TRAUMA: BLEEDS, BREAKS AND THE FIRST TEN MINUTES
12 min · Free lesson · written lesson, video in production
After this lesson you know the priority order for serious trauma a long way from help: stop the big bleed first, protect the airway, splint what is broken, and package the casualty for the hours ahead.
The Technique
- Catastrophic bleeding jumps the queue - it comes before everything, even airway. Bright, pumping or pooling blood gets direct, hard pressure immediately: knee, palm, whatever reaches fastest, then a firm pressure dressing.
- If direct pressure cannot hold a limb bleed, a proper tourniquet applied the way you were taught in training - high on the limb, tight enough to stop the bleed, time written down - is a life-saving tool. Buy a real one, learn it on a course, and keep it where your group knows it lives.
- Airway and breathing next, exactly as your DRSABCD training taught. An unconscious casualty who is breathing goes on their side into the recovery position - in the backcountry, on insulation, not on snow or cold ground.
- Breaks and dislocations: splint them roughly where they lie, pad everything, and check warmth, movement and feeling beyond the injury before and after. Splints improvise well - poles, foam mats, a folded shovel blade - the padding matters more than the hardware.
- Suspected spine, head or pelvis injuries change the plan from "move them" to "keep them still, keep them warm and bring help here" unless a bigger danger forces your hand. Moving is a last resort with these, not a convenience.
- Package for the wait: insulation below, layers above, head covered, and reassurance running the whole time. Write down times, observations and changes - the rescue team that arrives will trade a lot for that piece of paper.
- Shock is quiet and it kills: pale, cold, fast and anxious. Treat every serious trauma casualty for it before it shows - lying down, insulated, warm and reassured.
Common Mistakes
Peeking under a pressure dressing to see how it is going. Fix: it is going how it was going. More blood means more pressure on top, never a look underneath.
- Splinting tight and forgetting the fingers and toes. Fix: recheck warmth, movement and feeling every fifteen minutes - a splint that stops blood flow is a second injury.
The Drill
The kit teardown: empty your first aid kit on the floor, name what each item is actually for, and cull the ornaments. If you cannot explain when you would use it, it is weight. Then repack with the bleed kit on top.
Tourniquets, wound packing and spinal management must be learned hands-on with qualified instructors, not from any written page including this one. Book the course. This content is general guidance, not medical advice.
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