Transcript of Get Ready Report podcast, episode 52

This is APHA’s Get Ready Report, coming to you from Washington, D.C.

Hello everyone! Welcome to our latest edition of the Get Ready Report. Today we’re joined by Dr. Lenworth Jacobs, chairman of the Hartford Consensus and leader of the American College of Surgeon’s “Stop the Bleed” Program. He’s going talk to us today about Stop the Bleed and how it relates to emergency preparedness.  


Welcome Dr. Jacobs, to get started can you tell us what is stop the bleed?
Yeah. The ‘Stop the Bleed’ Program is a national program designed to inform, educate and then empower the public to stop severe bleeding from any cause.


Great! That sounds like an awesome program. So why is it important to know how to help someone who is bleeding?
Well it’s important to know how to help somebody who is bleeding because generally speaking if you can keep the blood inside the body ‘til you get to a center or hospital or an emergency or a trauma center, that can definitively take care of you, your ability to survive is dramatically increased. And classically, this came out following the Sandy Hook uh issue in Connecticut five, six years ago. But as you can imagine there has been an increasing number of events — both active shooter and intentional mass casualty incidents — which are causing major uh uh bleeding for patients nationwide. However, those events, although they are very uh newsworthy are very infrequent. What is much more frequent is cut with a chainsaw or cut with a kitchen knife or falling on a sharp instrument or a motorcycle or motor vehicle accident where somebody is bleeding significantly in an environment where there’s not a medical provider immediately available. And if you can stop that bleeding using your hands, or a hemostatic dressing or a tourniquet, then you will allow that patient to keep the blood inside their body and get to the hospital in a much, much better state. And the reality is that if you can get to the hospital alive, you have a very high likelihood of surviving.


I’m glad that you touched on school shootings. This ties into our next question. Which communities should prepare for a bleeding emergency? Who is most at risk?
Well that’s a good question because really every community should be prepared for a significant bleeding event. Because it doesn’t have to be something horrendous like a shooting or an explosion. It can literally be anything that cuts a major artery or a major vein. So, everyone should be prepared. Um both in a household event or if you’re going camping or doing something which is likely to or has the potential to causing you a bleeding event. So I would say everyone needs to be prepared for this.

Awesome, so everyone needs to prepare.  How is preparing for serious bleeding similar or different than other emergency preparedness?
Well, in preparing for a serious bleeding event the basic difference is that something caused it. And most people are not accustomed to seeing severe bleeding, so they’re going to be very frightened and that can induce panic and the panic causes them to not do anything. So the person, person continues to bleed. Classically what would happen is someone then gets a towel or something and covers up the bleeding. They don’t stop the bleeding. They just cover it so they can’t see it. So that means you will continue to bleed until either a first responder gets there who can stop the bleeding or ‘til you get to the hospital. In the meantime, a significant amount of blood has left the body and is no longer available to carry oxygen to your heart, brain and kidneys. So, it’s really important to stop the bleeding immediately or as close to immediately as it starts.


I understand that panic of being scared of blood; I also get a little scared of blood. On that note how can schools and people with children better prepare themselves for a serious bleeding emergency?
Again, great question because especially with children, mothers or, or caretakers generally want to take the child and hug them. Which is a great thing, but it’s not going to stop the bleeding. So you have to inform people A) that’s it’s all right to intervene, you’re not going to cause harm; B) that you can use your hands or a shirt or a, you know, a dressing of any sort to stop it immediately. And if you do have a bleeding control kit which has a hemostatic dressing or a tourniquet in, it’s okay to apply that before professional help gets there. And that’s really just informing and educating the public that it’s important to stop bleeding as soon after the event as possible.


I’m happy you touched on education and information, where can someone go to get training?
Well, there, there increasingly large numbers of of instructors whether they be in in um hospitals or public places or schools, etc. Um the American College of Surgeons has this bleeding control site, which is bleedingcontrol.org, which in which you can actually identify — actually, all the, all the educational equipment on that site is downloadable free. It does also have places that you can go for training which um are available on the site. And, in your own community classically the hospital or a center there will have people who are instructors in Stop the Bleed training and they can inform you as to when they’re doing a class, where to go to and how long it is. Generally speaking, these are short. There’s a half-hour didactic lecture and a half-hour hands uh on educational session which teaches you how to use your hands, how to use a dressing to stop bleeding and how to apply a tourniquet. And then you have to show back to the instructor that you know how to do this and you’re finished! So in one hour you have this life, life-saving skill which you can take with you forever.


You mentioned a tourniquet to stop bleeding. What other supplies are needed to stop severe bleeding and where can we get them to add into our emergency preparedness kits? 
On the internet in the American College of Surgeons site, bleedingcontrol.org, there is a store on there where you can get the equipment. Now the college only deals with equipment which has been approved by the Department of Defense because the Department of Defense unfortunately has the greatest experience with bleeding from the wars in Iran and Iraq and uh Afghanistan. So they know the right equipment, they’ve tested it in all kinds of environments whether they’re in the desert, under water, etc. So the equipment works 100 percent of the time. And we advocate using Department of Defense-approved equipment.


We’ve talked about some really valuable information here. So is there anything else that we should know that we haven’t talked about yet?
Well as I said, I think that the most important thing is that this is a skill anybody can have. And the reason is that we want basically 200 million people to have this skill. So that if something happens, the the person right beside you is informed, educated and empowered to stop bleeding. And similarly if the person beside you is bleeding, you don’t have to just be in a panic, you know what to do and you do it. And as I say, all you really have to do is hold pressure on the bleeding site until a professional comes. And that will end up saving the life and the limb of that patient, so it’s really important that everyone has this skill. And on a side note, I surely encourage you to both download the, the uh educational equipment and, and read it, but then yourself seek out the training because it, it is very simple to do and very effective and it’ll counteract that feeling of panic you have which “oh my god this is bleeding,” “what am I going to do,” “this is awful.” It’ll give you the ability to say, “I know what to do. I can do it and I’m going to do it.” And you will probably end up saving the life and the limb of that patient. So it’s really worth it to get the training.


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