Kevin A. Roberts
I’m sitting in what is perhaps the most diverse classroom in St. Louis. My fellow classmates are all different ages—I’m next to a young couple with a 1-year-old—and races. But we’re not meeting at a university. I’m at the Delmar Divine, where a group of 40 people have signed up for free Stop the Bleed and Community First Responder training, hosted by The T, a nonprofit that offers services related to bullet injuries and overdose.
It’s been two weeks since the shooting at Central Visual and Performing Arts High School and Collegiate School of Medicine and Bioscience in South City. Firearms are now the leading cause of death in children, and uncontrolled bleeding is the No. 1 cause of preventable death from trauma. Because so many people enrolled in the class, we’ve had to move to the bigger space at the Delmar Divine. A sad realization motivated me to sign up for Stop the Bleed training: My 3-year-old has had more intruder training than I have, and in the event of a shooting, stabbing, or even a car accident that causes severe bleeding, I wouldn’t know what to do to help someone.
Dr. LJ Punch is leading the training and poses a question: What would we do if someone with a gun entered the room, shot one of us, and fled? I panic because of my aforementioned cluelessness, but the overachievers in the class leap into action. They shout: “Call 911!” “Pack the wound!” These are good answers, and they’re what we should do, sure. But what’s more likely to happen? Punch cues some music, and the disco song “Le Freak” by Chic starts playing. Ahhhhhhhh, freak out! Punch starts grooving. My mood lifts from total despair—the room feels a little lighter. And, yes, I agree, I would absolutely freak out and freeze in panic if that happened for real. But now Punch is going to train me so that it hopefully doesn’t happen.
Stop the Bleed training was created in the aftermath of the 2012 Sandy Hook Elementary School shooting in Connecticut that left 26 children and staff dead. A local trauma surgeon convened a panel of experts—other trauma surgeons; leaders from law enforcement, fire, and EMS circles; higher-ups in the military—to wrestle with the question: What can we do so that fewer people die in mass casualty events?
The experts took an interest in a 2011 study done in the military: After tourniquet use on battlefields expanded in 2005 and 2006, researchers found that “potentially preventable deaths from extremity hemorrhage” decreased by 67 percent. The experts decided that more could be done to train people, including the public, on how to treat life-threatening bleeding. So just as CPR training, which exploded in the 1960s and ’70s, taught ordinary Joes what to do if someone goes into cardiac arrest or stops breathing, the experts decided that the public could benefit from training in what to do in an emergency when someone is losing a lot of blood. But Stop the Bleed faces a challenge similar to the one CPR faced: In the U.S., only about 1 million people have gone through Stop the Bleed training. COVID-19 stalled its progress, which local educators are hoping to jump-start. So far, 10,000 St. Louisans have completed Stop the Bleed training.
A WOUND ON THE CHEST OR BELLY? THE BEST TREATMENT IS GASOLINE, PUNCH SAYS. DRIVE FAST.
Stop the Bleed doesn’t ask bystanders to do anything that would put their lives in danger; in fact, one of the most important points that the program makes is that you need to ensure your own safety before you can help someone else. You can’t put on a tourniquet if you’re injured (or worse). So back to Punch’s original question. What is the first thing you should do in case of a bleeding emergency? Make sure you’re out of harm’s way and take a big breath, which resets your parasympathetic nervous system and signals your body to calm down.
For the next two hours, we’ll learn even more about anatomy (the average human body has about three 2-liter containers worth of blood, for instance, which I didn’t know and makes me feel a little lightheaded) and how to treat bleeding on different parts of the body. An injury to someone’s arm or leg is easy—you can apply a tourniquet; those appendages are compressible. A wound on the chest or belly? The best treatment is gasoline, Punch says. We must look confused. Punch pretends to press down on a car’s accelerator. Oh, drive fast. We get it now.
A wound on someone’s neck, armpit, or groin? “Definitely don’t put a tourniquet around someone’s neck,” I type in a note on my phone. For bleeding in those areas, you’ll want to pack the wound with gauze or something gauze-adjacent (a T-shirt, a dirty sock, as long as it’s dry…you can treat an infection later) and apply direct pressure. On our desks are slices of pool noodles about 6 inches long. Each has a different size “wound”—either a slit or a crater in the foam—outlined in red painter’s tape. We each grab a pool noodle and practice packing, taking one end of a roll of gauze and feeding it into the wound, the goal being to reach the base of the wound to stimulate clotting. Then, we stand up, place one hand over the other, and touch the wound with our fingertips—not our palms—applying direct pressure.
Now it’s time to practice the tourniquet, and Punch leads us through the 4-T approach. First, we loop the Velcro around our pool noodles and pull it tight. Next, we grab the plastic rod on the tourniquet and turn it as far as it will go. If we were in a real emergency, this is the point at which the bleeding would hopefully slow down and stop. We tuck the rod into the tourniquet’s C clip and fold over a strap that has “TIME” written on it. It’s important to note when the tourniquet is applied, but, if this were real life, we’d mark the time and then hopefully EMS would arrive, or we would be booking it to a hospital.
That last point is important, Punch says. One study out of Florida showed that after 10 minutes, for every minute an injured and bleeding person is delayed getting to the operating room, the chances of dying increased by 4 percent.
The most difficult part of this training, I realize, is learning to make a decision—and doing so quickly.
For more about Stop the Bleed training and The T, visit thetstl.com.
