New turn in first response saves lives
Almost two weeks ago in Anchor Point, a man accidentally shot himself. According to the Alaska State Troopers, he was found in a pool of blood. But he survived, largely because of specialized training the responding troopers recently received from the Alaska Department of Health and Social Services.
“Troopers were there first, recognized the man was going into shock … major hemorrhage. And immediately got a tourniquet, and are really credited with saving his life," said Todd LeCours, a trainer with DHSS. “The man ended up coming to Anchorage, getting some care here and going on to Seattle. And all the way through, the tourniquet’s what really saved his life.”
The use of tourniquets has evolved in recent years from what used to be taught in first aid courses and the Boy Scouts. LeCours says the change was the result of lessons learned by battlefield medics.
“Of the last, of course, the 15 years we’ve been at war in the Middle East, there have been some valuable lessons learned, specifically with regards to extremity hemorrhage — bleeding out from an extremity trauma," he said. "And we learned that tourniquets work, and that tourniquets should not be a last-resort type of choice, but should be moved up very, very quickly, and should be actually be one of the first choices in stopping major hemorrhage.”
LeCours says that the “airway, breathing, circulation,” or ABCs of first-aid response are still important, but that a patient can die of blood loss much quicker than from lack of oxygen.
After the American College of Surgeons issued guidance and recommendations regarding the use of tourniquets, the state of Alaska started offering training.
“It just kind of spread like wildfire," LeCours said. "We have done everything from law enforcement groups, the troopers, the municipal police departments — Kenai, Soldotna as well as even small civic groups — the Nikiski Gun Club is another great example of where the potential is higher for traumatic injury and bleeding.”
LeCours says that if you learned, perhaps in a first aid class, that tourniquets need to be loosened periodically, that guidance is also no longer valid.
“The thinking now is to save every red blood cell you can and allow that clot to form. And then not loosen it until they’re in a place where the surgeon can go in and fix the compromise, fix the tear in the open vessel, or they at least have blood replacement products available," LeCours said. "So, no, we don’t loosen tourniquets any longer. Keep them on and keep them on the entire way, until they get to definitive care.”
The bleeding control, or B-Con, training LeCours conducts is funded through a federal grant, as are the commercial tourniquets he distributes to groups he addresses. You can find more information on the Alaska Department of Health and Social Services’ trauma system web site.