Emergency Medical Cabinets

Stop the Bleed tourniquet

The primary purpose of the tourniquet is to stop life-threatening external bleeding. Most often, the need for a tourniquet comes from exposure to a traumatic situation. Emergency medical services regularly use tourniquets alongside other bleed control methods.

Tourniquets are used when all other options to stop bleeding have failed. This includes elevation of the limb above the heart and applying direct pressure to the wound for 15 minutes to allow for a clot to form. A tourniquet may be the only option if these efforts don't work. The purpose of a tourniquet is to restrict blood flow to the injured limb and prevent life-threatening blood loss. It is only intended as a preventative measure to buy time until emergency services arrive.

If you need to apply a tourniquet, follow these steps: 

1. Find the source of the bleeding. If possible, have the injured person lie down. This will make it easier for you to find the exact source of bleeding as quickly as possible. If 911 has been contacted, place them on speakerphone so that you can keep them updated on your actions, and they can help guide you in making the appropriate decisions every step of the way.
2. Apply pressure. Once you find the source of the bleeding, apply pressure to the wound. If the bleeding does not slow or stop after 15 minutes of uninterrupted pressure, you will need to find or make a tourniquet. If the injured person is awake and alert, tell them what you intend to do. They need to know that the process can be painful, but the intention is to save their limb or even their life.
3. Position the tourniquet on the person. The tourniquet will need to be applied to the bare skin, so you will need to remove, cut, or tear any clothing around the wound. Next, position the tourniquet several inches above the injury closest to the heart. For example, if the injury is below the elbow, you will need to apply the tourniquet above the elbow. Never place the tourniquet directly on one of the body’s joints, as this can cause permanent nerve, joint, or blood vessel injury. 
4. Tighten the tourniquet around the limb by twisting the windlass, which is the stick-like part of the device, and securing it in place. Keep an eye on the bleeding and note when it starts to slow. Continue twisting until the bleeding has stopped or is significantly reduced. When the bleeding has stopped sufficiently, secure the windlass. 
5. Make note of the time you put the tourniquet on. You can do this by marking "T" with the date and time on the person's forehead or another easy-to-see place. This will help the emergency staff know what to do when they arrive.

Do not remove a tourniquet!

A tourniquet should never be loosened or removed by anyone other than a healthcare professional.

QuikClot hemostatic dressing

QuickClot is a topical dressing intended to help with localized management of bleeding wounds such as cuts, lacerations, and abrasions. It may also be used temporarily to manage severely bleeding wounds caused by traumatic injury. 

If you need to use QuickClot, follow these steps:

1. Verify the expiration date on the package labels prior to using the product. Remove dressing from packaging.  
2. Apply dressing directly to the source of the bleeding and use it to apply manual compression directly over the bleeding source. The dressing can be packed in the wound tract of penetrating injuries. More than one dressing may be required. 
3. Continue to apply manual pressure for five minutes, or until bleeding is controlled. 
4. The dressing may be left in place for up to 24 hours. Gently remove dressing. If the dressing is difficult to remove, hydrate with sterile saline. At the end of the procedure, thoroughly irrigate the wound to remove kaolin that may be released from the dressing. 
5. Show product removal directions to medical personnel if the patient is transported and the dressing remains in place. 

Things to remember when using QuikClot:

 • The QuikClot must be applied to the actual source of the bleeding. The dressing cannot prevent blood loss by being placed near the bleed. 

 • If bleeding persists, additional product should be applied to the wound.  

The largest component of the emergency medical cabinet is the AED. An AED is a compact and mobile device that administers an electrical pulse through the chest to the heart to correct irregular heartbeats and restore normal rhythm. AEDs are crucial in aiding individuals experiencing sudden cardiac arrest, a condition where the heart ceases to beat consistently due to malfunctions in its electrical system. Without quick action, cardiac arrest can rapidly result in death. AEDs are designed so anyone can use them, including those without medical training. They are user-friendly, reliable, and precise. 

Individuals in non-medical roles, such as first responders, are trained to use AEDs. While not mandatory, formal AED training is recommended to increase confidence in handling the device, and it is available on campus.

An AED guides the user with spoken instructions, visual cues, and written directions. It comes with two varieties of adhesive pads: one for adults and another for children. Adult pads should be used for anyone aged 8 and above or weighing over 55 pounds.

When using an AED, follow these steps:

1. Power on the AED and listen to the verbal instructions.
2. Clear the chest area of any garments. Dry the chest if it’s wet.
3. Remove the protective backing from the pads and place them on the exposed chest as depicted in the pad’s diagram.
4. Connect the pad’s connector to the AED.
5. Stand clear while the AED determines if a shock is necessary, either delivering it automatically or indicating when to manually administer it.
6. Persist with CPR if a shock isn’t required. If a shock is needed, ensure no one is in contact with the individual, press the shock button, and then promptly continue with CPR.
7. Maintain CPR until the arrival of emergency medical services. Stop if more advanced medical personnel arrive and take over, the scene becomes unsafe, or you are too exhausted to continue.

Opioids are a type of drug that includes heroin, fentanyl, and prescription opioid medications. Overdoses of these drugs cause thousands of deaths across the country. Opioid overdose reversal drugs can save lives if administered to people experiencing an opioid overdose.

Naloxone is a life-saving medication that can reverse an overdose of opioids—when given in time. At Iowa State University, all our Emergency Medical Cabinets have a dose of Narcan® brand naloxone nasal spray. Naloxone is safe to use – it has no effects on those who are NOT experiencing an overdose.

Signs of overdose

Recognizing the signs of opioid overdose can save a life. Pay attention to these symptoms:

• Small, constricted “pinpoint pupils”
• Falling asleep or losing consciousness
• Slow, weak, or no breathing
• Choking or gurgling sounds
• Limp body
• Cold and/or clammy skin
• Discolored skin (especially in lips and nails)

How naloxone works

When administered to someone experiencing an opioid overdose, naloxone blocks the effects of opioids in the brain and can restore breathing within 2-8 minutes, if not immediately, to prevent death.

If you need to administer Narcan® brand naloxone nasal spray, follow these steps:

1. Call 911 if someone is unresponsive.
2. Peel the package and remove the spray.
3. Place the tip of the spray into either nostril.
4. Press the plunger firmly to release the dose.
5. If still unresponsive after 2-3 minutes, give a second dose.
6. Stay with the person until help arrives.