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Stop Bleeding

Bleeding refers to the loss of blood from blood vessels anywhere in the body. If someone has been wounded and is bleeding, it's important to work quickly to control blood loss. In most cases, you should be able to keep the bleeding under control without much difficulty. In more severe cases, however, uncontrolled or severe bleeding can contribute to shock, circulatory disruption, or more serious health consequences such as damage to tissues and major organs, which can lead to death. Follow the steps below to control bleeding.

Steps

Minor Wounds

A minor wound is one where the bleeding is oozing, slow, or the wound appears like a scrape, nick, or a scratch.

  1. Make sure the person is sitting or lying down.
  2. Clean to remove dirt and foreign debris. Clean the wound using running tap water or with an alcohol-free wipe. Do not use antiseptics, as these may damage the skin.[1]
  3. Apply a sterile bandage or dressing to the wound.
  4. Use finger or hand pressure directly on the wound. For minor injuries in people who do not have clotting problems, bleeding is likely to stop in under 10 minutes.[2]
  5. Seek medical attention if bleeding does not stop with continued pressure.

Serious Wounds

If a person is bleeding seriously, you will see blood spurting from a wound, or blood flow that is rapid and fails to clot despite measures being taken to stem the bleeding.

  1. Get the person to lie down. It will help to lessen the likelihood of shock if you can elevate the legs or position the head lower than the trunk. Check the victim's breathing and circulation before proceeding. See How to Treat Shock for information about how to recognize and manage symptoms of shock.
  2. If possible, elevate a wounded limb. It can help to control bleeding if a wounded limb can be elevated above the heart.[3] If you suspect a broken bone, however, do not attempt to move the limb.
  3. Remove dirt, any visible foreign body, and debris, but do not clean the wound thoroughly.[4] Your immediate priority is to stop severe bleeding. Cleaning the wound can wait.

    • If the foreign object is large however (large piece of glass, knife, or similar) do not remove it. It is most likely stopping a lot of the bleeding itself. Just put pressure and bandage around the object taking care not to push it in further.
  4. Apply firm pressure directly to the wound until the bleeding stops. Use a pad of clean gauze, dressing, or clothing. (Even your hand can work if nothing else is available.) Place your hand over the pad and apply firm pressure with fingers or a hand to the wound.
  5. Continue applying pressure steadily. If the injury is on a limb, you can use tape or a cloth wrapped around the wound to maintain pressure (a folded triangular bandage placed over the wound and tied is ideal). For groin or other parts of the body where you cannot wrap the wound, use a heavy pad and keep using your hands to press on the wound.[3]
  6. Look for seepage from the wound. Add more gauze or additional bandages if the original soaks through. Do not over-wrap it, however, as increased bulk risks reducing pressure on the wound. If you suspect the bandage is not working, remove the bandage and pad and reassess the application.[5] If the bleeding appears controlled, maintain pressure until you are sure the bleeding has stopped or medical help has arrived.
  7. Use pressure points if necessary. If you cannot stop bleeding by pressure alone, combine using direct pressure to the wound with pressure to one of these pressure points. Use your fingers to press the blood vessel against the bone. The most commonly needed are described below:[6]:

    • The brachial artery - For wounds on the lower arm. Runs on the inside of the arm between the elbow and armpit.
    • The femoral artery. For thigh wounds. Runs along the groin near the bikini line.[7]
    • The popliteal artery - For wounds on the lower leg. This is found behind the knee.
  8. Continue applying pressure until the bleeding stops or help arrives.
    • Do not use a tourniquet except as the last resort to save a life. How and when to use a tourniquet. If it is done incorrectly, it may lead to an unnecessary serious injury to or loss of the leg or arm. Warning: Using a tourniquet to stop bleeding is really only if the wound is so severe you are in danger of bleeding to death from it before it can be stopped. Get to help immediately.
  9. Monitor the victim's airway and breathing at all times. Check that the bandages are not too tight - if the victim has cold, pale skin, toes or fingers that do not restore to normal color after compression, or the victim complains of numbness or tingling, it is probable that the bandaging is too tight.[8]

Internal Bleeding

This article relates principally to controlling external bleeding. Unfortunately, there is very little you can do control internal bleeding, often the result of a severe accident, a disease, or an inherited medical condition. Internal bleeding should always be suspected following a serious injury. What you can do, however, is:

  1. Call an ambulance immediately. Get the bleeding victim to hospital as quickly as possible.
  2. Keep the victim calm, resting comfortably, and prevent further injury.
  3. Monitor the victim's airway, breathing and circulation. Attend to external bleeding as above.
  4. Maintain normal body temperature.</div>

Tips

  • There are three types of external bleeding: arterial, venous and capillary:[9]
    • Arterial bleeding: Arterial blood is under more pressure and moves rapidly, making it hard for clots to form. It is a bright red color owing to the oxygen content. It is the hardest to deal with.
    • Venous bleeding: This is easier to control; it is bleeding from veins, and is usually under less pressure and flows more slowly than arterial blood. Being lower in oxygen, it will be darker in color, more like maroon or dark red. Note that bleeding from varicose veins (usually found on the legs) can be profuse and can lead to death and should be treated as for severe bleeding.
    • Capillary bleeding: This is the most common type of bleeding. Blood from capillaries tends to "ooze" slowly from a wound, as the blood is under low pressure. It's not as red as arterial blood.
  • For serious bleeding, call for help, or ask someone else to call for help, as soon as possible.
  • When applying pressure to a bleeding wound, do not move the dressing to determine if bleeding has stopped. Instead, continue to apply pressure.
  • If available, put on rubber or latex gloves before coming in contact with others' blood. You can even use clean plastic bags to protect your hands.
  • If a person has suffered severe abdominal injuries, do not reposition organs. Cover them with a dressing until the person can be moved by people with emergency medical training.[4]
  • Venous bleeding can be stopped with a general pressure over the bleeding area or a "pressure" type dressing (not circumferential!) As stated, do NOT look under dressing to see if bleeding stopped. If the dressing is soaked with blood then it probably hasn't stopped. Reapply dressing with pressure in a different location. Get medical help
  • Arterial bleeding requires more specific pressure on the bleeding vessel than generalized pressure on venous-type bleeding. This may require finger-tip pressure at the point where the bleeding is coming from - NOT a generalized pressure. This is due to the higher pressure of the arterial system. ALL ARTERIAL INJURIES WILL ULTIMATELY REQUIRE PROFESSIONAL MEDICAL ATTENTION.</div>

Warnings

  • It is not generally recommended that you use a tourniquet. However, in the case of severe injuries or severed limbs, it is possible that you may need to use one to save a life. Understand that this may very well cost the person a limb.[10]
  • To prevent the transmission of disease between you and the victim, it is important to take specific precautions:[11]
    • Use a barrier between the bleeding and your skin. Wear gloves (preferably non-latex since some people may have an allergic reaction to latex), or use a clean, folded cloth.
    • Wash your hands thoroughly with soap and water after attending to a bleeding victim. Use a hand basin, not one usually used for food preparation.
    • Do not eat, drink, or touch your nose/mouth/eyes until you have thoroughly washed your hands after treating a bleeding victim.</div>

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Sources and Citations

  1. United Kingdom - National Health Service, at http://www.nhs.uk/chq/Pages/1054.aspx?CategoryID=72&SubCategoryID=72
  2. http://www.nlm.nih.gov/medlineplus/ency/article/003656.htm
  3. 3.0 3.1 U.S. NASD - Basic First Aid
  4. 4.0 4.1 MayoClinic.com - Severe Bleeding:First Aid
  5. Australian Red Cross, First Aid, Responding to Emergencies, p. 89, (2002), ISBN 9-780909-896744
  6. https://www.health.harvard.edu/fhg/firstaid/directPres.shtml
  7. http://firstaid.about.com/od/bleedingcontrol/ss/bleedingsteps_3.htm
  8. Australian Red Cross, First Aid, Responding to Emergencies, p. 89, (2002), ISBN 9-780909-896744
  9. Australian Red Cross, First Aid, Responding to Emergencies, p. 88, (2002), ISBN 9-780909-896744
  10. Survival, Evasion and Recovery - U.S. Military Field Manual FM 21-76-1 (1999)
  11. Australian Red Cross, First Aid, Responding to Emergencies, p. 90, (2002), ISBN 9-780909-896744

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