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This re-enacted training video shows how to use a major trauma dressing (aka Israeli Dressing) to stop catastrophic bleeding. This is an essential skill for those taking part in Forestry First Aid courses, or for anyone who work with chainsaws, or work in any situation where there is an increased risk of very serious injury. The Israeli dressing works well for limb injuries. Direct pressure should be your first technique used to stop catastrophic bleeding in a civilian setting. Step 1. The primary Survey is now DR (C) ABC so we will control a catastrophic bleed before moving onto airway management. Get the casualty to lie down. Step 2. Identify the site of the catastrophic bleed and apply direct pressure. Wear gloves to minimise the risk of cross infection. Step 3. Cut through clothing so that you can visualise the wound and place the Israeli dressing against skin. Step 4. Tear through the inner and outer wrapper. Get the absorbent pad ready to place against the wound. Step 5. When your colleagues hand is removed, visualise the wound and now use the pad of the Israeli dressing to reapply direct pressure to the wound. Place the centre of the pad over the centre of the wound. The cleat is off-centre. Step 6. Wrap the bandage round, come through the cleat and now reverse the direction in which you wrap. This will pull the cleat over the centre of the wound. Pull tight and wrap round. This technique will utilise the elasticity of the bandage to create firmer pressure. Step 7. Keep going, pulling tight and wrapping round. Make sure that the edges of the sterile pad are covered. When you get to the end of the bandage, the plastic bar with barbs can be used to secure the bandage. DO NOT elevate the limb. Once catastrophic bleeding has been controlled, continue with the rest of the Primary Survey, make sure someone has called 999 or 112. Finally and very importantly, keep your patient warm whilst you wait for the rescue services. Blood clotting is a chemical reaction. The blood will clot faster if the patient is warm, and blood clots that have formed will start to break down if the patient becomes cold.