Hemorrhage Control 

Overview for 

Law Enforcement

Demo by Alexander L. Eastman

Created and produced by 

Melissa Bradley, Debra R. McCullough,

and Deborah L. Spence 
About Alexander L. Eastman:

Lieutenant Alexander L. Eastman is the 

deputy medical director of the Dallas Police 

Department and the lead medical officer for 

the Dallas Police SWAT Team. He also serves 

in a similar capacity for The University of Texas 

System Police. Eastman is actively involved 

in national planning for law enforcement 

medical support through The USDOJ’s Officer 

Safety and Wellness Group, the Committee 

on Tactical Emergency Casualty Care, and 

The Hartford Consensus Working Group. 

In addition, he recently participated in the 

USDHS Active Shooter Stakeholder Forum. 

Eastman is also the interim medical director 

of the Trauma Center at Parkland Memorial 

Hospital and an assistant professor and 

trauma surgeon in the Division of Burns, 

Trauma and Critical Care at UT Southwestern 

Medical Center. A graduate with distinction of 

the George Washington University School of 

Medicine, he completed his general surgery 

and two fellowships at The University of 

Texas Southwestern Medical School/Parkland 

Memorial Hospital. He is board-certified in 

both General Surgery and Surgical Critical 

Care and has a master’s degree in Public 

Health from The University of Texas Health 

Science Center--Houston. His research 

interests include the pre-hospital care of 

the injured, novel methods of hemostasis, 

cost effective wound care, and the interface 

between medicine, law enforcement, and 

public health. 

Recommended citation:

Eastman, Alexander L. 2014. Hemorrhage Control Overview for Law Enforcement. Washington, DC: Office of 

Community Policing Services. http://www.cops.usdoj.gov/Default.asp?Item=2729.

The Internet references cited in this publication were valid as of the date of publication. Given that URLs and 

websites are in constant flux, neither the author(s) nor the COPS Office can vouch for their current validity.
1

About This Transcript

The following content is a transcript of the video slideshow Hemorrhage Control Overview for Law 

Enforcement, which is available online at www.cops.usdoj.gov/Default.asp?Item=2729. 

Medical Disclaimer

The Hemorrhage Control Overview for Law Enforcement demonstration is posted with permission from 

Lieutenant Alex Eastman. This demonstration is for general informational purposes only and is not intended as 

professional medical training, advice, diagnosis or treatment and should not serve as the basis for any medical 

decision. Reliance on any information provided in this demonstration is solely at your own risk.

Introduction by COPS Staff

In this slideshow, Lieutenant and Deputy Medical Director Alex Eastman of Dallas (Texas) Police Department 

provides an overview of the Dallas Police Hemorrhage Control Program.1

 Law enforcement officers are often 

the first to respond to a scene involving persons with critical injuries and have an opportunity to save lives 

threatened by uncontrolled bleeding.2

 Efforts are underway by a collaborative of law enforcement, emergency 

responders, and trauma surgeons, referred to as the Hartford Consensus, to train law enforcement officers 

in medical care procedures for hemorrhage control to maximize survival of injured community members and 

public safety personnel at active shooter and mass casualty events.3, 4, 5

1 Deborah L. Spence, “Enhancing Survivability at Mass Casualty Events,” Community Policing Dispatch 6, no. 12 (2013), 

http://cops.usdoj.gov/html/dispatch/12-2013/enhancing_survivability_at_mass_casualty_events.asp.

2 Lenworth M. Jacobs, David Wade, Norman E. McSwain, Frank K. Butler, William Fabbri, Alexander Eastman, Alasdair Conn, and Karyl 

J. Burns, “Hartford Consensus: A Call to Action for THREAT, a Medical Disaster Preparedness Concept,” Journal of the American 

College of Surgeons 218, no. 3 (2014): 467, doi:10.1016/j.jamcollsurg.2013.12.009.

3 Joint Committee to Create a National Policy to Enhance Survivability From Mass-Casualty Shooting Events, 

“Improving Survival from Active Shooter Events: The Hartford Consensus,” Bulletin of the American College of Surgeons 98, 

no. 6:14–16, http://bulletin.facs.org/2013/06/improving-survival-from-active-shooter-events/.

4 Joint Committee to Create a National Policy to Enhance Survivability From Mass Casualty Shooting Events, 

“Active Shooter and Intentional Mass-Casualty Events: The Hartford Consensus II,” Bulletin of the American College of Surgeons 98, 

no. 8, http://bulletin.facs.org/2013/09/hartford-consensus-ii/.

5 American College of Surgeons, “Training Begins for Police Officers to Control Bleeding of Mass-Casualty Victims in the U.S.,” news 

release, February 27, 2014, http://www.facs.org/news/jacs/hartford0214.html.
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Bandage Demo

All right. So for mild to moderate hemorrhage, we recommend the use of the Olaes Modular Bandage. The 

Olaes bandage, made by Tactical Medical Solutions, is a great combination bandage for you to use. The steps 

are pretty easy.

Pretty much the first thing you do is open the package. Remove the bandage from the package. If you need 

instructions for use, there are some rudimentary instructions that come on the outside of the packaging material.

Once you get the bandage open, it has several key components. The first of these components is a white, 

absorbent gauze material (figure 1). The second most important of these components is the elastic bandage 

that is around the edge (figure 2). This is used to generate pressure when you apply the bandage.

Figure 1 Figure 2

To apply the Olaes bandage, you take the bandage and apply it to the officer’s wounded extremity (figure 3), 

placing the white piece over the wound and wrapping the bandage as tight as possible (figure 4). You use the 

elastic of the bandage by starting away from the patient’s heart, as far away down their arm, and covering the 

entirety of the bandage with that elastic. There’s a plastic piece embedded in the outside of the bandage that 

is designed to apply pressure to the wound. That plastic piece should be just on the other side of the wound 

from the white absorbent portion of the bandage.

Figure 3 Figure 4
3

By using the elastic incorporated into the bandage and wrapping the wound tight, you can achieve a very-easyto-apply pressure dressing. The bandage has Velcro included in it, which you can use to secure the bandage at 

the end. The finished product should feel firm, almost like a cast (figure 5). That way you know you’ve applied 

enough pressure to the wound to stop the bleeding.

Figure 5

Tourniquet Demo

The next piece of equipment we use and we recommend is a Special Operations Forces Tourniquet. This 

tourniquet is one of two that is approved by the Committee on Tactical Combat Casualty Care for use in 

the United States military. This tourniquet comes pre-folded for use, where all you have to do is open the 

tourniquet. Right out of the package it’s ready to go (figure 6). The tourniquet has some important pieces. It 

has a buckle and a clip that secures it shut. It’s got a free end to pull on that you tighten. It has a windlass; 

that’s the way you tighten the tourniquet up to stop bleeding (figure 7).

Figure 6 Figure 7
4

Tourniquets should be used for life-threatening hemorrhage only. The way that you use them is simply to put 

the tourniquet between the heart and the bleeding wound. You do not want to put the tourniquet below the 

bleeding wound, as that will cause an increase in bleeding. When you have a wound to the arm like you see in 

the picture here, the tourniquet goes above the bandage that you’ve already applied (figure 8). This would be 

used if the bleeding continues.

To place this tourniquet, you can either simply slide it over the wounded officer’s arm, or if you cannot slide it 

over the wounded officer’s arm for some reason, you can simply remove the clip here by separating this, and it 

will open, and then you can pass the free end around the wounded officer’s arm, reconnect it, and then begin 

the process of tightening the tourniquet (figure 9).

Figure 8 Figure 9

Once you’ve got the tourniquet in the proper position, you simply cinch down on the free end of the strap 

that’s open until it’s snug (figure 10, see next page). Then you turn the windlass that’s on the tourniquet until 

the bleeding stops. It’s important that you continue to turn this windlass until all hemorrhage is controlled. It 

will be tighter than you anticipate, and it could elicit some discomfort in the person who you’re saving.

Once the bleeding is controlled, you take the tourniquet, put the end through the plastic clip that’s on the 

bandage, and secure it in place. It’s very important, once you get this tourniquet on, that you get the wounded 

officer to medical attention as fast as possible. Do not loosen the tourniquet. Don’t take it off until you’ve 

arrived at a trauma center.

Figure 10 
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Gauze Demo

The final piece of the Dallas Police Department Hemorrhage Control Program is Quick Clot Combat Gauze, 

which you see here in the picture (figure 11). Quick Clot Combat Gauze is a specially impregnated gauze that’s 

designed to control hemorrhage where tourniquets are not appropriate. This would be in the chest, the torso, 

the neck—those areas.

Figure 11

The instructions for use on the Combat Gauze are on the back of the package, but it is a key component of our 

hemorrhage control program.

Disclaimer by COPS Staff

The opinions contained herein are those of the authors and do not necessarily represent the official position or 

polices of the U.S. Department of Justice. References to specific agencies, companies, products, or services 

should not be considered an endorsement by the authors or the U.S. Department of Justice. Rather, the 

references are illustrations to supplement discussion of the issues.
Office of Community Oriented Policing Services

145 N Street NE

Washington, DC 20530

To obtain details on COPS Office programs, 

call the COPS Office Response Center at 800-421-6770.

Visit the COPS Office online at www.cops.usdoj.gov.

e06145651

Published 2014