Massive Haemorrhage Control in Hostile Environments

Humanitarian & Disaster Medicine
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This is Part 2 of a 2-part webinar series on hostile environment medicine with tactical care instructor and paramedic Scott King.

Following on from Part 1 (The Fundamentals of Hostile Environment Medicine), this session takes a deep dive into the critical topic of massive haemorrhage control. In austere and high-threat settings, uncontrolled bleeding remains the leading cause of preventable death. This conversation explores the latest techniques, technologies, and human factors influencing trauma care in these environments.

Drawing on real-world operational experience, Scott covers:

  • Tourniquet placement: from ‘high and tight’ to deliberate application and conversion

  • Hemostatic agents: what’s changed, what works, and when to use them

  • Junctional injury management and the limits of field intervention

  • Wound packing: what responders often get wrong and how to get it right

  • Tactical triage and decision-making in mass casualty incidents

  • The importance of training, trust in kit, and self-preservation under pressure

  • A look ahead at future developments in haemorrhage control, from AI to nanotechnology

This final session builds directly on the foundational principles laid out in Part 1 and completes the series with practical, field-tested guidance for anyone preparing to deliver care in complex or hostile settings.

Scott King is a paramedic with over 22 years’ experience in ambulance services, military instruction, and hostile environment training. He continues to advise on hostile awareness and tactical casualty care for UK Government, NGO, and specialist responders.

Watch Part One here.

Contact Scott directly via [email protected]

This is the first session of a series exploring hostile medicine in depth, designed to complement the upcoming Hostile Environment Medicine Course in Namibia this June.

🧭 Learn more about this course by clicking here.

More Information

Length: 1hr
Guests: Scott King
Host: Eoin Walker

Intended Learning Outcomes

By the end of this session, participants will be able to:

  1. Describe the decision-making process during the first 30 seconds of a massive haemorrhage incident in hostile environments.

  2. Explain the rationale behind ‘high and tight’ tourniquet placement and the conditions under which conversion is appropriate.

  3. Evaluate different types of hemostatic dressings and understand current evidence-based guidelines for their application.

  4. Identify appropriate techniques for managing junctional bleeds and discuss their limitations in resource-limited settings.

  5. Demonstrate a clear understanding of wound packing, including common mistakes and best practice.

  6. Discuss how human factors, environmental pressures, and triage dynamics impact decision-making in mass casualty scenarios.

  7. Reflect on the future of haemorrhage control, including emerging technologies and challenges in non-compressible bleeding.

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