Tincture of Benzoin and Butterfly Strips!
This is what we teach our CERTs on bleeding injuries:
Trauma is the leading cause of death for persons aged 1-44 and causes more deaths annually in the U.S. than all diseases combined. The average EMS response time from report of injury to EMS arrival on the scene is 6-8 minutes; average on-scene treatment time is 30-40 minutes, and average transport time to hospital is 8-10 minutes.
Death from trauma:
Phase 1 minutes, irrepairable damage to vital organs
Phase 2 hours, crush injuries, rapid bleed-out from internal injuries,
Phase 3 days, systematic organ failure from injury-caused infections
Bleeding injuries and Shock - the "Killers"
Rapid loss of perfusion: - Blanch test nail bed > 2 secs.
Head or spinal cord injury causes blood vessel dilation drops BP
Chest injuries
Major bleeds
Abdominal injuries
Handle GENTLY, elevate feet, keep warm, direct pressure, pressure point
Prevent secondary infection, irrigate only, apply dressing, bandage
The FDA approved Emergency Bandage is designed to staunch blood flow from traumatic hemorrhagic wounds in pre-hospital emergency situations.
It consolidates primary dressing, pressure applicators, secondary dressing and (if necessary) tourniquet, into one unit and is designed to be easily and quickly applied by non-medical personnel for immediate, accelerated hemorrhage control. See the URL:
Emergency Bandage - First Care Products
Do not attempt suturing an open wound unless you have been trained to do so and have actually practiced it. Good suturing is an acquired skill which requires practice and not easily done "on the fly" without having learned. Military field units no longer hand suture, but apply an aerosol wound gel and use a surgical "stapler" to close large lacerations. (
I have been trained by my doctor how to use a medical stapler, have used used one on myself, and also have the scars to show for it).
There are few lacerations which cannot be closed adequately with butterfly strips, after liberal application of tincture of benzoin around the wound edges, so that the adhesive tape will "stick." Avoid use of benzoin near the eyes!
Infection is always a risk in any field environment. So while you want to close gaping wounds, they must be able to drain and to be periodically irrigated and cleaned while they are healing.
If severe bleeding is an issue a pressure bandage handles most.
If you don't have the military issue wound compress in your CERT kit, carry sanitary napkins and duct tape you can improvise with.
Level III CERT personnel who have completed their training are issued military type wound compresses and Z-Medica First Response packets. These are a lifesaver.
Z-Medica which produces Quik-Clot sells only to trained medical personnel, because the material produces an exothermic reaction in the presence of moisture and some precautions are needed to prevent burns which could exaerbate the injury.
Online training for serving military personnel and first responders is available at the URL:
Welcome to Z-Medica Web Site
For product purchasing information go to the URL:
QuikClot - ON SALE
Celox is a UK-produced competitor product which is also FDA-approved, does not cause an exothermic reation, has no known side effects or allergic reactions, and is in current use by UK forces in Iraq and Afghanistan. It can be purchased at military exchanges or
Untitled Document without restriction. It requires no special training to use. Just pour it in, pack it, and apply pressure.
Celox