Mass. Trauma Surgeon Teaches First Responders How to Stop the Bleed

The Salem News, Beverly, Mass.

Dec. 28—DANVERS—About an hour after Massachusetts General Hospital trauma surgeon Dr. David King finished running the Boston Marathon in 2013, word reached him about what happened on Boylston Street.

He headed back to the hospital for many more hours in surgery as the Boston hospital treated 43 people wounded in the bombing that afternoon.

However, it was King's experience in combat in Iraq and Afghanistan, especially after his first tour of duty in Iraq in 2007, that made him aware of the importance of having a tourniquet on hand to save those with severe leg or arm injuries.

The Marathon bombing and the region's sensitivity to the tragedy has given him a platform from which to preach the importance of having tourniquets not only in police cruisers and ambulances or on fire trucks, but in schools, cars and homes.

"What the Boston bombing did was," King said, "it really drove home this message that this is not a military skill set. And this is not a military device. The tourniquet is not a military device. It is a medical device and this is a medical skill set that anyone can have and everyone should have."

King, who is a lieutenant colonel in the Army home from a recent deployment, along with members of the National Guard came to the Danvers High auditorium Wednesday afternoon to teach dozens of first responders about how to properly use a tourniquet.

Those trained were each given an orange tourniquet, which cost about $26. They were also asked to train two others.

Among those in attendance were members of the Danvers Police and Fire departments, Danvers dispatchers, the Middleton Fire Department, the Swampscott Fire Department, the North Reading Fire Department and others, including some members of the FBI.

The hands-on training was organized by Danvers fire Lt. David Mondi, the department's EMS coordinator. It was the North Reading Fire Department which Mondi said gave him the inspiration to provide the regional tourniquet training.

The training included everyone in attendance learning the correct way to apply a tourniquet using a dummy limb, going through the routine three times.

National Guard Col. Richard Bailey, commander of the 804th Medical Brigade, was also on hand and also personally trained first responders.

King said lessons from combat in the global war on terror over the past 17 years has informed the thinking on tourniquet use. Survival rates were poor at the start of the war, he said, because soldiers, airmen and Marines were not carrying them.

That changed, and around 2008, everyone in the field was carrying one or two, which resulted in a drop in the rate from those who died from arm and leg wounds to single-digits.

"It's an absolutely preventable cause of death," King said.

Later, first responders came together, studied the causes of death from a variety of mass casualty and other incidents, and concluded that no one should die from limb bleeding. Training should not be confined to professionals, but to all people, King said.

King said he took this message to his local school and trained all the teachers, administrative staff and custodians on how to use a tourniquet. A news story about this sparked something in Col. Bailey, who realized he could do this with those in his command. Bailey has helped train about 1,000 people in Massachusetts, he said.

King said that after the Marathon bombing, those who were the first to give aid were not professionals, "but the person standing next to them," which he called "by-doers" who jumped into action.

However, people lacked tourniquets, King said.

"Not a T-shirt, not belt, you need an actual tourniquet," he said.

King said experiences of improvised tourniquets, both in the field and on Boylston Street, "failed to be completely effective. So, the first thing we want is for you to have the right equipment. And, if you are not carrying a purpose-made tourniquet with you to work if you are a professional first responder, you need to change that."

Bailey said most of the time tourniquets are being used for routine incidents, such as someone getting hit by a car.

"The fire department members in this area see this all the time," Bailey said.

Bailey wants to make knowing how to properly apply a tourniquet as ubiquitous as people who know how to perform CPR or perform the Heimlich maneuver.

"What we want you to learn and want the populace to know is this. How do you put on a tourniquet? Well, you pull it really tight and you twist the thing. It's that simple. And if we can do that, we're successful," Bailey said.

One of those who took the training and found it valuable was Danvers Fire Chief Robert Pyburn.

"It's valuable training and it's a little bit different than what we've been taught in the past," said Pyburn, who said the use of tourniquets was frowned upon when he first became a firefighter. "But they are finding out, especially from these mass casualty incidents, that people are dying because they are bleeding out. And, if you can stop that bleeding immediately, you give them a chance."