Stopping Severe Bleeding: Pressure, Packing, Tourniquet

Uncontrolled bleeding is one of the fastest ways an injured person dies, and one of the most preventable. The Stop the Bleed program run by the American College of Surgeons teaches three actions anyone can take. Take one of its free hands-on classes: reading about this is no substitute for practice.

First

• Make sure the scene is safe for you.
• Call 911 (or have someone call) if help exists.
• Protect yourself from blood with gloves if you have them.
• Find the bleeding. Open or cut away clothing to see the wound. Life-threatening bleeding is blood that is spurting, pooling, or soaking through clothing or bandages.

1. Direct pressure

Put a clean cloth or gauze on the wound and press hard with both hands, with your body weight behind it. Don’t keep lifting it to look. Keep pressing.

2. Pack the wound

For a deep wound, especially where a tourniquet won’t fit (neck, armpit, groin), pack it: stuff gauze or clean cloth firmly down into the wound, right onto the bleeding, until it is filled, then hold hard pressure on top.

3. Tourniquet (arms and legs)

If pressure doesn’t stop severe bleeding from an arm or leg, apply a tourniquet:

• Place it 2–3 inches above the wound, between the wound and the heart. It can go over clothing.
• Not on a joint. If the wound is at or just below a joint, go above the joint.
• Tighten the strap, then twist the windlass until the bleeding stops, and lock it in place. It will hurt. That is normal.
• Note the time it was applied: write it on the tourniquet or the skin, or tell responders.
• If bleeding continues, a second tourniquet above the first is standard training.
• Leave it on. Removing it is for medical professionals.

A commercial tourniquet is far more reliable than an improvised one. Carry one in your kit and car, and practice putting it on yourself one-handed.

Then

Keep the person warm, since blood loss and cold make each other worse (see hypothermia), keep pressure on, and get them to care as fast as you can.