As serious accidents or attacks demonstrate, bleeding is the most common cause of preventable death from traumatic injury. Following the 2013 Boston Marathon bombings, initiatives like the White House’s “Stop the Bleed” national awareness campaign aimed to prepare laypeople to treat compressible hemorrhages. In fact, according to Meghan McDonald, MSN, Nurse Director of the Trauma Program at Brigham and Women’s Hospital, intervention from bystanders can help save lives. “Educating laypeople on hemorrhage control, either by direct pressure or tourniquet application, is the right and responsible thing to do as a trauma center,” she says.
McDonald co-authored a 2018 Brigham study, in partnership with Gillette Stadium and the New England Patriots, and with support from the Brigham’s Gillian Reny Stepping Strong Center for Trauma Innovation, to identify the best way to disseminate tourniquet education to the public. She found that in-person training was more effective than instructional flashcards or audio kits –insight that can inform public education.
Educating laypeople on hemorrhage control is the right and responsible thing to do as a trauma center.Meghan McDonald, MSN, Massachusetts General Hospital
Tourniquet application for external bleeds is only part of the story. In the case of a noncompressible abdominal hemorrhage, the average 36 minutes of blood loss as patients are transferred from the emergency department to operating room is a major challenge. “In the history of medicine, the only way to stop internal bleeding is through surgery,” says David King, MD, Trauma and Acute Care Surgeon in the Massachusetts General Hospital (MGH) Trauma Center. “You can’t put pressure on the bleeding like you can with other body parts.”
Throughout 10 years of research and clinical work, Dr. King and an engineering team have developed ResQFoam, an injectable polyurethane trauma foam that quickly expands to fill the abdominal cavity, applying stabilizing pressure to the wound. Easily removed in surgery, the foam received FDA approval for a clinical trial with 40 patients. If the foam receives full approval, this innovation can save lives – at MGH or at any remote trauma setting.