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What do I do when there's no breathing and lots of blood?
I’m busy boning-up on motorcycle safety ahead of my Ridiculously Random Motorcycle Tour. I recently watched a Dan Dan the Fireman video where a group of motorcyclists happened upon a crashed vehicle (not shown). The car was upside down, the driver trapped behind the wheel.
A biker tried and failed to break the driver’s side window. His compadres banded together, flipped the car upright, prised open the door and removed the injured driver.
As Dan the Man pointed out, wrong answer. The driver could have had spinal injuries; the impact of righting her vehicle could have made them worse.
Removing her from the car – which was in no further danger – was also a mistake. Moving a victim can exacerbate internal bleeding and/or organ damage.
A Man’s Got to Know His Limitations
The good samaritans should have called 911, looked for other victims (who may have been struck by or ejected from the vehicle), checked the driver for bleeding and breathing (as much as possible), calmed her (assuming she was conscious) and waited for the professionals.
That’s it. Nothing more. But there are cases where you should act to save a life.
After consulting with my EMT amigos, here’s some first aid advice on breathing and bleeding intervention that I’m taking on the road. NB: This is a rough guide. Get proper training.
Keep Calm and Call 911
As a non-professional first responder at an accident involving injuries, I’ve been advised to do only what’s necessary.
Keep yourself and others safe from additional injury
Call 911
Locate the victim(s)
Check for breathing and/or bleeding
If the vic isn’t breathing, check for a pulse. If there isn’t any, begin CPR.
My main man Taylor cautions: don’t get your hopes up. “Resuscitations by CPR alone are statistically insignificant.” All the more reason to call the professionals pronto.
Blood Belongs Inside
The time it takes to bleed to death varies depending on the severity of the injury and the location of the wound. If a major artery is compromised, it can be a few minutes – or less.
If the bleeding is severe – spurting blood, blood flow that won't stop by simple pressure or extensive bleeding from multiple wounds – you need to act.
The wound’s location determines the response.
The general rule of thumb EMT’s use: "seal the box, pack the junctions, tourniquet the limbs." Only the first and the third parts apply to you. Maybe.
Seal the Box!
If blood’s pouring from a wound in “the box” – from the collarbone to the pelvis all the way around the trunk – cover it with an occlusive dressing (like this one on Amazon).
If you didn’t think to keep an occlusive dressing handy, cover the wound with whatever bandages you have, a clean cloth, something.
Apply pressure. But not so much pressure that you’re moving around the bowels or impeding breathing. It's not cut and dry, but it’s a sound basic concept.
Tourniquet the Limbs
If the bleeding’s coming from a severed artery in the victim’s arm or leg, you need a tourniquet.
Twisting a strip of cloth tied around a stick, wrench or something long and rigid (called a windless) could work. But there’s no substitute for a proper medical tourniquet with a built-in windless. It’s literally a matter of life or death.
One study pegged the survival rate for patients where tourniquets were applied at 92 percent. The survival rate for those who missed out on the device was… wait for it… zero percent.
Don’t worry about the long-term health of the limb unless the victim is more than two hours away from professional medical attention. According to a 2008 study in Iraq, not a single loss of a limb was attributed to tourniquet placement.
Practice!
A victim bleeding to death in front of you – perhaps with spurting blood – is the dictionary definition of daunting. Practice!
Once you’ve got the hang of it, refold the tourniquet the right way, as above.
Make sure it’s the right tourniquet. There are cheap Chinese counterfeits out there – sponsored on Amazon no less. Purchasing one could be the worst buying decision of yours or someone else’s life.
One of my combat-tested EMT advisors recommends a three pack from narescue.com. It could be the best, the most important $15 you’ll ever spend.
In My Months on the Road…
I’m sure I’ll come across an accident or ten. Hopefully, nothing serious and, sorry-to-say more importantly, nothing up close and personal.
I’ll have a small tourniquet-equipped first aid kit ready to go, and some basic training. I’m reasonably confident I’ll do what I need to do, starting with a call to the pros. I’m equally confident I’ll not do what I shouldn’t do. What about you?
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