Stop the bleeding first.

When it comes to first aid, this comes first, say the experts.

For many years, first aid protocol was carried out and remembered by the abbreviation “ABC,” standing for “airway,” “breathing” and “circulation,” said Katie Johnson, trauma coordinator and emergency department educator for Aurora Medical Center, Kenosha.

In 2015 the American Heart Association changed its guidelines to CAB, to shift emergency treatment emphasis to bleeding first.

“The AHA wants you to stop the bleeding, then check the airway, then help the person breathe,” say Johnson. “In the instance when you come across a person who is non-responsive and not breathing, you need to stop the bleeding first and then go onto their airway.”

This is particularly relevant to our community, says Johnson. “Many in our population are heart patients on blood thinners. We are finding that the number one cause of preventable death (for these patients) is hemorrhage.”

Also rolled out in 2015 was the national initiative Stop the Bleed. A collaboration of the American College of Surgeons, the Committee on Trauma and the Hartford Consensus, the program was established as a response to the 2012 Sandy Hook school shootings.

“The intention of the initiative was to train lay people and first responders techniques for stopping bleeding before emergency services personnel arrive on a scene,” Johnson said.

Johnson presents Stop the Bleed programs and classes to schools and other local agencies by request.

Stop the Bleed kits include quick-clot dressings, a tourniquet, shears, gloves, a mask and an instructional card.

“Typically EMS carry these kits, but now we want them in classrooms,” she said.

Sometimes, however, as in the accident scene at which Stephanie Mortensen assisted last May, bleeding sources are hidden from view. In these cases, first responders work to alleviate distress with what they can assess, restoring breathing and clearing the airway using first aid and CPR techniques.