Leaky People: Patch, Wrap, Wait, or Yes?

It all depends on where, what else, and what else is leaking. One of the first things that any First Aid or bleeding control instructor, or other emergency situation instructor, will tell you is that you need to take a deep breath and evaluate the site. Slow down. It’s like firearms – slow is smooth, smooth is fast. If you go rushing into a situation and become a second victim, no one gets helped. Is there a live power line? Is the shooting still in progress? Is there green (or reddish orange brown) air in the room? Don’t do it! Look for Plan B, or observe and call for help and give calm information to the dispatcher.

If you don’t have training, and/or you don’t know what else to do, see about moving bystanders to a safer, quieter place. Call for help, relay what you see as best you can, and get others well clear. If bad people set up the initial problem, they may have delay-action nasty stuff waiting. Move people away, because you might prevent even more people from getting hurt. Ditto if you see green/red/brown/black air coming from where the initial problem started.

Then comes the evaluation of the leaky person. Where are they leaking from? No, you cannot use a tourniquet on someone’s neck, no matter how tempting it might be. Arms and legs, yes. Torso? Good luck finding a place where you can clamp the punctured blood vessel against a bone to stop blood flow. So you can use a tourniquet on an arm or leg, pack and/or apply pressure on the shoulder, hip, or other area like that, and use a chest seal on the torso. The class or instructor goes through how do to those with either a “real” tourniquet like a CAT-5 or other brand, or a pressure band like a SWAT-T. If you are dealing with a child, you’re not going to find a tourniquet small enough in most first-aid kits or field emergency kits. That also applies to small or frail older people.

It’s going to be messy, no matter what’s going on. If there’s a bullet entry point (or shrapnel from an explosion of some kind), there might be an exit would. You have to deal with both. There’s going to be blood, messy clothes, possibly other stuff to deal with. You might have people losing their cool, or trying to take pictures, or just freezing. You night need a second set of hands, or several really big people to hold down someone while you try to slow or stop the leaks.

And you need to act quickly, if you can. The class started with a video of a 20-something guy in Pakistan who “fooled around” and tried to start a monkey dance with some cops or paramilitary guys (there’s a lot of overlap in that part of the world.). He “found out” the hard way and got shot in the leg, femoral artery. One minute and a few seconds later, he was close to dead. He had a large leak from a relatively small bullet (7.62 the instructor said.) Time really is of the essence when people leak profusely.

I learned a great deal, and it confirmed the importance of mindset, at least for me. I tend to game through things in my head. I’ve added “messy and chaotic” to my mental run-through. How will I deal with people who are losing their cool as I’m trying to keep mine while dealing with problems? Who in my daily round could I call on for a second set of hands, if needed? If other people have the scene, how would I move a group away, calmly, and try to keep them from having breakdowns all over the place?

I suspect a lot of it comes down to me being calm and organized. Sort of like horses. A horse thinks, “Oh, the predator on my back is tense. I need to freak the heck out right now!” And does so. If the adult-types stay calm and start dealing with matters, then other people will stay calmer. Because no group of people will all stay mellow if there is blood and stuff all over the floor. (If they do, I should probably worry about something else, because that’s NOT normal behavior for most ordinary teens and adults.)

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