Stop the Bleed training teaches people how to control life threatening bleeding until first responders arrive on scene to render aid. The training focuses on the use of direct pressure, tourniquets, and wound packing to treat bleeding after a traumatic injury. While the original impetus for Stop the Bleed training was preventable deaths from blood loss during mass shooting incidents, the techniques can be applied to any kind of traumatic injury the results in serious blood loss. For more information about Stop the Bleed visit their website https://www.bleedingcontrol.org/.
When we implemented this program on our campus one of the major hurdles was finding training aids. There are many very cool, realistic, and effective training aids that feel like flesh or spurt blood. But like most really cool things these cost a lot of money and aren't practical for a program with a limited budget. This Instructable details the cost effective training aids we bought or built to conduct Stop the Bleed training on our campus. These idea aren't originally ours, this is just how we implemented them.
NOTE: This Instructable won't provide training on bleeding control, merely on how to make the training aids. If you want bleeding control training visit Stop the Bleed or contact your local response agencies to find a class.
Step 1: Tools and Materials
The tools and materials for these training aids are readily available at stores or on-line.
The tools I used included:
- Tape Measure
- Paint Pen
The materials included:
- Pool noodles
- Wooden dowel rods (optional)
- Metal bar (optional)
Step 2: Bandages/Gauze
Bandages or gauze are key to using direct pressure or wound packing. Ideally you'd have sterile hemostatic gauze that is designed to prevent infection and speed clotting. However since this is training and sterile hemostatic gauze is expensive we don't train with it. Instead I raided our department's stash of rags and processed the bigger ones into long strips to simulate gauze. I did this by laying out the material flat on a table and then marking of three inch intervals along one edge. I then cut upward from each mark for the length of the rag. This resulted in "bandages" between 18 and 24 inches in length. I did this until I had several dozen strips.
Step 3: Tourniquets
One of the key parts of Stop the Bleed training is the use of tourniquets to halt bleeding from extremities. While it is possible to improvise tourniquets, commercial tourniquets are more reliable and easier to use. Stop the Bleed specifically references the Combat Application Tourniquet (CAT) as it is easy to apply to yourself or others.
I had originally intended to purchase the standard blue training tourniquet, but these were around $30.00 each on Amazon and other sites. However, CATs intended for actual use were almost half that price. So I ordered the duty tourniquets and used a paint pen to write "TRAINING ONLY" on them.
NOTE: You should never use a training tourniquet to actually treat blood loss. After repeated use the band inside the tourniquet which occludes blood flow stretches out and it is no longer able to pinch off the blood vessels.
Step 4: Wound Packing Part 1
Another key element of Stop the Bleed training is packing bandages or gauze into a wound to control blood loss. To simulate packing a large puncture we use Play-Doh because it is cheap and the squishy consistency gives people some idea of what packing a wound will feel like. Additionally, it comes in its own handy storage container.
The first picture shows the virgin untouched Play-Doh in it's container. All you have to do is smash the Play-Doh down into the container until it forms an even layer. Then use your thumbs to push down and make a divot in the Play-Doh. It will displace up the sides and your can sculpt it into a crater shape. See the second picture for the end result.
The third picture shows what the Play-Doh looks like after the "wound" has been packed with "bandages". As in real life the Play-Doh will deform as the "wound" is packed. After each training session you simply need to massage it back down into the container to restore your crater.
Step 5: Wound Packing Part 2
Stop the Bleed also focuses on packing wounds with a small entry point that have created a larger wound internally. To simulate this we make use of pool noodles as they have a nice internal cavity. Pool noodles are also great because you can pick them up for almost nothing at the end of summer.
I measured and marked my pool noodle at approximately one foot intervals. I then used a knife to cut through the pool noodle so they were a more manageable length for training use and storage. With that done I estimated the center and cut a slit about 3 or 4 inches long through one side of the pool noodle that intersected the internal cavity. The students can then pack "bandages" into the slit and force them up into the internal cavity.
After a few classes we made some modifications to make them easier to use. We instruct the students to pack the wound toward the heart. Since chunks of pool noodle aren't comparable to human anatomy, students invariably asked "Which way is the heart?". To save time explaining this I drew a heart on one end of the pool noodle. (Picture 4)
We also noted that the slit in the pool noodle was difficult to locate so I used a red marker to add "blood" around each slit. (Picture 5)
NOTE: Be sure to let the marker dry completely before handling or your hands will be stained.
Step 6: Going Little Deeper
Feedback and questions from Stop the Bleed classes have inspired a couple of modifications/innovations of our training tools.
Students rightly observed that humans aren't big bags of homogeneous jelly. In fact we're riddled with 206 bones which could be exposed to the light of day in the event of a traumatic injury. To add a little realism and surprise to future training sessions I've added some dowel rods to some of our wound packing simulants.
For the crater packing I gathered laid a dowel rod across the diameter of the Play-Doh container and used a marker to identify the ends. I then used the saw blade of my multi-tool to trim it to size and filed off the rough edges. With that complete I pushed it down into the Play-Doh and smoothed the Play-Doh around the ends. (Pictures 1-3)
The small entry simulants I inserted a dowel rod into the pool noodle below the internal cavity with an upward angle that would result in the rod passing beneath the incision, the far end embedding itself in the upper portion of pool noodle beyond the end of the incision. (Pictures 4-7)
Additionally we've had questions about how to apply these principles when a person has been impaled by a foreign object like a knife or tree branch. To simulate this I stuck a metal rod into the slit of a pool noodle and pushed it out the other side. This will allow students to either apply a tourniquet above the impalement site or pack around the object.
Step 7: Wrapping Up
We began our program Stop the Bleed program with a single trainer and with the techniques noted above spent less than $150 to create training materials for classes of 8 to 10 people. Through multiple classes we've now trained over 90 people and with a recent expansion of our training cadre we'll soon be able to host larger classes. This Instructable is proof you don't need a big budget in order to affect change.