Stanch the Flow

Stop Bleeding, Bind Broken Bones

Medical Response in Churches

Tying fabric around an arm to stop bleeding

For the life of every creature is its blood: its blood is its life. ~ Leviticus 17:14

… and the blood of the wound flowed into the bottom of the chariot. ~ 1 Kings 22:35

And immediately the flow of blood dried up, ~ Mark 5:29

Eli fell over backward from his seat by the side of the gate, and his neck was broken ... ~ 1 Samuel 4:18

He heals the brokenhearted and binds up their wounds.. ~ Psalm 147:3


Trauma BBB

"BBB" is commonly recognized by the public as standing for the Better Business Bureau. But for us in this article, it will be the Bleeding and Broken Bones of trauma (severe injuries), whether accidental or intentional.

For safety and security ministries in our churches, these BBB injuries are safety concerns. Whether someone falls, is hit by a vehicle or falling objects, or is shot, knifed, or clubbed by an assailant, severe injuries need immediate attention, especially those with serious bleeding and fractures (or likely fractures) to the skull, neck, back, hip, or thigh.

This is when First Aid is most critical. Everyone on the safety team, as well as leaders of kinesthetic activities (such as sports and hiking), should know how to stop bleeding, immobilize broken bones, and avoid further injury, critically when dealing with possible spinal or cranial fractures, and to a lesser degree with pelvic and femoral fractures.

It's Critical to Stop Bleeding

There is a continuum in severity of bleeding. This ranges from some blood oozing from abrasions (skin scrapes) to the uncontrollable flow from a ruptured or severed major artery. For an abrasion, the primary concern is cleaning the wound. For minor cuts, stopping bleeding is relatively easy. For major cuts, tears, and punctures, it is more challenging and more critical, because the injured person can bleed to death.

The Hartford Consensus

The American College of Surgeons convened a meeting of medical groups, law enforcement agencies, the military, and government security agencies in Hartford, Connecticut. This was in response to an increase of intentional mass casualty events (such as mass shootings) and their rising severity. Their conclusion stated in part:

The overarching principle of the Hartford Consensus is that no one should die from uncontrolled bleeding. The Hartford Consensus recommends that all citizens learn to stop bleeding.[1]

How to Stop Bleeding

Since ancient times, there have been ways to stop bleeding. The Roman army had medics who traveled with the soldiers. They were trained in treating wounds and some common illnesses. Among their skills, they could stop bleeding. Thanks to them, many wounded Roman soldiers lived to fight another day. Over time these techniques have been refined to the methods we use today.

Instructions for stopping bleeding are taught by the Red Cross, Boy Scouts, and Girl Scouts. They are also part of the training curriculum for law enforcement officers, the military, firefighters, and medical professionals. Several organizations - such as BleedingControl.Org [1], Mayo Clinic[2], Harvard Medical School[3], Health Line[4], Medical News Today[6], WebMD[7], and others - publish bleeding control methods online.

Before starting, see what kinds of injuries the person has:

  1. How severe are they? If too severe, call for help so it's on the way while you start.
  2. Are there any embedded objects? Don't try to remove them - it may cause further injury.

The two universally recognized methods for stopping bleeding are (1) Apply Pressure, and (2) Raise the Area (if on a limb). These are followed by (3) Cleanse, (4) Protect, and (5) Call for Help. In the following instructions, the injury is called a "wound" whether a cut, tear, or puncture.

Apply Pressure

This is the oldest technique to stop bleeding, and still the most effective.

  1. Make a pad of clean cloth.
  2. Press down on the wound to block the outflow of blood, and press down upstream of the wound to pinch the blood vessel supplying the blood.
  3. If the pad becomes soaked, put another pad on top and continue to apply pressure.
  4. Continue until bleeding has stopped.
  5. Do not pull the pad up to check the bleeding, since this will remove any blood that has clotted. It is the clotted blood that will seal the wound.
  6. Extreme bleeding may require the use of a tourniquet upstream of the wound. This compresses the blood vessels enough to reduce blood pressure in the wound so bleeding can be stopped. Work quickly in cleaning and packing the wound so the tourniquet is not on too long.

Raise the Area

If the wound is on a limb, raise the limb higher than the heart to reduce blood pressure. If the limb is a leg, the patient should be lying supine (on the back). Hold or prop up the leg until bleeding has been stopped.

Cleanse

A wound needs to be cleansed to prevent infection, but only after bleeding stops. In Jesus' parable, the Good Samaritan cleansed the wounds of the man who'd been robbed (Luke 10:34).

  1. An abrasion can usually be cleaned fairly early.
  2. Bleeding washes loose matter out from inside of a cut, but other material may remain from the cutting agent.
  3. Puncture wounds are more serious because they are difficult to clean, and unsanitary matter can be trapped inside.
  4. Use liquid soap or cleansers that are both antiseptic (germ killing) and astringent (shrink tissues in the wound). If soap is used, rinse it out of the wound when done.
  5. Avoid using iodine of hydrogen peroxide. These can damage the tissues. They're acceptable for sterilizing unbroken skin before an invasive procedure.

Protect

After cleansing, cover (bandage) the wound with sterile cloth or gauze. Tie or tape the packing so it stays in place. Don't tie too tightly. The Good Samaritan bound (bandaged) the robbery victim's wounds.

Call for Help

Call for medical help (911) if

  1. The wound is deep,
  2. Blood spurts out,
  3. Bleeding cannot be stopped within 15-20 minutes,
  4. The wound is on the face, or a severe cut is on the head - a head injury may also include a concussion, and if severe may cause a cranial hemorrhage,
  5. Blood pools on the floor or ground and/or clothing is soaked with blood, indicating too much blood has already been lost (King Ahab bled to death in his chariot),
  6. The patient is unconscious or delirious,
  7. There may be internal bleeding,
  8. This is a bite by a human or an animal.

The patient should be taken to a doctor if

  1. Stitches are needed,
  2. The wound cannot be cleaned,
  3. The wound appears to be infected,
  4. The wound is deep or a puncture and the patient has not had a tetanus shot in five years.

Responding to Broken Bones

When a bone is broken, the first concern is to not flex the break. Leave setting the bone to the doctor, who is equipped and trained for that. The best we can do is to insure that the broken bone is immobilized to prevent further damage. This may be done by splinting - binding a stiff object (metal or wooden rod) to the limb that is broken. A broken finger may be taped to an adjacent finger.

Some fractures are of special concern.

  1. A skull fracture indicates probable brain injury, and poses the risk of additional injury if pressed upon.
  2. Spinal fractures carry the risk of injury to the spinal cord and/or nerves exiting the spinal column. Care must be taken, since these injuries can lead to paralysis.
  3. Depending on the nature of the break, bone protruding inward from a hip fracture could possibly injure organs in the pelvic area, though this is not common.
  4. A sharp end of a fracture of the femur (thigh bone) on the inside (toward between the legs) has the potential of penetrating the femoral artery. Also, splinting a broken femur risks stopping circulation in the leg if too tight.

These fractures require special care to avoid additional injury. They also require emergency medical care. Call 911.

Summation

As members of safety ministries in our churches, we must be prepared to treat injuries, whether accidental or intentional, following the example of our Lord, as foretold in Psalm 147:3 - "He heals the brokenhearted and binds up their wounds."

Every member of the safety team should learn BBB response, especially how to control bleeding. Ideally, this should be taught not only safety ministry personnel, but as many church members as possible. Besides instruction, there should be practice.

Resources

Sheepdog Church Security Online Training https://sheepdog-church-security.thinkific.com/collections

- "Church Safety and Security Volunteer Academy" https://sheepdog-church-security.thinkific.com/courses/church-safety-and-security-volunteer-academy

Hear Kris and Ron discuss the subject of this article on the podcast: https://soundcloud.com/churchsecurityrollcall.