Bleeding

Severe bleeding can cause a person to go into shock, and if too much blood is lost, an injury can be fatal. It is always important to control bleeding as soon as possible when providing first aid. Never give a person who is severely bleeding anything to eat or drink, as they may need anesthetics later on. To best control severe external bleeding, take the following steps:

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1. Have another bystander call for emergency medical help while you attend to the bleeding. If there are no other bystanders, call for emergency help yourself.

2. Put on sterile latex-free exam gloves.

3. Expose the wound by removing all clothing or jewelry in the area.

4. Place a sterile bandage or clean cloth directly on the wound, holding firm, constant pressure to control the bleeding. Never apply direct pressure on an eye or on an embedded object.

5. Have the injured individual lie down, ideally on a rug or blanket to prevent heat loss, with his or her legs in the air above heart level. If possible, elevate the injury above the level of the heart.

6. Once the bleeding stops, secure the dressing with firm pressure that does not impair circulation. If blood seeps through the original dressing, do not remove the dressing but place another dressing on top of the saturated one. If blood seeps through both dressings, remove the dressings and apply a fresh dressing. 

7. Monitor vital signs and circulation in the injured area while you wait for help to arrive. Monitor the individual for signs of shock, including a pale complexion, shallow breathing, and/or fainting. 

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To treat a wound with an embedded object, take the following steps:

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1. Do not put pressure directly on the embedded object and do not attempt to remove the object. Simply apply pressure on both sides of the object.

2. If possible, elevate the injury above heart level.

3. Place gauze gently over the object and apply padding on either side of the embedded object.

4. Check circulation, monitor vital signs, and treat for shock if necessary.

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Even when blood is not visible, it is still possible for an individual to be suffering from internal bleeding. Signs of internal bleeding include:

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• Pale, clammy, or cold skin

• Blue/gray colored skin

• Thirst

• Shallow, rapid breaths

• Fast and weak pulse

• Loss of consciousness

• Confusion, agitation, or restlessness

• Blood coming from body openings (vomiting blood, pooping blood, urinating blood, coughing up blood, etc.)

• Patterned bruising

• Pain (especially at injury site)

• Swollen or tight abdomen

• Nausea and vomiting

• Headache or Dizziness

• Mechanism of injury or recent illness consistent with internal bleeding (such as blunt force)

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There is no first aid treatment for internal bleeding. However, if you suspect an individual is bleeding internally, take the following steps:

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1. Call immediately for emergency medical assistance.

2. Have the individual lie down and elevate his or her legs above the heart.

3. Cover the individual with a blanket to keep them warm. Don’t give anything to eat or drink.

4. Monitor vital signs and level of consciousness. If they become unconscious, lay them on their side. If breathing and circulation ceases, begin CPR immediately. 

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Resources

Austin, M., Crawford, R., & Armstrong, V. J. (2014). First aid manual. (G. M. Piazza, Ed.) (5th ed.). DK Publishing. https://kuiyem.ku.edu.tr/wp-content/uploads/2016/12/American-College-of-Emergency-Physicians-ACEP-First-Aid-Manual.pdf.

Better Health Channel. (n.d.). Bleeding. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bleeding.  

Mayo Clinic Staff. (2020, October 10). Severe bleeding: First aid. Mayo Clinic. https://www.mayoclinic.org/first-aid/first-aid-severe-bleeding/basics/art-20056661.