SEAL Survival Guide (76 page)

You can usually detect if there is major bleeding by color, since bright red, spurting bloods comes from arterial wounds, while a darker red bleeding is usually venous, or from smaller veins. Arteries are larger and are a source from which a lot of blood can be lost quickly, causing sudden death. You must be calm and unhesitating. Once you find the source of the bleeding, place your fingers or hand on the wound to apply direct pressure, which frequently helps to stop the more rapid loss of blood. If bleeding continues, and you do not suspect a fracture or a broken bone at the wound area, then try to elevate the arm or leg, for instance, above the level of the heart, while continuing to apply direct pressure.

Dressing the Wound

As soon as bleeding subsides, try to wrap and cover the wound with what’s called a
field dressing,
such as gauze or bandaging. Utilize the dressing to apply continuous pressure to the source of bleeding, wrapping
it tightly. If no sterilized field dressing is available, use the cleanest cloth on hand. At this point, the bleeding must be stopped, so use homemade bandages made from T-shirts, socks, or any other garment within reach.

• 
Field dressing
is what’s applied directly to the wound to control and stop bleeding.

• 
Pressure dressing
is added and put over the wound and wrapped very tightly, even using a knot above the wound to create additional pressure on the dressing.

Once you have good pressure applied to the wound, keep it in place and monitor it. The moment it becomes soaked with blood, apply new dressings directly over the old dressings. Remember, the less a bleeding wound is touched and disturbed, the quicker the natural coagulants will have a chance to kick in and help to quell the blood flow.

If all this fails to control bleeding, then work on identifying a nearby
pressure point.
For wounds on arms or hands, pressure points are located on the inside of the wrist, the place where you’ve seen doctors and nurses feeling for a pulse by using their fingers. Another pressure point is on the inside of the upper arm (called a brachial artery). For wounds of the legs, the pressure point is near the crease of the groin (called a femoral artery). Try to apply pressure to these areas.

Lastly, if there is broken glass, for example, or something impaled in the wound, and the object is sticking out, don’t at first try to remove it in the field. Instead, stabilize the object with bulky dressing made from the cleanest material available. If possible, try to keep the limb that is bleeding elevated. Sometimes, pulling out the impaled object will make the wound larger, and the first course of action is to control blood loss.

When a Tourniquet Is Needed

If none of this works, you then need to resort to fashioning a
tourniquet,
defined as any device that can be twisted and constricted tightly around a limb and above the wound to cut off the blood flow to the area. It can be placed around an upper arm or thigh and then tightened to stop the flow of blood.

With one exception, a tourniquet should be used as a
last resort,
when all other methods have failed, as it stops circulation and, if improperly applied, could kill a person. However, if there is an
amputation
or a loss of any part of the upper arm, forearm, thigh, or lower leg, then a tourniquet is the first course of action and essential. Apply a tourniquet to an amputated limb before attempting to use field or pressure dressings. Incredibly, I’ve seen that when there is nothing but a stump left for a leg, it oftentimes shows very little bleeding. Nevertheless, apply a tourniquet above the area first and foremost.

Do not
apply a tourniquet if there is an amputation to only part of a hand or part of a foot, as this could adversely affect the remaining fingers or toes and cause all the otherwise healthy digits to get cut off from circulation, killing the cells in these areas. Use only a pressure dressing to control bleeding for these types of wounds.

MAKE A TOURNIQUET

Ideally, tourniquet bands will be made from a cloth or flexible material, cut into two-inch-wide strips. Many other things can operate as tourniquets—belts, ties, headbands, waistbands, towels, duffel bag
straps, or dress socks. Keep your wits and improvise with what is at hand.
Do not
use thin wires, electric cords, or shoestrings as tourniquet bands, as these will cut into the flesh.

For best results, apply regulated pressure, wrapping the cloth around a stick and twisting until tight. Also, try to find something to serve as padding to place between the limb and the tourniquet band. Sometimes you can just use the casualty’s shirtsleeve, their trouser leg, or the part of the clothing you removed to see the wound.