Page 138 - Journal of Special Operations Medicine - Fall 2015

Public Access Hemorrhage Control
and the Stop the Bleeding Coalition

Matthew J. Levy, DO, MSc, FACEP

Introduction
The military and civilian tactical medical communities access to lifesaving hemorrhage control kits that con-
have long realized the potential of early life saving in- tain effective-commercially available tourniquets and
terventions. Pioneered by the Committee on Tactical hemostatic dressings, gloves, and other equipment. This
Combat Casualty Care (TCCC) and adapted by the ci- equipment must be strategically predeployed in high-
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vilian Committee for Tactical Emergency Casualty Care occupancy and/or access-delayed locations, including
(C-TECC), the importance of early hemorrhage control public and commercial buildings, airports, schools, court-
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and the ability to address immediately correctible causes houses, shopping malls, etc. This is a departure from the
of death have been proven to save lives. Considered conventional stockpiling model often used in civilian di-
standard for military and most civilian tactical medical saster preparedness. The placement of hemorrhage con-
units, these concepts have begun to be implemented into trol resources should be in a manner similar to that of
mainstream civilian law enforcement and prehospital automatic external defibrillators (AEDs).
emergency medical services (EMS).
A Need to Educate and Advocate
In the wake of some of the United States’ worst recent
active shooter and intentional mass casualty attacks, Lawmakers and public administrators must be provided
national attention has been given toward strategies to with an awareness of the need to educate immediate re-
improve survival and enhance response. The recent sponders on how to stop bleeding, as well as the impor-
Hartford Consensus III recognizes uncontrolled bleed- tance of placement of public access hemorrhage control
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ing as the most significant preventable cause of death in resources. Once empowered with an understanding
the prehospital environment and calls for all responders of this information, public officials can craft policy to
to have the education and necessary equipment for hem- promote education campaigns and allocate funding to
orrhage control. facilitate placement of hemorrhage control resources.
Additionally, opportunities exist to incorporate public
access hemorrhage control training into the workplace,
A Critical Gap Exists
community events, civic groups, and models similar to
For every minute that goes by following a critical inci- existing hands-only CPR training programs.
dent, the probability of survival decreases for severely
injured patients. Improving survival from active shooter The Stop the Bleeding Coalition
and intentional mass casualty events necessitates a
change in how society views and responds to emergen- The Stop the Bleeding Coalition (SBC) was formed in
cies. Prior events have demonstrated that some individu- 2014 and is composed of medical professionals, law
als present during or immediately after will try to help enforcement officers, former military personnel, tacti-
those injured. Members of the community need to be cal first responders, educators, nonprofit organizations,
empowered as “immediate responders” and provided public officials, and concerned citizens. The SBC strives
with the knowledge of how to perform lifesaving inter- to educate and raise awareness about the importance
ventions until emergency responders arrive. The ability of having prepositioned hemorrhage control resources
for immediate responders to provide near-instantaneous on-site and readily available in case of a mass casualty
hemorrhage control is a vital link in the Chain of Sur- incident, active shooter, or any trauma event.
vival for victims.
SBC’s purpose is to:
Public Access Equipment
• Raise awareness of the importance of hemorrhage
Survival from active shooter/intentional mass casualty control among the general public as well as across all
events requires that immediate responders have rapid levels of government;

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