lives saved, even if just by a witness to a car accident? How many lives would have to be saved for such a subject to be worthwhile to teach?

Teaching bleeding control can help in natural disasters, too

Certainly, a first aid bleeding control course in schools would not be for kindergarteners, but for older children and teenagers and, also, school staff. Videos and demonstrations would be important to desensitize students to the topic.

Would it make students uncomfortable to take a class on bleeding wounds? Sure. Of course, some parents concerned that their child would be traumatized emotionally will protest. Perhaps, however, those who underwent the training might become imbued with sterner stuff than some of our current crop of collegians, who melt like snowflakes if faced with adversity.

In terms of trauma, how about this: Burns cause some pretty horrible wounds and death, but I don’t see kids running from the fire extinguishers in the hall. Violence is part of the “New Normal” and we must learn to deal with it in ways that save lives. Teaching kids to use the medical kits tucked in with the fire extinguishers is a way.

These are hard times, and they come with hard realities. We can live in denial of the importance of teaching bleeding control in schools, but I think you’d be grateful if the life of a loved one was saved by someone who learned “Reading, ‘Riting, ‘Rithmetic, and “Reduce hemorrhage”.

Joe Alton MD

Dr. Alton

May is “Stop the Bleed” month. Check out Nurse Amy’s entire line of quality medical kits, tourniquets, hemostatic dressings, and much more at

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