Reconsidering tourniquets.

Bystanders apply pressure to woman’s leg to stop bleeding after explosion at 117th Boston Marathon. Photo by John Tlumacki / Boston Globe via Getty Images.

Have you ever used a windlass tourniquet? I had never even heard of one until recently. The only tourniquets I knew were fashioned from belts, scarves, or neckties, and we were always admonished to use these sparingly, because it was thought that they could cause severe damage to a limb.

In “Leading the Effort to Promote Bleeding Control in Our Communities” in this month’s AJN, James Reed and Margaret Carman dispel myths about tourniquets and share the growing evidence for their safety.

They also introduce us to the Stop the Bleed campaign. Hemorrhage is the second-leading cause of death (head injury, the first) after a traumatic injury, and when an extremity is the source of bleeding, rapid tourniquet application saves lives.

“More than 50,000 casualties sustained in the wars in Central and Southwest Asia have provided evidence that recognizing hemorrhage and controlling it should be the highest priority in caring for an injured person. As with battlefield trauma, uncontrolled extremity hemorrhage is a significant cause of preventable death in civilian trauma.”

After the Sandy Hook Elementary School shooting in December 2012, a group of trauma experts came together to develop recommendations that could improve prehospital care in mass casualty incidents. This group, known as the Hartford Consensus, saw the need to support both traditional first responders and untrained laypersons.

Educating the public on simple steps to stop or slow bleeding.

Stop the Bleed grew out of Hartford’s recommendations. The campaign strives to empower the general public by raising awareness of the simple steps that can be taken to stop or slow life-threatening bleeding. In a bleeding emergency, first responders may not have quick access to the injured, and bystanders are sometimes the only lifesaving “personnel” who are immediately available.

This article is essential reading for all nurses. It also includes information on how to begin a Stop the Bleed campaign where you live.