Sadly, knife crime in the UK, seems to show no decrease and barely a day goes past without a stabbing incident being reported.
If a stabbing results in catastrophic bleed, it is highly likely that the victim will die if the bleeding isn’t stopped as a matter of urgency.
The barefoot first aider takes you through a scenario where a person has been stabbed.
Now over to Beefy the Barefoot First Aider.
“Here I was, minding my own business, walking down the high street when I hear some sort of commotion, some kids shouting, and I thought “handbags at dawn”!
One bloke legged it, between some shops; skinny geezer wearing a hoodie, and dark trousers.
The other geezer was walking a couple of paces backwards and forwards, side to side and starting at me. His mouth was moving but not talking and he was holding his stomach.
A girl shouted, “Oh my god, he’s been stabbed!”
This situation, this incident has suddenly become surreal, there’s a growing crowd of headless chickens and people using their phones to make video recordings.
I’m approaching this poor bloke and I’m fully aware that there is potential danger that I could be stabbed whilst helping him – how do I protect myself?
I’m also aware that at this moment in time if this bleeding isn’t stopped, he will die in a few minutes.
Blood on the floor always looks like loads but this guy is stood and trampling in his own blood and its pouring from his clothes.
“Has anyone called an ambulance?” I shout…The answer is ‘No’, nobody has and a couple of young men, in a menacing tone suggest “the Old Bill better not get involved”.
I feel vulnerable and in potential danger.
If I get stabbed, I can’t help him; and I don’t particularly want to get stabbed anyway!
Less than one minute has gone past.
If he loses two pints of blood, he’ll be on his way out. If he loses more that four pints he’ll be dead and that could be in as little as three minutes.
I’ve put my phone on hands-free and called 999, the ambulance call handler has assured me that she’ll stay on the line, direct and monitor the situation. Although I know what I need to do, it’s a good thing to have her listening in in case it all escalates.
I shout out “will any of you guys watch my back please whilst I help him, just give me the heads up if anyone gets too close” –
A few blokes have formed a protective human wall.
I feel safer now and need to reassure the victim that I’m on his side and I’m going to stay with him, and I’m going to help him the best I can.
He’s asked me if he’s going to die and I’ve told him he’d better not!
I’ve told him my name; he’s told me his and that he trusts me. This is important.
I need to get him to lay down, but don’t want him to panic. At the same time, I want to put pressure on his wound, but I need to assess the injury.
I shout out “girls, ladies, listen up! Who’s got any sanitary towels, panty liners – even baby’s nappies?”
I’ve got a few absorbent pads and I’m told the ambulance is local.
I’ve applied a pad on the would and applied pressure but being mindful that I need him to lay down I have asked him if he’s feel dizzy or faint. He admits he is and compliant with my request that he lays.
Three bystanders have assisted me in carefully placing him down.
Think, where can I get some clean linen? I’ve asked some bystanders to go into pubs and restaurants, even shops.
I have added a couple more absorbent pads to his stab would and I’m maintain pressure, people are now returning with clean linen and staff from these places are coming out with first aid kits but there’s nothing in those small boxes that will help this stab wound.
Simply by asking people to help, we have a community getting stuck in.
I’ve chosen nice clean white cotton linen and asked some bystanders to tear off pieces, then fold each piece.
I’m placing them on the wound and continue to apply pressure.
If I need more of my makeshift bandages, I’ll apply them without removing the first one.
A young lady has approached me and introduced herself as a nurse. Our victim slowly raises his hand to ‘high five’ her.
I’ve asked her to maintain pressure whilst I tear his T-shirt and expose his chest and belly to see if there are any more wounds.
I’m already thinking about holding the linen in place with strips of cloth. It even crossed my mind to use strips of duct tape to close the wound as close as possible to the original skin position, but the ambulance and police has arrived.
The victim is still alert, and I’ve left him with my best wishes.”
Two other considerations we need to look at:
The above scenario is a potted version of treating a stabbing without a first aid kit and covers dealing with stomach wound by applying direct pressure on the wound but there are different methods depending on the type of wound and place of wound.
Let’s say the stabbing or bleed is on the arm or leg.
It is important to note that there are older teachings that instruct first aiders to elevate the wound above the heart.
Gudelines were changed by the European Resuscitation Council (ERC) and elevation is no longer recommended for the treatment of bleeding. This is based on the fact that there is no evidence that it actually reduces bleeding.
On that note, indirect pressure is no longer recommended because there is no evidence that this helps control serious bleeding, but, direct pressure is recommended.
This means apply direct pressure immediately on the wound, anywhere other than directly on the wound is ‘indirect’ pressure and not recommended.
Whatever you use as an improvisation for bandages, (such as sanitary pads), do not remove the blood-soaked pad because you will disturb any blood clots that have started to form, these help stop the bleeding.
If blood does soak through, place another pad on top of the blood-soaked one and then continue applying direct pressure.
We’ll talk about improvised tourniquets in another part but need to stress here that tourniquets should only be used in cases of catastrophic bleeding when direct pressure does not control blood loss.
Reassuring and keeping the patient calm is important. Even making the patient comfortable helps. So, if possible, place a jacket, bag or backpack under the patient’s head.
Deploy bystanders, ask someone to sit with the person’s head in their lap and talk to him. It helps to soothe the patient and help them keep calm
Take nothing for granted
If a person is holding a particular place on their body, it doesn’t necessarily mean that it is the stab wound or indeed the only stab wound.
With this in mind, you should examine the patient in full to determine the extent of injuries.
Blood soaked trouser legs below the knee does not mean the injury is exactly there. It could mean there are other stab wounds and blood is dripping on other places. Clearly, damaged fabric could be an indication of a stabbing site but be mindful that brand-new jeans can be bought with rips and tears.
Examine the front AND back of the body.
You may feel uncomfortable when examining someone’s body, but it is a crucial action and there is no time for embarrassment.
You may even need to part the person’s clothing to properly identify the wound(s) and even expose parts of their body; it is a matter of life and death!.
If possible look for and identify all wounds before starting any treatment but, if you do notice a severe wound that needs urgent treatment, you should deal with this immediately.
What is a ‘severe’ wound?
A severe wound is when it is oozing with blood, bleeding steadily and profusely or one that it spurting out blood in a rythm. Spurting blood generally indicates that an artery has been cut.[/vc_column_text][vc_column_text]
It is not necessary to elevate the wound above the heart.
It is necessary to apply firm pressure with a cloth, such as sheet, towel, flannel, T-shirt, sock etc, directly on the wound.
Get help, and/or call 999/112.
Do not remove a pad if it is soaked through with blood because you will disturb any blood clots that have started to form to help stop the bleeding.
If blood does soak through, simply place another pad on top of the soaked one and continue applying direct pressure.
When the bleeding does slow down or stops, tie the pad firmly in place with strips of cloth suchas, a necktie, strips of sheet, or a shoelace etc.
Do not tie it so tightly that blood flow to the rest of the limb will be cut off.
Stay with the patient until medical help arriv
As mentioned perviously indirect pressure is no longer part of the European Resucitation Council guidelines but it is worthwhile focusing on what ‘indirect pressure’ is.
Direct pressure is physical pressure on a wound, not near it or close to it but directly on it.
Indirect pressure is physical pressure nrear the wound.
By putting pressure on the body’s pressure points (areas of the body where blood vessels run close to the surface) blood flow will be slowed, thus allowing direct pressure to stop bleeding.
It is important to note that when using pressure points, make sure you are pressing on a point closer to the heart than to the wound.
Pressing on a blood vessel further from the heart than the wound will have no effect on the bleeding.
Common pressure points:
- Arm between shoulder and elbow, this is the brachial artery
- Groin area along bikini line, this is the femoral artery
- Behind the knee, this is the popliteal artery