The Hartford Consensus (2015) established that preventable deaths in mass casualty events are primarily from uncontrolled hemorrhage, and that bystanders equipped with bleeding control knowledge can save lives in the 3–5 minute window before EMS arrives. A STOP THE BLEED kit in a home, car, or workplace bridges this gap. This guide covers the specific contents, assembly, and use of a complete bleeding control kit.
Core Kit Contents
A complete STOP THE BLEED kit contains:
- CAT Tourniquet (Combat Application Tourniquet, Gen 7): The military-standard tourniquet used by US armed forces. Time of application stamp on the band. Windlass tightening mechanism. Single-hand application capable. Cost: $28–35. Avoid cheap imitations — counterfeit CATs fail to stop arterial bleeding and have caused deaths. Buy from authorized distributors (North American Rescue, Chinook Medical).
- SOFTT-W Tourniquet (Stretch-Widened): Alternative to CAT; slightly wider band and different routing mechanism. Some users find it easier for large thighs or arms. Same cost range.
- Quikclot Combat Gauze (or Celox Gauze): Hemostatic (clot-accelerating) gauze impregnated with kaolin (QuikClot) or chitosan (Celox). Used for wound packing of non-tourniquet-able wounds (groin, shoulder, neck). 3-inch × 4-yard roll costs $25–35. Store sealed in original packaging.
- Pressure bandage (Israeli bandage or similar): An elastic pressure bandage with integrated wound closure pad. Used to maintain pressure after wound packing or for wounds requiring sustained pressure. Cost: $5–8.
- Nitrile gloves (2 pairs): Universal precautions — gloves on before touching any wound. Size L or XL fits most hands.
- Permanent marker: Write the tourniquet application time in large digits on the tourniquet strap or on the victim’s forehead (standard EMS/military protocol). This critical information prevents ischemia complications.
- Chest seal (Hyfin Vent or Bolin Chest Seal, 2 per kit): For penetrating chest wounds — prevents tension pneumothorax by allowing air out but not in. One per wound; most penetrating chest wounds have entrance and exit, requiring 2 seals.
Tourniquet Application: The Critical Steps
A tourniquet must be tight enough to stop arterial blood flow — this requires significant pressure and causes pain. Undertightening is the most common error; an undertight tourniquet stops venous blood flow while allowing arterial flow to continue, which can actually worsen bleeding by increasing venous pressure.
- Apply 2–3 inches above the wound (not at the wound — above it, toward the body)
- Route and tighten until bleeding stops — not until it seems tight, but until bleeding actually stops
- Twist the windlass until resistance stops, then lock and secure
- Mark the time (T followed by hours and minutes: “T 14:23”)
- Do not remove the tourniquet once applied until the patient receives medical care — removal in the field can cause rapid blood loss and shock
Wound Packing Technique
For wounds that cannot be tourniqueted (junctional wounds at the groin/shoulder/neck):
- Apply gloves first
- Pack hemostatic gauze into the wound opening, filling it layer by layer using your fingers to push each layer in firmly
- When the wound is full, apply firm direct pressure using both hands for a minimum of 3 minutes for hemostatic gauze; 5–10 minutes for plain gauze
- Do not release pressure to check — this disrupts clot formation
Free STOP THE BLEED Training
The American College of Surgeons offers free 2-hour in-person STOP THE BLEED courses nationwide. Find a class at bleedingcontrol.org. Classes are offered through hospitals, fire departments, schools, corporations, and community organizations. The course includes hands-on tourniquet application and wound packing on training manikins. Many employers will host a class on request.
Kit Storage and Inspection
- Access: Keep the kit immediately accessible, not locked away. Wall-mounted clear kit cases (TASMANIAN TIGER IFAK pouch or similar) in visible locations in the home. Vehicle kits in a consistent accessible location (console, under seat).
- Inspection schedule: Annual inspection — check tourniquet for brittleness or damaged velcro; check hemostatic gauze seal integrity; replace gloves if powdery or deteriorated; verify marker writes.
- Temperature: Do not store in a vehicle in high heat for extended periods — extreme heat (above 120°F interior temperature) can degrade tourniquet straps and packaging seals over time. Use an insulated storage sleeve for vehicle kits in hot climates.
The full active shooter response and mass casualty protocol is in active shooter and terrorism preparedness: run-hide-fight, threat recognition, and bleeding control.
