When you learn the ABC’s of first aid, there’s usually an “X” before the “A.” The A stands for airway, which you need to check quickly. Then comes B for breathing, and then C for circulation. But before you start with the A, you’ll check for X—this stands for “exsanguinating hemorrhage”, which is blood loss on a massive scale. Deep cuts, gunshot wounds, and many other forms of trauma can create severe blood loss which could kill a person in a minute or two if unchecked. The average adult has about five liters of blood in their entire body. If a person loses one or two liters, they are at risk for numerous issues, but they’re still likely to survive. Losing more than that amount, however, is usually life-threatening. Since the human heart pumps several liters per minute, if the right artery is opened, death can come fast if we don’t catch the bleed quickly. An exsanguinating hemorrhage can kill in mere minutes. But by quickly responding with the proper bleeding control techniques, it’s possible to save a life. Study up on these three techniques, buy a tourniquet and practice with it (not using full pressure), and make sure you have the medical supplies to handle this life-or-death injury.
Direct Pressure: Sometimes, your first instinct is the right move. When you see a heavily bleeding wound on yourself or someone else, use a large dressing (or bare hand, if need be), and apply heavy pressure to the wound. It’s best if there is a dressing over the wound, one that can be constricted such as an Israeli bandage. It’s also helpful to elevate the wound.
Tourniquet: When direct pressure isn’t working or you have a wound that is literally squirting blood, it’s time for a tourniquet. Apply the tourniquet as high on the limb as possible, and crank down hard enough to stop the blood flow and eliminate the pulse on that limb, no matter how much the victim screams (tourniquet use is very painful). Write down the time you applied the tourniquet, and rush them to modern medical care. Never remove a tourniquet in the field, unless you are days away from medical care. In that rare situation, and only if you think you have controlled the bleeding, release the tourniquet after one hour, and very slowly—one turn per minute over a five-minute period. Never release it after two hours, as toxins may have built up in a limb without blood flow, and releasing them by restarting circulation can be fatal.
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