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In June 2017, a group of congressmen were practicing for the annual Congressional Baseball Game when gunshots erupted. Quickly after the shooting began, House Majority Whip Steve Scalise was shot. Fellow Congressman Brad Wenstrup immediately worked to stop the bleeding from Scalise’s wound by using a tourniquet, a method of cutting off the blood supply to an injury.
“The tourniquet he applied, many will tell you, saved my life so I could actually make it to the hospital in time with all the blood loss,” Scalise said.
Congressman Scalise was fortunate to have Wenstrup nearby, a former military physician and Army Ranger. But many individuals are not as lucky. Because they often cause intense bleeding, trauma-related injuries, from gunshots and stab wounds to car accidents and falls, are the most common cause of death in the United States for people under the age of forty-five. However, some of these deaths can be prevented, thanks to the tourniquet, which doesn’t require a medical degree or military experience.
The tourniquet’s impact was seen during the Boston Marathon bombing in 2013, where three people died and over 280 were injured. The local trauma centers sprang into action, and there was not a single death among victims who arrived at the hospital alive. Of those patients, 31 had life-threatening bleeding- 26 had tourniquets placed before arriving at the hospital.
The widespread use of a simple tourniquet is a relatively recent development. Before the wars in Iraq and Afghanistan, tourniquets were not commonly used in the military; they were seen as a last resort. With the creation of a more effective tourniquet, the military’s reevaluation in how they were used, and improvements in their ability to evacuate injured soldiers from the battlefield, tourniquets emerged as a valuable military tool.
Medical personnel use the acronym MARCH (Massive hemorrhage, Airway, Respiratory support, Circulation, Hypothermia) to prioritize care in a severe trauma patient; simply put, their first priority is to stop any major bleeding. The circulatory system is like a network of pipes, and just like a leak in the pipes needs to be stopped, so too does bleeding.
Each part of the body is supplied by a network of blood vessels that carries blood back and forth to the heart. When someone applies a tourniquet, they are stopping the flow of blood to an injury by physically squeezing the blood vessels that lead to it. For example, one could stop the bleeding in the arm or leg by applying a tourniquet on that limb, right above the injury. This simple device can be applied in seconds, almost like a buckle. In fact, when Congressman Scalise was shot, Congressman Wenstrup did not even need a formal tourniquet; he used a belt he had on the baseball field.
Significant technological progress has been made in military trauma care over the decades. However, many surgeons say that one of the most critical advances in trauma care is still the basic tourniquet. Today, the individual first aid kit that every soldsier carries includes a tourniquet. Although tourniquets are not a long-term solution, they can help injured patients to survive the “golden hour”- the hour of time following an injury when medical treatment is most likely to be successful. If an injured service member can survive long enough to reach a combat hospital with a heartbeat, they have up to a 98% chance of survival. This is similar in the civilian world, where surviving until arrival at a Level 1 trauma center results in a 95% chance of survival.
Modern tourniquets have become a staple of not only deployed military personnel, but of police officers, paramedics, and trauma centers across America. Their benefits have not been limited to high profile incidents like the Boston Marathon bombing or the shooting at the Congressional Baseball Game. Tourniquets have been saving the lives and limbs of patients across the country who are injured in motor vehicle accidents or violent crime.
Due to the frequency of traumatic injuries and the effectiveness of tourniquets, the Department of Homeland Security has organized a program called Stop the Bleed. Stop the Bleed teaches everyday Americans how to use a tourniquet in an emergency. Some states have even passed laws requiring that “Stop the Bleed kits” be kept in public places. Just like with CPR, you can get trained to apply a tourniquet and potentially save a life in just a few hours in your hometown.
There are very few actions that a person can take which could immediately save another person’s life. Although we all hope that the need never arises, applying a tourniquet is one of those actions.
Sign up today to get trained in the Stop the Bleed Campaign!
Will Cohen is a 4th-year student at the University of Chicago, majoring in Biology. He will be attending medical school next year.