Howie Mell – How to Stop Bleeding Without a Hospital
Summary by: Rosy Wang
Howie shows us the tools in his toolkit:
– Tourniquets save lives and do not cause limb ischaemia. The aorta is clamped for many hours in cardiac surgery. Data from the battlefield showed that in >800 cases where tourniquets were applied, there were 3 adverse outcomes (loss of sensation in the distal fingertips).
– Haemorrhage control (Israeli) bandages are tourniquets with a haemostatic agent that can be applied to a bleeding wound
– QuickClot (haemostatic powder) can be used for abdominal wounds but may draw the ire of surgeons because they cause an exothermic reaction that burns surrounding tissue
Howie emphasises that not all bleeding have to be stopped – if it’s not pouring out, it can wait. He teaches us to quantify blood loss in the field – three 335 mL cans of soda worth is when to start worrying.
The talk ends with an interesting mini Q&A session as trauma surgeons and paediatricians also weigh into the debate.