Dr. Slishman’s perspectives on bleeding, bleeding control devices, and the Slishman Pressure Wrap “Why?”
After many wars, and plenty of mass shootings, one of the few silver linings is that we have learned some things about helping injured people to survive. When I started my emergency medicine residency, the ABCs (airway, breathing, circulation) were never questioned. Now we acknowledge that aerating blood free lungs is pointless.
The acronym “MARCH” stands for Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia and is being used more and more frequently nowadays, with heavy emphasis placed on the “M”. If massive hemorrhage isn’t addressed quickly, it’s hard moving to “A.” The emphasis on rapid bleeding control has led to development of a wide variety of devices, hemostatic agents, infusions and techniques, along with numerous simulation devices and “Stop-the-Bleed” trainings.
When considering which of these innovations to adopt, it is useful to consider vantage points. If you are a general watching from your horse on a hilltop, a medic saving lives under fire, a foot solider on the frontlines, a civilian police officer, a teacher or a student in a classroom, your calamity preparation choices may differ. Costs and opportunity costs, along with probabilities Vs. possibilities should be considered. The best ways to stop bleeding in civilian settings like malls, schools or airports may differ from those used on battlefields.