See how employee training, strategically-placed equipment, and awareness of the potential problem all converge to help companies reduce the number of life-threatening bleeding events on their premises.
It was a few months after the 2012 active shooter incident at Sandy Hook Elementary School in Newtown, Conn., when several government and medical community representatives sat down to create a national policy to enhance survivability from active shooter and intentional mass casualty events.
Known as the “Hartford Consensus", this initiative spurred both public and private organizations to begin “pre-placing” hemorrhage control equipment for use by the general public, bystanders and first responders. "With the recent incidents at the Navy Yard (Washington, DC) and Westgate Mall (Nairobi, Kenya), this topic is very much top of mind,” Hartford Hospital’s Lenworth M. Jacobs, MD, MPH, FACS, said in a press release at the time.
The goal of this nationwide initiative is to “train every American in basic bleeding control techniques and to work tirelessly toward placing bleeding control kits in every public venue, including schools, community centers, places of worship, and stadiums.” To help stop the bleed in the workplace, companies should stock up on one-time use tourniquets, rescuer trauma kits, and multi-casualty bleeding control packs. They can also situate first aid cabinets near their AEDs.
“In one case, emergency responders were delayed 40 minutes because law enforcement didn’t want to put them in danger,” Jacobs continued. “Most of these shooting events are over in 15 minutes and people can bleed to death within five minutes from these severe injuries. Responses to save victims have to be immediate, fully orchestrated, and ready to go, day or night, in any city in the U.S.”
Two Hours or Less
According to the New England Journal of Medicine, death from hemorrhage represents a substantial global problem, with more than 60,000 deaths per year in the U.S. attributed to physical trauma. Early recognition of hemorrhagic shock and prompt action to stop the bleeding are lifesaving, it says, since the median time from onset to death is two hours.
“Rapidly controlling the source of hemorrhage and restoring the patient’s intravascular volume and oxygen-carrying capacity serve both to limit the depth and duration of the shock state and to repay the accumulated oxygen debt,” the publication reports, “in the hope that the debt is repaid before shock becomes irreversible.”
Of course, it doesn’t take an active shooter to create a situation whereby someone needs immediate help to “stop the bleed.” In an industrial setting or out on a job site, for example, even a minor accident can turn into a potentially fatal event if not handled properly.
Knowing this, some companies are co-locating this equipment with their automatic external defibrillators with clear messaging and signage so that individuals can easily and rapidly access this equipment. Other companies are implementing hemorrhage control programs to train employees on what to do to “stop the bleed” in the event of an accident.
Companies also have numerous training resources at their avail, including the American College of Surgeons class search. Remember that during an incident, safety must be a top priority. Should the rescuer become injured, he or she might not be able to help the victim; care should only be initiated if the scene is safe.
It’s also important to wear gloves (if available) to protect yourself from blood-borne infections. Finally, be sure to alert 9-1-1 to notify emergency medical responders and/or police officers of the event, and to get them to the scene as quickly as possible.
It Starts with Employee Training
According to the Hartford Consensus, many trauma deaths result from injuries that are intrinsically non-survivable, but others occur from potentially survivable injuries if optimal care had been given. This puts companies in a very good position to help improve survivability numbers and reduce the chance of life threatening bleeding events happening to their employees or visitors.
Prepare for 20 Potential Victims
According to Reuters Health, military and emergency medicine experts recommend that public venues install bleeding-control kits for at least 20 victims. If public venues are equipped with nitrile gloves, a basic tourniquet, wound dressing to stop severe bleeding, rolled gauze and trauma scissors, then these kits could allow bystanders to help save lives after bombings, mass shootings or stabbings.
Bleeding-control kits range in price from $50-$300, depending upon desired contents and the number of individuals treated. The kits include instructions so bystanders can quickly grab items in the midst of chaos to take care of a victim, the publication notes. Researchers and policymakers are now determining the best place to put these kits in public venues, including next to AEDs.
It’s important to note that it doesn’t take a criminal attack to create a situation that puts an employee or site visitor in peril. “Accidents with kitchen knives or chainsaws are more common than terrorist activities, and these kits help then, too,” Jacobs told Reuters Health. “Bleeding control is a life skill that everyone should have.”