How to Stop a Neck Hemorrhage
Neck trauma, especially ones involving severe bleeding, can be life-threatening. These types of severe neck injuries typically result from penetrating trauma rather than blunt trauma and can affect common carotid arteries, jugular veins, and cranial nerves located in the neck.
Knowing how to respond promptly and effectively to a neck hemorrhage is crucial. If you understand the steps involved with hemorrhage control, you could potentially prevent a person from bleeding out and ultimately save their life.
How to Control a Neck Hemorrhage
The following steps will help with hemorrhage control in the event of a severe neck injury.
1. Assess the Situation
Prioritize your safety. Your ability to assist the victim is compromised if you become injured. Only provide care to the injured person if the scene is deemed safe. If, at any point, your safety is jeopardized, make an immediate effort to remove yourself and, if possible, the victim from danger and move to a secure location. Put on gloves if available to protect yourself against bloodborne infections.
2. Call for Emergency Assistance
Seek assistance promptly. If you are in the U.S., call 9-1-1 or instruct someone else to make the call. Also, grab a bleeding control kit if available.
3. Find the Source of Bleeding
Open or remove any clothing covering the injured area and carefully wipe off pooled blood to gain a clear view. Identify if there is life-threatening bleeding.
What Is “Life-Threatening” Bleeding?
This refers to various critical scenarios, for example, blood spurting out of the wound and/or continuous uncontrolled bleeding. Often when the common carotid artery has been punctured, there will be uncontrolled bleeding.
If you determine the bleeding is life-threatening, it will require immediate attention and intervention to prevent further harm to the injured person or even death.
4. Pack the Wound With Hemostatic Dressings and Apply Direct Pressure
It can be very difficult, if not impossible, to tell if it’s an injury to the common carotid artery or jugular vein, or both. So, then what? You'll need to control both above and below the injury.
If you have a hemostatic gauze dressing, pack the wound aggressively and make sure you maintain direct pressure (even if you have to ride with the patient to the ER). You must apply direct pressure from the side toward the spine to avoid crushing the trachea—and please, no tourniquet around the neck!
There are some excellent online videos, such as How to Pack a Neck Wound by Lazarus Training, that demonstrate the wound-packing technique. Following the wound-packing procedure while maintaining constant direct pressure should significantly decrease blood loss for a neck hemorrhage.
The Lifesaving Role of Hemostatic Dressings
Hemostatic dressings play a vital role in controlling bleeding, especially in neck injuries. According to the U.S. Military’s Committee on Tactical Combat Casualty Care (CoTCCC), QuikClot® Combat Gauze is the ideal choice when you can’t use a tourniquet, such as in a neck hemorrhage.
Hemostatic dressings, like QuikClot® Combat Gauze or NuStat® Hemostatic Dressing, accelerate the clotting process and can be crucial in preventing excessive blood loss. Having hemostatic dressings in your trauma kit could save someone's life.
What If You Don’t Have a Hemostatic Dressing?
If you don’t have a hemostatic dressing, use plain gauze or clean cloth (e.g. a shirt) to pack the wound and always maintain the pressure as you pack the wound.
5. Watch for Trachea Compression
It is important to achieve and maintain airway patency—this is the ability of a person to breathe normally through their mouth and nose. Applying pressure from the side toward the spine avoids compressing the trachea and compromising airway patency.
6. Apply Pressure for a Minimum of 3 Minutes and Review
You will need to maintain strong direct pressure on the hemostatic dressing for at least three minutes. After three minutes, carefully check the neck wound to determine if you have achieved neck hemorrhage control. Do not remove the dressing from the wound.
If the neck hemorrhage has stopped bleeding and the packed dressing is not soaked in blood on the outside, then you can proceed with the next step.
If the neck hemorrhage has not stopped and/or the packed dressing is soaked in blood, immediately apply strong direct pressure again to the neck wound.
7. Secure With Standard Trauma Dressing
Once you have achieved hemorrhage control, use a large standard trauma dressing to hold the packed dressing in place by wrapping it across the upper chest to the opposite armpit and then across the back to the neck to stabilize the neck.
8. Seek Professional Help
Even if you have achieved hemorrhage control, seek immediate medical assistance. Neck trauma can involve complex structures, and professional evaluation is necessary.
Tips and Precautions to Keep in Mind
These tips and precautions can assist you in the unfortunate event of handling a neck hemorrhage.
Avoid Tourniquets
Do not use tourniquets around the neck as they could lead to further complications and compromise the airway.
Maintain Direct Pressure Continuously
Always maintain direct pressure on the wound—even during the packing procedure—to minimize the loss of blood. If bleeding persists, add additional dressings without removing the ones you have already placed.
Avoid Compression on the Trachea
Part of airway management is preventing compression of the trachea, as this can obstruct the airway. Apply pressure carefully from the side, directing it toward the spine.
Stay Calm and Reassure the Injured Person
Your calmness can positively impact the injured person. Reassure them while waiting for professional help.
Send the Hemostatic Dressing Packaging
The person will be taken to a hospital for possible surgical exploration of the neck hemorrhage. Send the hemostatic dressing's packaging with the EMS personnel so that the attending medical professionals will know what was packed into the neck wound.
Prepare Ahead of Time
In the critical scenario of a neck hemorrhage, quick and effective action can make the difference between life and death. Knowing the steps for hemorrhage control and how to use hemostatic dressings cannot be overstated. With this knowledge, you have the potential to save a life in the event of severe neck trauma.
Remember, the inclusion of hemostatic dressings in your first aid kit or trauma kit can be a lifesaving investment. Their ability to accelerate clotting processes is crucial in preventing excessive blood loss and giving the victim the best chance at survival.
