Wound care and haemostasis in tree accidents

While climbing in the tree, you assume that an emergency will not occur. After all, you are well secured and you know how to handle your tools. Yet the risk of accidents can only be reduced to a minimum – unfortunately, they can’t be completely prevented. Especially when handling a saw, accidents which lead to bleeding injuries occur regularly. How do you behave in this case correctly – also as a second man on site?

Care for bleeding wounds

In case of a bleeding external injury, it is usually sufficient to cover it sterile with an plaster – or with a compress fixed with gauze bandage or stapling tape. If the blood loss is greater or if the bleeding does not decrease, a pressure dressing is necessary: either classically with wound dressing and bandage packs or with a special pressure dressing pack from the military sector. The last offers many advantages when used up in the tree.

If the bleeding is still not stopped, the next step is to apply pressure to the corresponding artery. If one of the arms is injured, press the arm artery in the armpit. If a foot or leg is affected, you will find the artery in the groin. Pressing is very strenuous but still preferable to the following treatment.

Stanching: Bad or good idea?

But what happens if neither pressure dressing nor pressing the artery helps because the wound is too large? For a long time, it has been taught on German first aid and rescue courses that stanching larger, severe bleeding wounds is not an adequate treatment. In case of doubt, even more tissue is destroyed, which can lead to amputation of the stanched limbs. Contrary to popular belief, however, the stanching of a larger wound is now accepted – under certain conditions.

Stanching only as an exception

First of all: Stanching is an exceptional measure! You must only use it if other treatments fail to take effect. For example, if a pressure dressing does not stop the bleeding because the wound is too large, as described above. This is quite likely when working with the chainsaw and similar equipment.

Never stanch with ropes

In addition, you must not stanch with unsuitable aids under any circumstances. It is precisely these ‘techniques’ that have long been the reason why stanching wasn’t recommended. If you stanch with ropes, cable ties, wire – or similar things lying around on the site –, nerves etc. will be crushed or destroyed. In the worst case, the affected limbs must be amputated as noted above.

Tool for stanching: Tourniquet

But what is the best way to stanch? With a so-called Tourniquet, the blood flow in the affected part of the body is blocked in order to prevent a threatening loss of blood. So far so good, because this is also achieved with other aids. But unlike wire or cable ties, the Tourniquet has a wide surface and does not cut into the skin. If used correctly, no further injuries are caused, nerves and blood vessels are not destroyed.

Ideally, especially if you are working in remote areas, you will also note the time you have set up the Tourniquet on the appropriate label. This is a very important information for the rescue team when loosening the stanching.

Of course, we hope you won’t be affected by an emergency. Nevertheless, it is important to be well prepared. Especially, the correct handling of the Tourniquet has to be trained and practiced. Only then you are able to act quickly if an accident occurs. The Münchner Baumkletterschule (Munich Tree Climbing School) offers first aid refresher courses specifically for rescue in tree climbing as part of the Climb-Update® (German).

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