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First Aid for Bleeding

If you want First Aid for Bleeding Info on any of the below links click on them to go to the specific page.
But if you want to understand more about bleeding, bloods appearance, components and functions continue
reading till the end of this page.
First Aid Severe Bleeding - External
What to do with severe bleeding:
Quick Summary:

Check the person's breathing and pulse. If needed apply CPR.

Then the immediatethings to do are :1. Call for help and call emergency services
2. Apply gloves if available
3. Apply pressure to the bleeding wound
4. And elevate above the heart. Injuries permitting
5. When the severe bleeding slows down or stops tie the padding firmly in place.
6. Montior DR-ABCD's - (New version of ABC's). If needed applyCPR.

**Please review the below explanations of these steps.**

Here is a more IN-DEPTH EXPLANATION of the above steps to treat severe bleeding:

If possible, before you touch the bleeding area wash your hands with soap and water. DO NOT wash the
wound except in the case of a dog bite or chemical burn.

If you have synthetic gloves "fantastic". Use them to protect you from possible transmission of the
unfortunate nasties that can be in peoples' blood (which is the primary reason why gloves are used in these
situations). Otherwise avoid coming in contact with blood if possible which is easier said then done.

You may need to remove or cut clothing so you can see the wound and make an assessment.

If the severe bleeding is from the trunk of the body and organs are showing or have come out do not
push them back in. Cover the wound with a dressing to help prevent foreign contaminates entering the area. It is
very difficult and usually not advised to apply pressure around organs.

At this point the priority is to stop the severe bleeding so don't probe around the wound removing
objects or cleaning at this stage. The only time to remove debris or objects is if they are on the surface of the
wound and are quickly and easily removed.

If exposed organs are not involved then apply DIRECT PRESSUREon the wound (but do not apply direct
pressure on penetrating objects see below).
NOTE:- the purpose of applying direct pressure is to help the blood form a clot at the wound site. This is the

body's natural way of forming a "cork" to block the blood from exiting. Much in the way a cork stops wine from
leaving a bottle.

If possible use a dressing pad but if that is not available be creative by using things such as a clean
towel/s, clothing like clean socks or even a clean nappy (diaper) anything that will absorb the blood and help
with applying pressure. If you can't locate anything to use straight away then just use your hand.

DO NOT apply pressure directly to penetrating objects. AND DEFINITELY do not remove large or
deeply embedded objectsas this can make the bleeding worse or cause more damage (at times these objects
may actually be assisting in reducing the severity of bleeding by blocking a damaged blood vessel). Leave their
removal to medical professionals.

And certainly do not apply disinfectant or the like as wound care is secondary at this stage. Your time
is best spent in stopping the flow of blood.

ELEVATE - (if injuries permit) Elevation assists in reducing blood flow to the area therefore reducing
pressure at the site and helps give clotting a better chance to form.

Hold continuous pressure for at least 20 minutes before you check to see if bleeding has stopped.

If blood seeps through the dressing do not remove it as this may dislodge the clot resulting in you
being back to square one where the blood flows freely again. You may need to make sure you are applying
pressure at the correct point and "peek" under the pad rather than remove it altogether for a look.

Then put a second padding on top of the first and re apply direct pressure.

IF injuries allow, lie the person down. This is for the reasons below:-

it can make it easier to elevate the effected area.

it can help reduce blood flow at the wound site.

the body's response will be to "faint/fall down" in an attempt to get the person to lie flat. This
makes it easier for the heart to get blood and therefore oxygen to the brain as it is not working "against"
gravity. So if injuries allow try and have the head lower then the heart to help this process.

some people find seeing blood difficult and can end up getting "wobbly" and faint, so if they are
laying down then they do not fall down. This is better for everyone.

If it is difficult to maintain pressure with your hand you can bind the wound with a bandage or the like
(strips of cloth etc) and the bandage can be held together with tape of any sort if available. The important thing
is that sufficient pressure is applied to help the clotting process.

If the bleeding has not been controlled by the above stepsthen go to first aid for uncontrolled
bleeding for what to do next.

When the severe bleeding slows down or stops tie the padding firmly in place.

If you have a bandage apply it but if not be creative again and use things like a scarf, a neck tie
or strips of cloth.

If it is difficult to tie or you prefer to tape the end of the "bandage" down then use any type of
tape that will adhere to the material, or wind the tape completely around so it can adhere to itself. Electrical
tape can work a treat.

But whatever you use do not bind/tie/tape it so tightly that blood flow is so restricted that the
area past the wound does not receive the vital blood that it needs. A slow pulse below the area and/or bluish
fingers or toes are signals that the bandaging may be too tight and impeding circulation.

Otherwise Immobilise the injured part. There are a variety of ways to do this such as using another
limb with an injured leg or the trunk if the arm is injured. So just use common sense as the principle is to stop
the area from moving around and re-triggering the bleeding.

If possible cover the person with a blanket. Do this in a way that does not interfere with access to the
wound so it can be observed in case it starts bleeding again.

Observe for Shock as it is highly probable as a result of severe bleeding. (see Shock)

Reassurance goes a long way in helping the injured person feel secure and safe.

Monitor DR-ABCD's (new version of ABC's). Stay with the person until medical help arrives. If you want a
better understanding of CPR go to CPR Questions and Answers.

Keep checking the injury site to see that it is stable so the severe bleeding remains under control.

Do not give food or drink unless given permission by medical help.

First Aid for Uncontrolled Severe Bleeding


Sometimes severe bleeding is caused by major injuries like partial limb amputations, deep lacerations by a sharp
object or animal attacks (like a bear or shark attack) can not be stopped by direct pressure.
Using a Constrictive Bandage/Tourniquet is a LAST RESORT so if you have not already done so go toFirst Aid
for Severe Bleeding.

If you have already applied direct pressure to the wound,


As well as tried to block the artery that supply's blood to the injured area, and these techniques have not
stopped this life-threatening bleeding.
Then you may need to resort to applying a constrictive bandage (tourniquet).

QUICK SUMMARY:
1. Make a tourniquet use Strips of cloth, wide belt or similar. NON-elastic is best.
2. Tie it firmly until the pulse below is no longer able to be felt and bleeding has stopped.
3. Write down the time of application.
4. After 30 minutes release the bandage and check if the bleeding has stopped. If it has then remove the
constrictive bandage.
5. If significant blood flow continues than apply direct pressure to the wound site.
6. If this does not stop the bleeding then reapply the constrictive bandage and check again in 30 minutes.
7. DO NOT forget to write the NEW time down.

8. When bleeding stops apply a sterile dressing and bandage.


**Please review the below explanations of these steps.**
If the injury involves an amputated limb please also read Uncontrolled Severe Bleeding involving a partial or full
amputation (below).

Here is a more IN-DEPTH EXPLANATION of the above steps to treat uncontrolled severe bleeding:What is needed to make a tourniquet:

Strips of cloth, wide belt or similar. NON-elastic is best. About the width of a large car key (7.5
cm or 3 in) and the length of a medium size leg (75 cm or 30 in). Use your creativity e.g. use a folded or torn
to size cloth/sheet or a folded triangular bandage.
How to apply a constrictive bandage:-

Wrap the cloth firmly around the injured limb between the heart and the bleeding wound. Usually
above the knee or elbow.

Tie it firmly until the pulse below is no longer able to be felt and bleeding has stopped. If you
have difficulty tightening the bandage tie a knot then put a stick, pen or similar on top of the knot and
than tie another knot. Turn the "stick" to twist the bandage tighter. Just enough to stop the bleeding and pulse
below the tourniquet. Secure one end of the "stick" to the limb to stop the stick from untwisting.

Write the time of application on the person's skin if at all possible (as a paper note so easily
is lost) and so medical staff can see easily and quickly when it was applied.

After 30 minutes release the bandage and check if the bleeding has stopped. If it has then
remove the constrictive bandage.

If significant blood flow continues than apply direct pressure to the wound site.

If this does not stop the bleeding then reapply the constrictive bandage and check again in
30 minutes.

DO NOT forget to write the NEW time down. This is easily forgotten and may cause action by
medical staff that is not needed.

When bleeding stops apply a sterile dressing and bandage if available if not then use
something clean like a shirt or clothing to prevent debris or the like from entering the wound.
VERY IMPORTANT NOTE: It is vital that the tourniquet is clearly visible and not covered by clothing, blanket or
the like. Ensure that you tell medical staff the location and time it was applied.

Uncontrolled Severe Bleeding involving a partial or


full amputation.
If this is the case once the severe bleeding has stopped at the attached limb or if help is available proceed to do
the below:Partial Amputation

If the limb is partially severed then any kinking or twisting should be corrected where possible.

Then cover the wound with a dressing (sterile if possible) or improvise with a clean cloth or the
like.

Splint the appendage to the limb. You can use another part of the body, such as a leg or torso to
immobilise the area. Consider putting a towel or similar in between the injured part and the splint for comfort.

If available apply ice to the severed part but do not allow direct contact as this can cause the
tissue to freeze and increase damage.

If ice is not available then wrap a moist cloth around the part.
Full Amputation

Collect amputated part.

Keep it dry.

DO NOT wash or clean it. Trained Medical staff will do this.

DO NOT soak it in water or any other liquid.

Seal the part in a plastic bag or wrap in water proof material.

If available put some ice in a container, place a cloth or towel on top of the ice and then place the
amputated part that is already in the bag on top (it must not be in direct contact with the ice and must not be
soaking in water) Freezing will kill the tissue of the amputated part.
If ice is not available than wrap the part in a moist cloth.
IT IS VITAL that the amputated part travels WITH the person to the hospital NOT separately.
Time is vital. If they get separated and surgery is delayed this may affect the viability of the amputated part
resulting in the amputation being permanent.

So being able to make a good assessment when you have someone bleeding is vital. Having
an understanding of bloods appearance and function can make all the difference to the end result. So
let's find out more about blood and bleeding...
First Aid for Internal Bleeding
Internal Bleeding occurs when there is a rupture of either an artery, vein or capillaries within the body.
Sometimes the bleeding is visible and other times not.

Concealed Bleeding is more difficult to recognise than visible bleeding therefore if you are unsure it is
better to treat the person as if they are losing blood internally. It does no harm to the casualty, to be managed this
way but it could be life threatening if treatment is not initiated.
Remember to look at the important observations that may indicate internal blood loss and a shock response , which
include:

Skin appearance

Conscious state

Pulse

Respiration
Also visible bleeding
For more signs and symptoms to confirm internal blood loss see Internal Bleeding - Recognition.
If you are unsure, assume the worst and treat for internal bleeding.Unfortunately, the untrained medical
person can not stop internal blood loss. However, the aim of management is to try and assist in slowing down the
loss of blood so the chance of survival is increased.

Management

Call or get someone to call emergency services. Dont wait to see if the person improves or deteriorates.

If available put synthetic gloves on as bleeding may become apparent.

Check airway, breathing and circulation. Begin cardiopulmonary resuscitation (CPR) if necessary. If you
want to understand CPR in more depth then go to CPR- Q's & A's.

If unconscious and breathing place the person in the recovery position and with legs higher than the
heart if possible. Injuries permitting.

If conscious lie the casualty down and raise or bend legs if injuries permit.

Keep casualty warm. This may help delay the onset of shock by minimising the bodies heat loss.

Reassure and stay calm. This helps provide security for the injured person.

Continue to check pulse and breathing.

Treat other injuries as appropriate.

Do not give anything to eat or drink as they may require surgery to stop the bleeding.
NOTE: If surgery is needed it is best that the person not consumed anything for minimum of 6 hours prior to
having anaesthetic. The reason for this is if the stomach has contents in it they can exit the stomach and be
inhaled into the lungs or remain in the throat and cause difficulty breathing during the operation. Neither the
patient nor the medical staff need this complication during surgery.

First Aid for Nosebleeds

First Aid for Cuts and Scrapes


Knowing first aid for cuts when someone has been hurt can make a big difference to the outcome.

Often cuts and scrapes can be treated at home, but more severe cutsrequire prompt first aid and may need
medical attention.
QUICK SUMMARY:
1. Wash your hands with soap and water.
2. Put gloves on if available.
3. Apply firm but gentle pressure on the cut with a clean cloth or piece of gauze for about 20 minutes.
4. If possible raising the injured part above the person's heart to help slow the bleeding.
5. IF the bleeding is more severe and injuries allow, lie the person down.
6. If bleeding from a cut can not be controlled with gentle pressure go to First Aid for Severe Bleeding.
7. Once the bleeding stops clean the wound. (See below for how to do this.)
8. Apply a clean if possible sterile dressing if needed. For smaller cuts and scrapes you may only need a
band-aid or a steri-strip or two (see below).
9. If you have any concerns seek medical help.

IN-DEPTH EXPLANATION of the above steps for first aid for cuts and scrapes:First Aid for Cuts and Scrapes - So what do I do?
If possible, before you touch the bleeding area wash your hands with soap and water.

If you have synthetic gloves "fantastic". Use them to protect you from possible transmission of the unfortunate
nasties that can be in peoples' blood (which is the primary reason why gloves are used in these situations).
Otherwise if possible avoid coming in contact with blood which is easier said than done.
First Aid for Cuts - What about the bleeding?

Bleeding helps clean or flush out wounds. This is one advantage or purpose for bleeding which is helpful
when there is debris or possible contamination.

Most small cuts or scrapes will stop bleeding in a short time but be aware that cuts on the face, head or
mouth often bleed a lot because they are rich in blood vessels.

Typically minor cuts and scrapes will stop bleeding easily on their own.

If the bleeding does not stop apply firm but gentle pressure on the cut with a clean cloth or piece of gauze
for about 20 minutes. The pressure should be continuous, so don't lift the cloth to check if the bleeding has
stopped.

If possible avoid using tissues or similar items that leave small fibres in the wound as these "foreign
bodies" can cause infection later down the track as well as prevent healing.

If blood seeps through the dressing do not remove it as this may dislodge the clot resulting in you being
back to square one where the blood flows freely again. If bleeding is from a large area or more severe than first
thought you may need to make sure you are applying pressure at the correct point and "peek" under the pad
rather than remove it altogether for a look. Then put a second padding on top of the first and re apply direct
pressure.

If the wound is on an arm or leg, raising it above the person's heart will help slow the bleeding.

IF the bleeding is more severe and injuries allow, lie the person down. This is for the reasons below:-

it can make it easier to elevate the effected area.

it can help reduce blood flow at the wound site.

some people find seeing blood difficult and can end up getting "wobbly" and faint, so if they are
laying down then they do not fall down. This is better for everyone.

If bleeding becomes or is severe the body's response may be to "faint/fall down" in an attempt to
get the person to lie flat. This makes it easier for the heart to get blood and therefore oxygen to the brain as it
is not working "against" gravity. So if injuries allow try and have the head lower than the heart to help this
process.
If bleeding from a cut can not be controlled with gentle pressure go to First aid for severe bleeding.

Or if it is spurting this usually means there is bleeding from an artery so if you have already tried the
steps at First aid for severe bleeding then got to First aid for uncontrolled bleeding.

First Aid for Cuts - Once the bleeding stops what should I do?

You will need to clean the cut. Flush the cut with clean water. If possible put the wound under running water or fill
a tub with tepid water and pour it from a container or cup over the wound. If you are away from running water
normal saline is ideal for wound cleaning.
What is tepid water temperature?
Put your finger under the flowing water if you do not feel a difference in temperature of the water compared to you
hand (so long has you have not had it under hot water for a while) you then have tepid water temperature.
Another way of putting it is lukewarm so not warm and not cold.
First Aid for Cuts - How do I clean the wound?
Using just water or normal saline on the wound itself should be adequate to remove most debris or bacteria. If any
debris like dirt, grass, hair etc. remain remove these with sterile tweezers or if not available use tweezers cleaned
with alcohol.

I find that water works fine to clean the surrounding area but you can use a mild soap if required, but don't get
soap in the cut. Soap will only irritate the open wound and cause discomfort to the person.
Thorough wound cleaning reduces the risk of infection and tetanus.
First Aid for Cuts - Should I use an antibiotic ointment?
This is up to you. Here are some things to consider:
Most minor cuts and scrapes will heal just fine without antibiotic ointment. These types of products don't make the
wound heal faster, but they can discourage infection and allow your body's healing process to close the wound
more efficiently.
Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the
ointment.
An appropriate dressing and bandage can do pretty much the same thing.
First Aid for Cuts - Should I use a wound dressing?
This depends on the wound and its size.
If it is a small wound and isn't in an area that will get dirty or be rubbed by clothing, you don't have to cover it. But
if it is in an area that will get dirty (your hand say) or be irritated by clothing (such as your knee), cover it with
band aide or a sterile non stick dressing and adhesive tape.
With larger cuts initially you will cover the cut with a dressing and bandage to prevent bacteria from getting in.
Bandages can help keep the wound clean and keep harmful bacteria out. After the wound has healed enough to
make infection unlikely a dressing may no longer be needed.

Change the dressing each day to keep the wound clean particularly if the wound is oozing. Ooze can be a breeding
ground for bugs therefore cleaning the wound and changing the dressing daily is important in stopping the bugs
partying and breeding in your wound.
First Aid for Cuts - When are stitches needed?
Stitches may be needed for deep wounds so more than 1/4 inch (6 millimetres) deep.
or
If the wound:

is gaping.

has jagged edges.

has fat or muscle protruding.


First Aid for Cuts - When should I use steri-strips or the like?
With smaller cuts you may be able to pull the edges together with a strip or two of surgical or cloth tape. These
tapes may be called butterfly tape or Steri-Strips.

If the mouth of the wound does not pull together neatly see your doctor as soon as possible as correct closure of
cuts within a few hours reduces the risk of infection and severity of scarring.
First Aid for Cuts - What should I do about scabs?
If the wound is small just leave them. Scabs are the body's original bandage. They form to protect wounds from
dirt. It's best to leave them alone and not pick at them, tempting as that maybe, as the area can become itchy.
They will fall off by themselves when healing has finished underneath them. Clever hey.

If the wound is larger, scabs can hide bacteria under them. The cheeky bugs can have a breeding party under the
scab. Therefore larger wounds usually heal better with a clean, moist dressing that is changed daily. There are
dressings that can remain on longer, these are called occlusive or semi-occlusive dressings, but have a medical
professional recommend if this is best for you. You can buy them in drug stores/chemists over the counter without
a prescription. So if you have seen a doctor or nurse they can tell you what dressing is best for the wound.
First Aid for Cuts - When should I call my doctor?
If the below occurs at the time of injury:

The cut has dirt in it that has not or won't come out.

The wound is jagged (as mentioned above).

The cut bleeds in spurts which would indicate that an artery is bleeding.

The bleeding doesn't stop after 10-20 minutes of firm, direct pressure.

The wound is on your face because medical professionals can treat the cut appropriately to help reduce
scaring.
or
If the below occurs at a later stage:-

The edges of the cut gape open.

The cut becomes tender or inflamed.

The cut drains a thick and/or smelly fluid.

You have a generalised temperature. This may indicate infection.

The area around the wound feels numb or hot to touch.

Red streaks appear near the wound.

If it's a deep cut or a puncture wound and you haven't had a tetanus shot in the past 5 years get the
booster within 48 hours of the injury.
Some points to note about a severely bleeding cut

Do not try to clean a major wound

Do not remove deeply lodged debris

Do not breathe on an open wound

Do not push back exposed body parts


Please refer to First Aid for Severe Bleeding for more on severe bleeding.
Also when you need to give first aid for cuts making a good assessmentwhen you have someone bleeding is
vital. Having an understanding of bloods appearance and function can make all the difference to the end
result. So let's find out more about blood and bleeding...

IMPORTANT NOTE: the likelihood of shock occurring with severe blood loss is high. So if you need to go
straight to First Aid for Shock than click here.

Bloods appearance, function and components


Having an understanding of bloods appearance, function and components can help with making a good assessment
when giving First Aid for bleeding so here is some important info...
Blood appearance is different depending on whether it is coming from arteries, veins or capillaries.
Arterial bleeding:

is bright red (although it darkens when it meets the air)

usually spurts with each heart beat

usually severe and hard to control


Venus bleeding:-

dark red to maroon in colour

is more steady in flow


Capillary bleeding is:-

red in colour

usually slow more like an ooze

Basic components of blood


Red blood cells - contain haemoglobin that carry oxygen around the body. It is the iron in the haemoglobin that
gives blood its red colour. When the blood goes from the heart to the lungs the haemoglobin molecules bind with
the oxygen in the lungs. After the blood passes through the lungs it briefly returns to the heart to be pumped to
the rest of the body delivering the oxygen to the rest of the body's cells.
White blood cells - the main function is to fight and remove disease from the blood. Some types of white cells eat
both harmful bacteria and the damaged and dead cells that naturally occur during the life cycle of the body.

Platelets - are responsible for blood clotting. When platelets are exposed to air during bleeding they are involved
in a process that creates a long stringy substance that mats together to create clotting. This blocks or "clogs
up" the wound with the intention of preventing blood from escaping.
Plasma - a yellowish watery fluid that is left after the red blood cells, white blood cells and platelets are removed.
Plasma dissolves various substances like sugar, food, minerals, waste products etc for transport around the body.

Three Main Functions of Blood

Transporting oxygen, nutrients and waste around the body

Assisting in the maintenance of optimum body core temperature

Transporting cells that are to defend against germs, assist with clotting and assist in the process of healing

I hope you have found our information on first aid for bleeding and the bloods appearance, function and
components helpful.
Now you may want to learn what to do for First Aid for Severe Bleeding...

Or see how to give First Aid for Internal Bleeding...

Maybe you have a nosebleed and need First Aid info NOW...