Uncontrolled hemorrhage is the largest cause of preventable mortality in trauma. When extremity bleeding is uncontrolled many, if not most EMS agencies, have now recognized the benefit of using tourniquets.

Today, because of national Stop the Bleed educational campaigns emphasizing bystander response to active shooter situations, many laypersons are now becoming familiar with simple but effective hemorrhage control techniques.

Using direct pressure and tourniquets on extremity bleeding is relatively straightforward for EMS providers. The most challenging wounds however, are those in the junctional areas-the groin and the axilla-where tourniquets can’t be used. The bleeding in these locations is often deeper and maintaining adequate external pressure can be difficult or impossible.

The U.S. military has been teaching wound packing with standard gauze and hemostatic dressings to its medics for years. Like the transition of tourniquets from military to civilian EMS, these skills are now becoming adopted by tactical EMS teams as well as field EMTs and paramedics. Wound packing can be utilized in concert with tourniquet use or as a solo hemorrhage management technique.

Uncontrolled hemorrhage is the largest cause of preventable mortality in trauma. When extremity bleeding is uncontrolled many, if not most EMS agencies, have now recognized the benefit of using tourniquets.

Today, because of national Stop the Bleed educational campaigns emphasizing bystander response to active shooter situations, many laypersons are now becoming familiar with simple but effective hemorrhage control techniques.1

Using direct pressure and tourniquets on extremity bleeding is relatively straightforward for EMS providers. The most challenging wounds however, are those in the junctional areas-the groin and the axilla-where tourniquets can’t be used. The bleeding in these locations is often deeper and maintaining adequate external pressure can be difficult or impossible.2

The U.S. military has been teaching wound packing with standard gauze and hemostatic dressings to its medics for years.3 Like the transition of tourniquets from military to civilian EMS, these skills are now becoming adopted by tactical EMS teams as well as field EMTs and paramedics. Wound packing can be utilized in concert with tourniquet use or as a solo hemorrhage management technique.