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Saturday, September 10, 2016

A good overall look at the changes in immediate trauma care since 9/11

I've let my US News and World Report subscription lapse for multiple reasons, but I've been taking a look at them recently. I may have to drop a few bucks on them. Good article on how immediate trauma care has changed in the years since 9/11.

Better Training and Techniques Since 9/11 Save Lives

War abroad and carnage at home since 9/11 have taught Americans much about saving lives after violent tragedies. Whether they were hurt in mass shootings or gruesome car accidents, it's not uncommon for victims to bleed to death on the scene because trained assistance didn't arrive in time to help them.

But one of the most powerful initiatives in trauma care in the past 15 years might make a difference.

Across the country, a public safety campaign is underway to teach both first responders, such as police officers, and average citizens how to stop trauma victims from bleeding to death. United under the banner of a White House-led public safety campaign called "Stop The Bleed," federal agencies, major health care and law enforcement trade associations, local governments and some companies are backing the effort.

The national push for broader training is "a direct descendant of the 9/11 experience," said Oscar Guillamondegui, medical director of the trauma intensive care unit at the Vanderbilt University Medical Center.

Better medical supplies and devices – perfected under combat conditions by the military since 2001 – combined with a first-aid technique once done only in hospitals, are playing leading roles in helping grievously wounded people when time matters most.

Here are three 21st century advances that are making U.S. trauma care better:


Groups such as National Association of Emergency Medical Technicians and the American College of Surgeons make instructional materials available free online so qualified instructors can train police officers and the public in bleeding control. Trauma departments across the country are offering similar programs.

In Boston, trauma surgeons are instructing teachers at schools run by the Archdiocese of Boston how to stop bleeding. Cities also are teaching police officers how to apply tourniquets and arming them with bleeding control kits – more than 36,000 officers from Phoenix to Philadelphia had taken such training by 2014, according to the American College of Surgeons.

In Denver, at least six citizens and five police officers have been saved the past five years because officers at the scene were trained in bleeding control, said Dr. Peter Pons, an emergency physician who created that city's program. He is also professor emeritus at the School of Medicine at the University of Colorado.


Tourniquets were rarely used in civilian accident scenes even 10 years ago because it was assumed that applying one would lead to amputation of the injured arm or leg.

When a tourniquet did need to be applied, paramedics and emergency medical technicians often created their own, using triangular fabric bandages and other materials carried in their vehicles. While tourniquets could not have helped the many 9/11 victims who died when hijacked airplanes crashed into the Twin Towers and the Pentagon, their usefulness has been proven in other circumstances.

Today, commercially designed tourniquets, called combat tourniquets, can be found in nearly every ambulance and emergency response unit in the country, and that's due in part to years of successful military use in Iraq and Afghanistan...

And in my body armor pocket, and in my emergency bag (with a couple of tampons, don't laugh, they will stop blood dead!)

...Wound Packing

When a tourniquet can't be applied to staunch profuse bleeding – such as gunshot wounds in shoulders or chests – another technique comes into play. It's called wound packing – literally, stuffing a wound with gauze and applying pressure to keep blood in the victim's body. Traditionally, only physicians were taught this technique, according to Denver's Dr. Pons. Now, ambulance personnel all over the U.S. are using wound packing, aided by special gauze treated with chemicals that make blood clot faster.

These "hemostatic dressings," with names like Combat Gauze and QuickClot, were developed and originally used by the military.

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