Hemorrhage Control

On Saturday Feb. 15 shortly after noon, Officer Salvador Varillas and Officer Joshua Burns of the Dallas Police Department responded to a domestic violence call. Minutes later Burns was critically wounded and his fellow officers were fighting to keep him alive.

Arriving at the northeast Dallas apartment building, Varillas and Burns noticed a man in his early 20s sitting in a car. The man opened fire. A gunfight ensued.

Burns was hit. One round was stopped by his vest, a second cut through his shoulder, and a third punched into his leg. He was bleeding heavily.

Officer Joshua Burns might have bled out and died if it wasn't for a new emergency medical program that the Dallas PD had implemented just weeks before he was shot. As part of that program, 3,200 Dallas officers had been trained in basic hemorrhage control techniques and issued Tactical Medical Solutions' Downed Officer Kit (DOK).

The DOK is a sealed 7x7x3-inch kit that contains a Special Operation Forces Tourniquet (SOF-T), QuikClot Combat Gauze, an OLAES modular bandage, nitrile gloves, a face shield, trauma shears, and medical tape.

To check the hemorrhages that could have killed Burns, his fellow officers used the QuikClot-impregnated gauze and the SOF-T tourniquet. Burns was then transported to a hospital. He survived his wounds.

Medical professionals are cautious about saying that the actions of his fellow officers saved Burns' life, but they believe it was certainly a factor. "When a patient has bad outcomes most of that is from unchecked hemorrhaging," Dallas PD Lt. Alex Eastman said at a press conference following the shooting.

Eastman is uniquely qualified to give an opinion on both police operations and trauma survival rates. He is a full-time police lieutenant and the interim chief of trauma surgery at Parkland Memorial Hospital. He is also one of the driving forces behind Dallas PD's decision to equip each officer who has contact with the public with trauma kits.

Eastman credits Dallas PD Chief David Brown with having the vision to budget funds and implementation resources for the trauma kit program. "We have an ongoing dialogue about what we need to do to give our guys the tools, equipment, and training to make them more safe out there," Eastman says.

The Dallas PD had some specific requirements for its hemorrhage control tools. "We wanted to have equipment that was proven in austere environments," Eastman says. "The equipment we chose has been proven on the battlefields of Iraq and Afghanistan over the last decade to be functional, useful, and durable."

Training is another essential element of any agency's hemorrhage control program and a critical concern for any chief or sheriff facing budget woes and labor shortages. But Eastman says it doesn't take much training time to make officers competent using the tools in the DOK kit.

"We think we have been able to train our officers very effectively," Eastman says. "The evidence of that effectiveness is that these kits have already been used several times to save both our own personnel and civilians."

The Dallas PD's hemorrhage control training consists of four parts. There are two roll call training videos that officers can also watch online on the department's intranet. In addition, officers complete the Z-Medica (manufacturer of QuikClot) online training program. The final element of the training is a reality-based exercise that requires officers to demonstrate their training on dummies and on role players.

There have been no best practices established for how to carry hemorrhage control kits in the field, according to Eastman. He says some Dallas officers carry the kits on their body armor, others on their legs, and others in their cars. Department policy only requires officers to carry the kits so they are easily accessible and that means no farther away than in their patrol cars.