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How to stop bleeding in the event of a mass casualty incident

Hartford — In Las Vegas, after a gunman carried out a 10-minute shooting spree on thousands of concert-goers at an outdoor country music festival, bystanders stepped into action, applying pressure to gunshot wounds and turning trucks into makeshift ambulances.

With mass shootings on the rise, there's a nationwide effort to make bleeding control kits more widely available — in places such as sports stadiums, malls, airports and schools. A Connecticut trauma surgeon is pushing for car manufacturers to include these kits in every new car. And U.S. Sen. Richard Blumenthal, D-Conn., said he plans to introduce legislation related to the proposal.

These easy-to-use kits, which include tourniquets, bandages, hemostatic dressing designed to stop bleeding, and protective gloves, can help save lives following a mass shooting or other kind of trauma event that causes severe bleeding.

"The goal is to keep blood inside the body and, if you can do that and get a patient to hospital, they have a very high likelihood of living," said Dr. Lenworth M. Jacobs, a trauma surgeon and director of the trauma institute at Hartford Hospital.

Following the Boston Marathon shooting, everyone injured in the attack who made it to the hospital alive survived, he pointed out.

Jacobs helped to develop a national model for increasing survivability following mass casualties driven by the 2012 mass shooting at Sandy Hook Elementary in Newtown.

In these situations, the first 10 minutes are crucial, and "in that time, the person that will be able to help you is next to you," Jacobs said.

In active shooter situations, emergency medical personnel may not have immediate access to the scene, and it takes several minutes for law enforcement to respond, and their first priority is securing the scene, he added.

To stop severe bleeding, you must first expose the skin so you can clearly see the wound. Using one or both of your hands, or even your knee, place dressing or clothing on top of the wound and apply direct pressure. Use gloves, if available, to protect yourself from the blood.

If the wound is large or deep, you can pack it with dressing or clothing and continue to apply steady pressure.

In the case of an arm or leg injury, wrap a tourniquet a few inches above the bleeding site and tighten until the bleeding stops. A second tourniquet can be placed above the first one, if bleeding persists. Make note of the time the tourniquet was put on, as they should be taken off within an hour or a little longer, Jacobs said. That will help hospital personnel identify whose tourniquet needs to be taken off first.

Throughout the process, the bystander should be communicating with the wounded.

"You're not treating a wound. You're treating a patient," Jacobs said, explaining that the bystander should let the wounded know that "this is going to hurt, but it's going to stop the bleeding."

With proper training and practice and with bleeding control kits more readily available, the public will feel empowered to take action, he said.

"If we can get a citizenry, which instead of calling 911 and watching you bleed to death, is calling 911 and jumping in to do these things that we're demonstrating, it will save lives, and they will feel better about themselves," Jacobs said.

Blumenthal, who went through bleeding control training at Hartford Hospital Tuesday, agreed.

"In everyday real life, it has meaning," he said.

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