By North American Rescue LLC.
Trauma is a national health problem. After a traumatic injury, hemorrhage is responsible for over 35% of pre-hospital deaths and over 40% of deaths within the first 24 hours. Despite the advances in trauma care and lessons learned from the military, roughly 80,000 lives are lost in the United States annually due to uncontrolled bleeding according to Centers for Disease Control. Of these deaths, the majority of them occur within the first 48 hours.
Trauma is caused by accidents, natural disasters, or intentional acts of violence and terrorism. The delay time in Emergency Medical Services response often exceeds the three to five minutes it takes to bleed to death for severe trauma incidents. Law enforcement officers are often the first professional responders on scene. In routine civilian trauma patients, delayed application of a tourniquet was associated with greater than 4.5-fold increased odds of mortality from hemorrhagic shock.
The federal government and non-profit academic organizations have taken steps to address this issue. The White House and the Department of Homeland Security originally crafted and launched the Stop the Bleed Initiative (dhs.gov/stopthebleed). The American College of Surgeons founded the Joint Committee to Create a National Policy to Enhance Survivability from Intentional Mass-Casualty and Active Shooter Events in the aftermath of the Sandy Hook Elementary School shooting incident and published the Hartford Consensus reports. One of the common and central themes found in the publications from these groups is the concept of providing individuals not serving in traditional medical roles with the necessary bleeding control kits and skills to save lives.
Professional first responders include law enforcement and EMS / Fire / Rescue. Law enforcement personnel must neutralize the threat in active shooter incidents and then, because they are usually the initial first responders on the scene, must act to control external hemorrhage. Victims with life-threatening external bleeding must be treated immediately at the point of wounding and all responders should be educated and have the necessary equipment to provide effective external hemorrhage control. The Hartford Consensus goes further and “strongly endorses civilian bystanders to act as immediate responders”. In some circumstances, civilian bystanders may be unwilling or unable to render aid to victims of traumatic injuries whereas law enforcement responders should be held to a higher standard due to their training and chosen profession to protect and serve the community. A scientific survey of a random sample of 1,051 adults in all 50 states on November 6–11, 2015 indicated 91% support for training police to provide bleeding control as a part of their duties.
The solution is for law enforcement officers to have immediate access to quality, evidence-based hemorrhage control devices that are easy to apply and that are effective at saving lives. This solution will have several positive outcomes: decreasing civilian mortality rates for casualties with severe external hemorrhage; increasing officer safety and survival with the capability to perform “self-aid” and “buddy-aid”; and improving the law enforcement officer image with the U.S. populations that do not perceive police as protectors or live savers.