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Stop the Bleed
Farm injuries can result in more than the loss of a limb. Severe bleeding can kill within minutes.
A national initiative from the American College of Surgeons (ACS) Committee on Trauma, “Stop the Bleed,” aims to prepare the public with the tools and information needed to act in an emergency, stop life-threatening bleeding, and potentially save lives. The Iowa Department of Public Health (IDPH) and the state’s Trauma Advisory Committee are working together to roll out this campaign in Iowa.
The campaign, which is also being rolled out state by state on a national level, is a result of the Hartford Consensus. The consensus is a series of reports that were first published in 2013, after the December 2012 shootings at Sandy Hook Elementary School in Newtown, Connecticut.
While the training can help save lives in active shooting situations and mass casualties, it can also come into play following a farming or automobile accident.
According to the National Institute for Occupational Safety and Health Division of Safety Research, every day about 167 ag workers suffer an injury that leads to lost work time, and about 13 of those injuries result in a permanent impairment. In 2012, 347 farmworkers died from a work-related injury.
Training the trainers
Over the summer, IDPH hosted multiple train-the-trainer sessions around Iowa, instructing paramedics, physicians, nurses, military instructors, and others how to teach bleeding control. The class, “Bleeding Control for the Injured,” was provided at no cost by IDPH. Peter Pons, a Colorado emergency physician and primary author of the class, provided the initial training, which he refers to as “trauma’s equivalent to CPR.”
Those who completed the training and registered as instructors on the ACS website were provided with information and resources to develop local training programs. This allows them to instruct others in their communities, as well as law enforcement officers, first responders, firefighters, security personnel, teachers, gun safety instructors, and other members of the public.
The IDPH also plans to facilitate training sessions for FFA, 4-H, and Scout groups, and would like to see the course offered in high schools alongside the required CPR training.
Turning Bystanders into First Responders
Richard Sidwell is a trauma surgeon at Iowa Methodist Medical Center in Des Moines, who has been active in raising awareness about the initiative.
“The problem is that severe bleeding is the leading cause of preventable death following injury, and there isn’t time to wait for trained medical personnel to arrive,” he says. “We want to turn bystanders into first responders who can stop the bleed and save a life.”
The class teaches intervention through the ABCs of bleeding: Alerting 911, finding Bleeding injuries, and using Compression to stop bleeding.
To simulate an actual bleeding trauma, the trainers use bone-in pork shoulders inserted into the legs of denim jeans. Artificial blood is pumped into the pork, and the trainees must use skills they’ve learned to stop the bleeding with wound packing and direct pressure.
Carry a Bleeding-Control Kit
IDPH recommends assembling or purchasing bleeding-control kits and keeping one in every vehicle and with every tractor or other piece of machinery on the farm. Having the tools ready to go and acting quickly can save precious minutes in case of a severe bleeding injury.
“This isn’t hard,” Sidwell says. “With a small amount of training and practice, anyone can learn what to do to save a life.”
Preassembled kits are available online from several sources, and they should include:
- A commercially available tourniquet that can be operated with one hand so a person can treat his or her own injured arm
- Trauma dressing or gauze
- Multiple pairs of nitrile gloves
- Trauma shears for removing clothing
- A permanent marker to note the time the tourniquet was applied
- Printed lifesaving instructions
IDPH recommends using a commercial tourniquet rather than a belt or rope. “Improvised tourniquets require substantial training and practice to be effective. Without that training, they can actually make the bleeding worse,” Sidwell says.
He also notes that while people commonly think use of a tourniquet automatically leads to amputation, that’s not necessarily the case.