Uncontrolled bleeding can result from manmade and natural disasters (e.g., active shooters, bombings, train crashes) and from everyday occurring emergencies e.g., vehicle crashes, plate glass window accidents, farming accidents). Severe bleeding can kill within minutes before EMS or other public safety providers arrive. Thus, the person closest to you or you yourself may be the only one who can stop the bleeding fast enough.
After the Boston Marathon bombings in the USA in April 2013, severe arterial bleeding in a limb at the point of injury was either left untreated or treated with an improvised tourniquet in the prehospital environment. This is when it was decided that effective methods of severe bleeding control that should mirror the military’s methods toward extremity bleeding control should be implemented as the current civilian methods at that stage was ineffective.
In April 2013, the Joint Committee to Create a National Policy to Enhance Survivability from Intentional Mass Casualty and Active Shooter Events was convened by the American College of Surgeons (ACS) in collaboration with the medical community and representatives from the federal government, the National Security Council, the U.S. military, the Federal Bureau of Investigation, and governmental and nongovernmental emergency medical response organizations, among others. The committee was formed under the guidance and leadership of trauma surgeon Lenworth M. Jacobs, Jr., MD, MPH, FACS, vice president of academic affairs and chief academic officer at Hartford Hospital, and professor of surgery, University of Connecticut School of Medicine, to create a protocol for national policy to enhance survivability from active shooter and intentional mass casualty events. The committee’s recommendations are called the Hartford Consensus.
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