Supervisors call for bleeding control kits at county buildings and parks


The response to recent mass shootings has included calls for controversial legislative change, but a less controversial response, in the event of shootings or other traumatic injury in San Diego County, was supported by the San Diego County Board of Supervisors at their March 27 meeting.

The response to recent mass shootings has included calls for controversial legislative change, but a less controversial response, in the event of shootings or other traumatic injury in San Diego County, was supported by the San Diego County Board of Supervisors at their March 27 meeting.

The supervisors’ 5-0 vote directed the county’s Chief Administrative Officer to raise awareness for bleeding control in San Diego County including the training of county personnel and the placement of bleeding control kits in county buildings and county parks. The CAO will report back to the board in 120 days with a proposed program.

“The focus of the program is to provide immediate response to bleeding,” said Todd Costantini, the assistant director of the UC San Diego Health trauma center.

“Uncontrolled bleeding is the most common cause of preventable trauma death in the United States,” said Supervisor Dianne Jacob. “There are steps we can take right here in San Diego County.”

In San Diego County, the top five causes of trauma injuries are falls, motor vehicle accidents, assaults, motorcycle accidents, and pedestrian incidents.

“This is not just mass shooting incidents,” Costantini said. “This happens every day in San Diego.”

The focus of the Stop the Bleed program is to provide immediate response to bleeding by recognizing life-threatening bleeding and utilizing appropriate ways to stop the bleeding.

“There’s a lot of death from extremity hemorrhage,” Costantini said. “We think the only thing more tragic than death is a death that could have been prevented.”

Acts of violence that have produced mass injuries with blood loss include bombings as well as shootings, and the kits and training would also limit the severity of motor vehicle crashes, work injuries, and home injuries. “This is really an extension of what we established in disaster preparedness,” Supervisor Ron Roberts said.

The primary principle of immediate response is to ensure one’s own safety before applying the ABCs of bleeding:  alerting professional emergency responders by calling 911, bleeding source detection to find the bleeding injury, and compressing to stop the bleeding. This last step is done by covering the wound with a clean cloth and applying pressure by pushing on it directly with both hands, using a tourniquet, or packing the wound by filling it with gauze or a clean cloth and then applying pressure with both hands.

“Once you have stopped the bleeding, you’ve done your job,” Costantini said.

Although the purpose of the measure reaches beyond gun violence at schools, it is not without warrant in classrooms as well. At least seven school shootings have occurred in San Diego County in the last half-century. 

On April 24, 1962, the president of the Vallecitos School District board fatally shot a trespasser on school grounds. Before San Miguel merged with The Bishop’s School, a San Miguel High School teacher and track coach addressed unruly student behavior by taking his starter’s gun out of his desk and firing blanks throughout the classroom. On January 29, 1979, a Patrick Henry High School junior who lived across from Cleveland Elementary School fired from her home onto school grounds and killed two staff members while wounding eight children and one police officer. On October 16, 1985, a 17-year-old entered the Memorial Junior High School classroom, which included his girlfriend, pistol-whipped a 13-year-old boy he had been told was making advances on her, and fired shots at inanimate objects in the classroom. On March 5, 2001, a Santana High School freshmen killed two students and injured 11 students and two school staff members. On March 22, 2001, a Granite Hills High School senior shot five students at the school, all of whom survived; another student was injured diving to the floor and one other student received medical attention for hyperventilation.  

The on-campus shootings do not include the April 1963 murder of a high school senior who was shot by her former boyfriend as she was walking to school, but that family had previously experienced an on-campus traumatic injury when her brother accidentally cut off his thumb in a junior high school woodshop class. The severed thumb was reattached, and Costantini notes that applying a tourniquet will not reduce the chance of a severed limb or digit being reattached.  

“The first step in any sort of amputation is to stop bleeding,” he said.

The bleeding control kits include a tourniquet, a compression bandage, gauze, gloves, a marking pen, and a guidebook.  

“Bleeding control kits could be placed in all county buildings and parks,” Jacob said.

Jacob noted the similarity between the bleeding control kits and automated external defibrillators, which are currently in county buildings and parks.  

“These kits could make a difference between life and death,” she said.

The county already has a security initiative, which includes training of county staff, and the training program for the bleeding control kits would also include citizens.  “This training is every bit as important as having a tourniquet available,” Roberts said.

The supervisors’ action also directs the CAO to amend the county’s legislative program to add support for legislation, which will advance or encourage the placement of bleeding control kits in public buildings of other jurisdictions.  Former State Assemblywoman Lori Saldana noted that early intervention to stop bleeding reduces the expense of medical treatment.  

“The cost savings of moving this forward at the state level will more than pay for itself,” she said.