EMS Protocol of the Week - Bleeding / Hemorrhage Control / Impaled Object (Adult and Pediatric)

For those of you who are still new to the splendor of these weekly emails, one recurring theme is that the EMS approach to trauma in NYC is all about ABCs and rapid transport to the appropriate hospital, often a trauma center. As such, most trauma jobs in the city can be performed at the BLS (EMT) level, with CFRs (FDNY firefighters) able to perform many (if not most) of the interventions.

This is well illustrated in the EMS protocol for bleeding, hemorrhage control, and impaled objects, where the bulk of care is in direct pressure (with hemostatic dressings, if available) and tourniquets (one initially for an uncontrolled bleed, with a second one that can be placed proximal to the first for continued bleeding). Note that, as per the Key Points section, tourniquets can also be used for bleeding dialysis access sites, if the bleed is life threatening and refractory to direct pressure. Impaled objects, briefly referenced, are to be left in place unless they are contributing to airway compromise.

That’s it! Stop the bleed! But don’t stop the learning! www.nycremsco.org or the protocol binder for more.

 Dave