Aaron, age 16, told me to hold the 4-by-4-inch cloth pad on top of the imaginary gunshot wound on my forearm. He then secured it in place with gauze, wrapping the material around and around, as quickly as possible, before tying it taut.
“I’m saving somebody’s life,” he said, with a chuckle.
He wasn’t saving anyone that evening, but he was learning how to in the future. Teenagers like Aaron aren’t the usual crowd in Kris Nelson’s bleeding control training, but that was his audience on this recent night at New York City Emergency Management headquarters in Downtown Brooklyn. The young men, participants in Brownsville In Violence Out, a violence prevention program in one of the city’s most violent neighborhoods, practiced on one another — and me — as Nelson, a New York City Fire Department EMT and NYCEM watch commander, taught us how to dress wounds, perform CPR, and apply tourniquets.
“I’ve been to plenty of shootings. I’ve been to plenty of stabbings. It’s a common thing that happens,” Nelson told them. “What I’m going to show you tonight is going to hopefully help.”
It may not be uplifting to think about teaching teenagers to “stop the bleed” — especially if that bleeding was caused by a shooting — but basic first-aid techniques, even when employed by young people with minimal training, could help save lives. Even rudimentary wound dressings limit blood loss from many injuries in the crucial minutes after a shooting when professional care hasn’t yet arrived.
To wit: A 2018 study that looked at pre-hospital firearm injury deaths in children and teens found that more than 20 percent of those deaths could have been prevented. Of the fatalities researchers examined, more than half were the result of blood loss. The same study also found that the onset of cardiac arrest — which can be temporarily treated with CPR — before EMS arrived was a considerable contributor to on-scene death.
“Training is power. Knowledge is power,” Nelson told me. “The more individuals that know a skill that could impact someone’s life, that’s the main thing.”
Nationwide, “stop the bleed” techniques have garnered media attention recently for their use to prep students for a school shooting. But the vast majority of shootings that injure or kill teenagers and kids don’t take place on campus — and few trainings reach communities with elevated levels of violence. That’s particularly relevant in neighborhoods like Brownsville, where shootings are still too frequent for comfort and emergency response times have gotten slower since COVID.
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“Have you ever been in a situation where you called an ambulance and it seemed like they were taking too long?” anti-violence organizer Dana Rachlin, executive director of We Build the Block and the architect of this training, asked the guys. Some had.
Later, as they took turns practicing CPR chest compressions, some of them playfully feigned distress when their legless blue manikins didn’t wake up. “You guys did better at the bleed training than the CPR, but baby steps, right,” Nelson told them with a tinge of sarcasm. It was a light moment in a heavy workshop — and quickly followed by a reminder of why they were there. “In a real-life situation,” Nelson continued, “if that really is your best friend or that really is your family member, you’re gonna want to help them as much as you can.”
Unlike CPR, which doesn’t require any equipment or materials, bleeding is easier to control with first-aid supplies like gauze. But kits that include the hemostatic gauze pads and rolls like those the guys practiced with aren’t as readily available in the neighborhood as they are in schools, sports arenas, and other venues. Rachlin wants to change that: This month, she and the training participants from We Build The Block and Brownsville In Violence Out plan to hand out “stop the bleed” kits, place other kits in public locations in case they’re needed, and host a trauma first-aid training at an upcoming community fair.
“Knowing how to pack a wound, knowing how to apply pressure — those basic things — until EMTs or paramedics can arrive on scene radically increases your likelihood that you will survive,” NYCEM Commissioner Zach Iscol, a veteran who learned similar skills in the Marines, told me. “The more of this that we can provide to young people, the better.”
The benefits of the training go beyond gun violence, Iscol said. It can be used for falls, kitchen wounds, heart attacks, and the list goes on. It may also be a first introduction to the medical field or emergency services. “Some of them might be taken by the medical field. Some of them might go on to try and become EMTs or paramedics or firefighters,” he said. In fact, a few of the guys asked about just that during the training.
In a better world, such preparation wouldn’t be necessary — at least not with gunshot wounds in mind. But the reality is that gun violence persists, and while “stop the bleed” isn’t a solution that directly addresses the epidemic’s root causes, it’s one way to mitigate the damage. It’s a form of harm reduction, like Narcan training to prevent opioid deaths. It won’t end the crisis, but it may save lives.
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