First Aid for External Bleeding: Step-by-Step Guide
Learn the step-by-step process of giving first aid for external bleeding, including essential techniques to control bleeding and ensure safety until help arrives.
Introduction
A sudden deep cut, a kitchen accident, or a traumatic injury: severe external bleeding is a frightening medical emergency where seconds count. Knowing what to do before professional help arrives can literally mean the difference between life and death. This guide provides clear, actionable steps for managing trauma external bleeding, empowering you to act confidently and effectively. We'll cover everything from identifying the type of bleed to applying advanced techniques like tourniquets, while also highlighting critical mistakes to avoid. Your knowledge is the first and most important aid anyone can receive.
Understanding the Types of External Bleeding
Not all bleeding is the same. Identifying the type of bleed helps you understand the severity and respond appropriately.
Capillary Bleeding: Minor Cuts and Scrapes
This is the most common type of bleeding. It originates from tiny capillaries close to the skin's surface. Think of a minor scrape on the knee or a small paper cut. The blood oozes out slowly and is usually bright red. It often clots and stops on its own within a few minutes with minimal intervention, typically just light pressure and cleaning.
Venous Bleeding: Steady Flow of Dark Red Blood
Veins carry deoxygenated blood back to the heart. When a vein is cut, the bleeding is steady and flowing rather than spurting. The blood is dark red, almost maroon, in color. While serious, it is often easier to control with direct pressure because the blood pressure in veins is lower than in arteries. However, a deep venous wound can still lead to significant blood loss.
Arterial Bleeding: Life-Threatening Spurting Blood
This is the most severe and dangerous type of external bleeding. Arteries carry oxygen-rich blood under high pressure from the heart. When an artery is severed, the blood spurts out with each heartbeat. The blood is bright, vibrant red. This type of bleeding can lead to fatal blood loss in a matter of minutes and requires immediate, aggressive action to control.
Consult a General Physician for the best advice
Your First Aid Priority: The Initial Response
In any emergency, panic is your enemy. Follow these three initial steps to ensure a calm and effective response.
Step 1: Ensure Your Own Safety
You cannot help someone if you become a victim yourself. Before rushing in, quickly scan the scene for ongoing dangers like traffic, fire, electrical wires, or violent individuals. If the scene is unsafe, do not enter. Call for professional help immediately and wait for them to secure the area.
Step 2: Call for Emergency Medical Help
For any significant bleeding, especially arterial or deep venous bleeding, call your local emergency number (e.g., 911, 112, 100) immediately or instruct a specific bystander to do so. Clearly state that there is a trauma victim with severe bleeding. If you are alone, put your phone on speaker so you can continue to administer aid while talking to the dispatcher.
Step 3: Locate the Source of Bleeding
Quickly find where the blood is coming from. You may need to cut away clothing to get a clear view of the wound. Do not waste time removing tightly stuck clothing; work around it. Identifying the exact source is crucial for applying direct pressure effectively.
The Golden Rule: Applying Direct Pressure
For the vast majority of external bleeding incidents, direct pressure is the single most effective way to control blood loss.
How to Apply Direct Pressure Correctly
1. Use a Barrier: If available, put on disposable gloves to protect yourself from bloodborne pathogens. If gloves aren't available, use a clean cloth, plastic bag, or any layer of material between your hand and the wound.
2. Apply Pressure: Place a sterile gauze pad or a clean cloth directly over the wound.
3. Press Firmly: Use the palm of your hand to apply firm, steady pressure. Do not peek to see if the bleeding has stopped for at least 3-5 minutes.
4. Add Layers: If blood soaks through the first layer, do not remove it. Removing the cloth can disrupt forming clots. Instead, add more gauze or cloth on top and continue applying pressure.
5. Elevate: If the wound is on a limb and you suspect no fracture, elevate it above the level of the victim's heart. This uses gravity to help reduce blood flow to the area.
When and How to Use a Tourniquet
A tourniquet is a last-resort device for life-threatening limb bleeding that cannot be controlled by direct pressure.
When to Use: Only for severe, life-threatening arterial bleeding (spurting blood) on an arm or leg.
How to Apply:
1. Place the tourniquet 2-3 inches above the wound, never on a joint.
2. Pull the strap tight and secure it.
3. Twist the windlass rod until the bleeding stops completely.
4. Note the time you applied the tourniquet and write it directly on the victim's forehead or on the tourniquet itself. Do not loosen or remove it once applied. This is a critical step for medical professionals.
Commercial vs. Improvised: A commercial tourniquet (like a CAT or SOF-T) is highly recommended. In an absolute emergency, an improvised tourniquet (a belt, strip of cloth, and a stick) can be used, but it is far less reliable.
Advanced Techniques for Severe Trauma
In cases of severe trauma, advanced medical techniques play a crucial role in saving lives and improving recovery outcomes.
How to Pack a Wound
For deep, gaping wounds where direct surface pressure isn't working (e.g., a large laceration or gunshot wound), wound packing may be necessary.
1. Fill the Cavity: Take sterile gauze or a clean cloth and firmly pack it directly into the depths of the wound.
2. Apply Pressure: Once packed, apply firm, direct pressure over the entire packed wound with both hands.
This technique helps transfer pressure directly to the source of the bleeding inside the wound.
Managing an Impaled Object
If an object (e.g., a knife, piece of glass, branch) is impaled in the body:
- DO NOT REMOVE IT. The object may be applying pressure to the injured vessels and preventing even worse bleeding.
- Stabilise the Object: Use bulky dressings, gauze, or cloth to build up around the object and hold it firmly in place.
- Secure the Dressing: Bandage around the object carefully to prevent movement. The goal is to immobilise the object until a surgeon can remove it in a controlled environment.
What NOT to Do: Common First Aid Mistakes
In emergencies, avoiding common first aid mistakes is just as important as knowing the right steps to take.
- Do Not Use a Tourniquet for Minor Bleeding: This can cause unnecessary tissue damage.
- Do Not Remove Impaled Objects: As stated above.
- Do Not Use Hydrogen Peroxide or Alcohol on a Deep Wound: These can damage tissue and hinder healing. Irrigation with clean, running water is best for cleaning once bleeding is controlled.
- Do Not Peek at the Wound: Lifting the dressing repeatedly disrupts the clotting process.
- Do Not Apply a Tourniquet Over a Joint: Place it on the bony part of the limb.
After the Bleeding Stops: Wound Care and Monitoring
Proper wound care after bleeding has stopped is essential to prevent infection and support faster healing.
Cleaning and Dressing the Wound
Once the bleeding is fully controlled, gently clean the area around the wound with soap and clean water, avoiding the wound itself initially. Pat dry. Apply an antibiotic ointment and cover with a sterile bandage or adhesive strip. For major wounds, paramedics will handle this.
Recognising Signs of Shock and Infection
Even after bleeding stops, monitor the victim for signs of shock (pale, cool, clammy skin; weakness; rapid pulse; confusion) and keep them warm and lying down. In the days following, watch the wound for signs of infection: increasing redness, swelling, warmth, pus, or fever. If you notice signs of infection or if the wound is deep, it is crucial to consult a doctor.
Building a Comprehensive First Aid Kit
Be prepared. Your kit should include:
- Multiple pairs of nitrile gloves
- Various sizes of sterile gauze pads
- Roller gauze for wrapping and securing
- Adhesive tape and bandages
- A commercial tourniquet (e.g., CAT Gen 7)
- Trauma shears for cutting clothing
- Antiseptic wipes
- A CPR face shield
- An emergency blanket
Conclusion: Be Prepared, Stay Calm, Make a Difference
Traumatic bleeding is a terrifying experience, but knowledge is power. By understanding the types of bleeding, mastering the technique of direct pressure, and knowing when and how to use a tourniquet, you transform from a bystander into a lifesaver. Remember the core principles: ensure safety, call for help, and stop the bleeding. Stay calm, follow these steps, and you can make a critical difference in an emergency. We encourage you to take a certified first aid and CPR course to practice these skills and build your confidence.
Consult a General Physician for the best advice
Consult a General Physician for the best advice
Dr. Rajib Ghose
General Practitioner
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr. Sandhya Chandel
General Physician/ Internal Medicine Specialist
16 Years • MBBS, MD (Int. Med.), IDCCM
Bilaspur
Apollo Hospitals Seepat Road, Bilaspur
(125+ Patients)
Dr. Paras Gangwal
General Physician/ Internal Medicine Specialist
28 Years • MBBS,MD General Medicine
Delhi
Dr Paras Gangwal Clinic, Delhi
Dr. Harshendra Jaiswal
General Physician/ Internal Medicine Specialist
12 Years • MBBS , MD (General medicine)
Kolkata
108 DHANA DHANVANTARI Clinic, Kolkata
(25+ Patients)
Dr. Sujay P R
General Physician/ Internal Medicine Specialist
3 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Consult a General Physician for the best advice
Dr. Rajib Ghose
General Practitioner
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr. Sandhya Chandel
General Physician/ Internal Medicine Specialist
16 Years • MBBS, MD (Int. Med.), IDCCM
Bilaspur
Apollo Hospitals Seepat Road, Bilaspur
(125+ Patients)
Dr. Paras Gangwal
General Physician/ Internal Medicine Specialist
28 Years • MBBS,MD General Medicine
Delhi
Dr Paras Gangwal Clinic, Delhi
Dr. Harshendra Jaiswal
General Physician/ Internal Medicine Specialist
12 Years • MBBS , MD (General medicine)
Kolkata
108 DHANA DHANVANTARI Clinic, Kolkata
(25+ Patients)
Dr. Sujay P R
General Physician/ Internal Medicine Specialist
3 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
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Frequently Asked Questions
What should I use if I don't have a first aid kit or clean gauze?
Use the cleanest material available to you. This could be a shirt, towel, or scarf. The priority is to stop the bleeding, even if the material isn't perfectly sterile. Using a plastic bag as a barrier between your hand and the wound is better than nothing.
How long should I hold direct pressure before checking the wound?
Hold firm, uninterrupted pressure for a full 5-7 minutes before even considering checking. Peeking too soon disrupts the fragile clot that is forming. If blood soaks through, add more layers on top and continue pressing.
Can a tourniquet cause someone to lose a limb?
The risk of limb loss from a properly applied tourniquet is very low, especially if medical help arrives within a few hours. This is a common fear, but it is far outweighed by the risk of death from uncontrolled bleeding. Saving a life always takes priority over saving a limb.
What are the best first aid steps for a nosebleed?
Sit up straight and lean forward slightly (do not lie down or tilt your head back, as this can cause blood to go down the throat). Pinch the soft part of your nose shut for 10-15 minutes. Apply a cold compress to the bridge of your nose.
When should I definitely go to a doctor for a cut?
You should seek professional medical care for a cut if: the bleeding doesn't stop after 10 minutes of direct pressure; the wound is deep, gaping, or has jagged edges; it was caused by a dirty or rusty object; there is numbness or inability to move the area; or if signs of infection appear later. For a quick consultation, you can connect with a doctor online on Apollo24|7 to determine if your wound needs in-person care.