A number of medical emergencies can arise in a jail or prison. That is why it is handy to have health care staff available to respond and treat life threatening conditions. Depending on the location of the man-down, however, it may take a while for medical staff to arrive. So, it is important to know what to do in the early stages of any medical emergency. This is part of a series to help corrections officers manage medical emergencies until health staff arrive to provide definitive care. I made a list of the common emergencies officers may encounter in the course of a shift. In this installment I discuss bleeding.
Recent stories from Bibb County, AL, Philadelphia, PA, and Jackson County, FL confirm that stabbings are happening in correctional settings. So, consider this emergency situation:
While working a usual shift on the Special Needs Unit with your partner you see him gasp and slump to the floor in the midst of a walking round of the common area. There were several inmates milling about at the time. You sound a man-down alarm and quickly lockdown the unit before evaluating his injuries. Medical and security staff are on the way but you need to do something immediately. His upper right arm is spurting bright red blood and he looks barely conscious.
What is Going On
Your partner appears to have been stabbed. Since the blood is spurting rather than flowing or oozing and bright rather than dark red, this looks like a life-threatening arterial bleed. Arteries are located deeper in the body than veins and are thicker walled so this indicates a significant cut. Arterial, bright red, blood transports oxygen and nutrients around the body while venous, dark red, blood returns back toward the heart/lung mechanism to be re-oxygenated.
What to be Concerned About
Arterial bleeding is harder to control than venous bleeding. The heart is actively pumping the blood right out of the body, so you need to act fast to save a life. Your partner is losing consciousness which indicates that blood flow to the brain is already diminished. Your concern is to effectively stop the blood loss as soon as possible.
Actions Until Medical Arrives
Use what is available to stop the bleeding until equipment and assistance arrives.
- Find the cleanest cloth ‘bandage’ available and cover the wound. This may mean you have to rip your shirt or use a pocket handkerchief. If you absolutely have nothing in arm’s reach, use your hand, preferably after donning an exam glove. Stopping the bleeding is more important than a sterile bandage when treating a life-threatening arterial bleed.
- Use the palm of your strongest arm to place pressure on the bandage at the wound site. You don’t want to remove pressure until help arrives.
- If the weapon is still in the wound (like a shiv), do not take it out as this can increase the injury or open up more bleeding. Instead apply pressure slightly closer to the heart from the injury. In this case, it would be slightly above the injury on the arm. This compresses the artery between the heart and the injury to stop blood loss.
- If trained, authorized, and equipped, apply a commercial or improvised tourniquet to uncontrollable extremity bleeding. Apply the tourniquet high on the extremity, above the wound.
- Law enforcement and correctional officers are starting to carry or be supplied with tourniquets for use in the field. Here is some information about police use of tourniquets from Police1.com.
- Try to minimize movement of the injured extremity as you apply pressure and move the victim to help.
- If the victim is not lying down, try to get them into that position or a position of comfort.
Help from Other Officers
If other officers arrive before medical, here are a few additional interventions.
- Get more clean bandages to apply on top of the original material or to stabilize the impaled weapon.
- Obtain a blanket for the victim. Keeping warm is important when the body is in shock.
What to Do Before This Happens to You
If you work corrections, there is a very real possibility that you could be in this situation. Be prepared to save a life.
- Keep up-to-date on first aid training. The Bleeding Control or Law Enforcement First Response Tactical Casualty Care courses from Prehospital Trauma Life Support are well-suited to corrections officers.
- A clean handkerchief is a handy item to have on your person at all times.
- Know where your first aid kit is secured in all units where you may be called to assist in an emergency.
- If tourniquets are not available in your facility ask about making them available through the medical staff.
- Keep in practice in how to quickly secure the units in which you are assigned. The unit must be secured before life-saving medical attention can be initiated.
Have you had to deal with a major bleed while on duty? Share your experience in the comments section of this post.
