Trauma Shears: Sometimes You Have to See the Injury Before You Can Treat It

By Kevin Wilson | Firefighter/Paramedic | Founder, IFAK360
Published September 15, 2026

Trauma shears are one of those tools that can look almost too simple to deserve much attention. They are just scissors, right?

Not really.

In trauma care, clothing, boots, belts, webbing, jackets, seat belts, and other gear can hide the injury you actually need to treat or simply get in the way of patient care. Before you can decide whether a wound needs direct pressure, packing, a pressure dressing, a tourniquet, or another intervention, you may need to remove whatever is between you and the problem.

Sometimes the first job of trauma shears is simply to get that obstacle out of your way.

You Cannot Treat What You Cannot See

Blood on a shirt, pant leg, or jacket does not always tell you exactly where the injury is. Clothing can absorb blood, spread it across a larger area, or hide the actual wound underneath several layers.

Sometimes what looks like a small amount of blood on the outside of a pair of jeans becomes a very different problem once the clothing is cut away. Other times, the blood you see is not coming from where you first thought it was.

That is why purposeful exposure matters. You do not need to cut every piece of clothing off a patient, but you do need enough access to identify the injury and treat it appropriately. Trauma shears give you a fast way to remove material that is in the way without trying to pull clothing over an injured arm or leg.

The American College of Surgeons Stop the Bleed program includes trauma shears in bleeding-control kits specifically so clothing can be quickly removed when it obstructs access to an injury.

Why Trauma Shears Are Different From Regular Scissors

A good pair of trauma shears is built for a very different job than the scissors in your kitchen drawer.

The serrated cutting edge helps grip fabric instead of allowing slippery material to slide away from the blade. The blunt clothing-lift tip is designed to slide under clothing while reducing the chance of poking the patient. The offset blade and handle design also provide leverage when you are working through heavy or layered material.

North American Rescue describes its responder shears with these same basic features: stainless-steel construction, a serrated lower edge designed for tough materials, and a clothing-lift lip with a rounded tip intended to improve patient safety.

And the materials they may encounter can be surprisingly tough. Heavy denim, thick jackets, leather, boots, shoelaces, webbing, straps, seat belts, and zippers can all stand between you and the patient or injury underneath.

Years ago, one of the claims to fame for a good pair of trauma shears was that they could cut through a penny. That was not just folklore. Leatherman has documented using penny cutting during development testing of its Raptor Rescue shears, along with much more practical materials including leather boots, combat uniforms, zippers, webbing, and splints.

The same style of trauma shear I use in my kits has also been demonstrated cutting a penny in half. The point is not that anyone should be cutting coins with medical equipment. It is simply a demonstration of how much cutting ability can be built into such a basic-looking tool.

If a pair of shears can work through material that demanding, it gives me confidence when I need them to get through the materials people are actually wearing or surrounded by.

See an external demonstration of trauma shears cutting a penny:
https://www.youtube.com/shorts/0qQgan71Ck4

They Do More Than Cut Clothing

Trauma shears are most commonly associated with exposing injuries, but that is not the only reason I carry them.

Over the years, I have used them to cut cardboard down to size for an improvised splint, remove rope or twine wrapped around a body part, cut seat belts at vehicle collisions, trim dressings and tape, cut oxygen tubing that became tangled during a patient transfer, and work through other materials that were getting in the way of patient care.

I have even used trauma shears to cut through a thick rope during an emergency. It did not separate with one squeeze. Repeated cutting strokes gradually worked through the fibers, almost like sawing through the material, until the rope finally separated. It was not elegant, but the tool kept making progress until it got the job done.

Sometimes the problem is not the injury itself. Sometimes it is the material around the patient that is keeping you from moving, treating, or transferring them safely.

That versatility matters. In first aid and EMS, you do not always have a purpose-built tool sitting next to you for every problem. Sometimes the tool you already have becomes the tool that solves the next problem. A rigid piece of material can become an improvised splint. Rope or cord constricting an extremity may need to be removed. A seat belt, strap, tubing, or webbing may have to be cut before you can safely reach, move, or transfer a patient.

I have even used trauma shears on simple low-voltage vehicle wiring when I knew exactly what I was cutting. That is not a general use I recommend. Trauma shears are not electrical tools, and unknown vehicle wiring should never be cut casually. Modern vehicles can contain high-voltage systems, batteries, airbag circuits, and other supplemental-restraint components that can create serious hazards for rescuers.

The common denominator is simple: something is between you and the care you need to provide, and the shears help remove that obstacle.

The Goal Is Access, Not Destruction

Just because trauma shears can cut through a lot of material does not mean everything needs to be cut apart.

The goal is to expose enough of the patient or remove enough of the obstacle to safely provide care. If you can move clothing out of the way without interfering with the injury, that may be all you need. If clothing, boots, straps, equipment, or another material are preventing access, then cutting becomes useful.

There are also times when removing nearly all of a patient's clothing is part of the treatment. While working with the Vancouver Fire Department Marine Team aboard Fireboat 1, Discovery, we recovered a person from extremely cold water who was barely staying afloat. Once we got the patient aboard and into the wheelhouse, the wet clothing needed to come off so we could get the patient out of those cold, water-soaked layers and into warm blankets while we headed back to shore for transfer to the ambulance crew.

I used trauma shears to cut through essentially all of the patient's wet clothing. There was a lot of it, and some of the material was thick enough that by the end my hand was sore and beginning to cramp. But the shears kept working and got the job done.

That experience stuck with me because it demonstrated both sides of patient exposure. Unnecessary exposure can increase heat loss, but in a cold-water patient, wet clothing itself can become part of the problem. Current hypothermia first-aid guidance recommends getting the patient out of wet clothing and replacing it with dry insulation or blankets.

Good patient care is not about cutting everything off. It is about understanding when clothing is protecting the patient and when it has become an obstacle to care.

Practice With the Tool Before You Need It

A pair of trauma shears sitting in a kit is only useful if you know where it is and how it feels in your hand.

This is an easy piece of equipment to practice with. Take an old pair of jeans, a worn-out shirt, some webbing, an old seat belt, or an old jacket and actually cut through it. Pay attention to how the lower tip slides under the material, how much pressure the handles require, and what happens when you hit a seam, zipper, or several layers at once.

Cutting clothing on a training table is easy. Cutting it while someone is moving, while you are wearing gloves, or while you are trying to maintain pressure on a wound is different.

The first time you use your trauma shears should not be the first time someone is seriously bleeding.

Built to Be Used More Than Once

Trauma shears are not inherently a single-use item. Quality models are built from durable materials and can remain useful through repeated use when they are properly cleaned, inspected, and maintained. Some professional models, including North American Rescue's Responder Shears, are specifically designed to tolerate repeated cleaning and sterilization.

In my experience, even an older pair that no longer feels factory-sharp can continue cutting clothing surprisingly well. The serrated edge can still grip and work through soft materials even after the shears have seen plenty of use.

That does not mean a pair should stay in service forever. If the blades become damaged, loose, badly contaminated, rusted, or no longer cut reliably, replace them. But unlike gauze, dressings, and many other supplies in a medical kit, a good pair of trauma shears may serve you repeatedly for years.

That durability is a big part of their value.

Why They Belong in More Than One IFAK360 Module

Trauma shears do not stop bleeding by themselves. They do not replace a tourniquet, hemostatic gauze, wound-packing gauze, a pressure dressing, or the other equipment needed to actually treat an injury.

What they provide is access and versatility.

That is why I include trauma shears in Module 1 Hemorrhage Control, Module 1-K9 K9 Hemorrhage Control, and Module 6 Veterinary Wound Care & Irrigation. Whether the patient is a person or an animal, sometimes you first have to get through clothing, straps, bandaging material, webbing, or another obstacle before you can provide the care that is actually needed.

In Module 1, that may mean exposing a bleeding injury so the hemorrhage-control equipment can do its job. With an injured dog, the same basic tool can help remove gear, bandaging material, straps, or other obstacles that are keeping you from accessing the injury.

The sequence is simple: remove what is in the way, identify the problem, and use the appropriate tool for the situation in front of you.

The shears do not stop the bleeding. They help you get to the problem so the right tool can.

Sources & Further Reading

American College of Surgeons Stop the Bleed
Trauma shears are included in bleeding-control kits to help quickly remove clothing obstructing access to an injury.

North American Rescue: Responder Shears
Product information describing stainless-steel construction, serrated cutting edges, clothing-lift design, rounded patient-safety tip, and reusable construction.

Leatherman: History of the Raptor Rescue
A behind-the-scenes look at development testing that included pennies, leather boots, uniforms, zippers, webbing, and splinting material.

American Red Cross: Hypothermia
First-aid guidance addressing wet clothing, warming, insulation, and protection from continued heat loss.

Centers for Disease Control and Prevention: Preventing Hypothermia
Guidance on removing wet clothing and warming someone experiencing hypothermia.

MedlinePlus: How to Make a Splint
Guidance on using rigid improvised materials when a manufactured splint is not available.

National Highway Traffic Safety Administration: Emergency Response Guides
Vehicle-specific responder guidance covering high-voltage systems, batteries, supplemental-restraint systems, and other rescue hazards.

About the Author

Kevin Wilson is a firefighter/paramedic, Navy veteran, Stop The Bleed instructor, and founder of IFAK360. He brings more than two decades of prehospital experience to practical first-aid, trauma, and preparedness education. IFAK360 develops modular medical and trauma kits built around practical field experience, straightforward organization, and the belief that people should understand the equipment they carry before they need it.

Paramedic-Built. Ready for Everyone.