Background: Blood loss is the leading preventable cause of death from trauma. The first, and often most effective, method of achieving haemostasis is manual compression. It is tiring to maintain pressure, however, and there are personal safety concerns about direct contact with bleeding wounds. Tourniquets are useful for extremity haemorrhage, but they are not always immediately available and take some time to apply (an average of one minute in simulations, even if the volunteers had one to hand). The authors of the current paper hypothesised that a martial arts technique could be adapted to compress major arteries and reduce blood loss.

 

 

Slevin JP, Harrison C, Da Silva E, White NJ. Martial arts technique for control of severe external bleeding. Emerg Med J 2019;0:1-5

 

 

The paper: A black belt in Brazilian Jiu-Jitsu was recruited to teach the 'knee mount' positions (see image on blog site) to the study authors, who then performed each on 11 healthy volunteers while using ultrasound to measure mean arterial blood flow velocity (MAV) in the arteries affected. MAV was significantly decreased during compression of the brachial and femoral arteries, but not the abdominal aorta. No one was injured during the study.

 

 

 

The bottom line: This is only a proof-of-concept study, but offers a potentially faster and more efficient technique for quickly reducing blood loss from an extremity wound.

 

 

Expert commentary:"Perhaps a little limited in its application to ED but likely of interest to our paramedic colleagues. Another learning point from this is that if people performing Jiu-Jitsu present with signs suggestive of limb ischaemia or groin/axillary pain, we should consider damage to underlying vascular structures in these areas."(Dr Robert Tan, ED Consultant)