Page 152 - Journal of Special Operations Medicine - Winter 2015

APRIL 29, 2015

ROUNDTABLE ON BYSTANDERS: OUR NATION’S IMMEDIATE RESPONDERS

PARTICIPANTS
• Air Medical Physician • Association of Air Medical • Major Cities Chiefs
Association Services Association
• American Academy of • Association of State and • National Association of
Physician Assistants Territorial Health Officials Emergency Medical
• American Ambulance • Eastern Association for the Technicians
Association Surgery of Trauma • National Association of
• American Association of • Emergency Nurses Association School Nurses
Critical Care Nurses • Emergency Medical Services • National Association of
• American Association for the Labor Alliance State EMS Officials
Surgery of Trauma • International Academies of • National Athletic Trainers
• American College of Emergency Dispatch Association
Emergency Physicians • International Association of • National Emergency
• American College of Surgeons Chiefs of Police Management Association
• American Heart Association • International Association of • National Volunteer Fire
• American Hospital Association Chiefs of Police Council
• American Nurses Association • International Association of • Society of Emergency Medicine
Emergency Managers Physician Assistants
• American Osteopathic • Society of Trauma Nurses
Association • International Association of
Emergency Medical Services • Trauma Center Association of
• American Physical Therapy Chiefs America
Association
• International Association of • White House personnel
• American Public Health Firefighters
Association • Interagency Bystander
• International Association of Workgroup team leaders
• American Trauma Society
Fire Chiefs • Federal invitees

Building Equipment Capabilities hospitals, schools, theaters, sports venues, transporta-
Immediate responders need to recognize that applying tion centers (such as airports, bus depots, and train sta-
pressure to a bleeding vessel is the appropriate first ac- tions), and facilities with limited or delayed access. All
tion to take and that their hands are a first-line resource. hemostatic dressings and tourniquets must be clinically
In most cases, control of external hemorrhage can be effective as documented by valid scientific data. The
accomplished by applying direct pressure on the bleed- Tactical Combat Casualty Care guidelines for the U.S.
ing vessel. military contain objective evidence to support the safety
and efficacy of the various options for tourniquets and
Hemostatic dressings and tourniquets may be needed to hemostatic dressings.
effectively stop bleeding. For this reason, the Hartford
Consensus recommends that all police officers and any Contents of the bleeding control bags should include the
concerned citizens carry a hemostatic dressing, a tour- following:
niquet, and gloves. This guideline should also apply to
all EMS/fire/rescue personnel. Ground and air medical • Pressure bandages
transport vehicles should carry multiple dressings and • Safe and effective hemostatic dressings
tourniquets based upon local need. In addition, bleeding • Effective tourniquets
control bags should be accessible in public places as de- • Personal protective gloves
termined by a local needs assessment. Potential sites for
bleeding control bags include shopping malls, museums, Placement of bleeding control bags should be as follows:

140 Journal of Special Operations Medicine Volume 15, Edition 4/Winter 2015