Immediate responders need to recognize that applying pressure to a bleeding vessel is the appropriate first action to take and that their hands are a first-line resource. In most cases, control of external hemorrhage can be accomplished by applying direct pressure on the bleeding vessel.
Hemostatic dressings and tourniquets may be needed to effectively stop bleeding. For this reason, the Hartford Consensus recommends that all police officers and any concerned citizens carry a hemostatic dressing, a tourniquet, and gloves. This guideline should also apply to all EMS/fire/rescue personnel. Ground and air medical transport vehicles should carry multiple dressings and tourniquets based upon local need. In addition, bleeding control bags should be accessible in public places as determined by a local needs assessment. Potential sites for bleeding control bags include shopping malls, museums, hospitals, schools, theaters, sports venues, transportation centers (such as airports, bus depots, and train stations), and facilities with limited or delayed access. All hemostatic dressings and tourniquets must be clinically effective as documented by valid scientific data. The Tactical Combat Casualty Care guidelines for the U.S. military contain objective evidence to support the safety and efficacy of the various options for tourniquets and hemostatic dressings. Contents of the bleeding control bags should include the following: