Bleeding

Severe Bleeding
External Bleeding
Internal Bleeding

Severe Bleeding

What is it?

Blood pumping from a wound, bleeding that does not slow down with pressure, and/or bleeding that is quickly soaking through bandage after bandage.

Plan of Action:

Call 911 or your local emergency number if the wound is deep or you're not sure how serious it is. Don't move the injured person except if needed to avoid further injury.

Before checking for the source of the wound, put on disposable gloves and other personal protective equipment if you have them.
Remove any clothing or debris from the wound. Look for the source of the bleeding. There could be more than one injury. Remove any obvious debris but don't try to clean the wound. Don't remove large or deeply embedded objects, and don't probe the wound.
Stop the bleeding. Cover the wound with sterile gauze or a clean cloth. Press on it firmly with the palm of your hand until bleeding stops. But don't press on an eye injury or embedded object. Don't press on a head wound if you suspect a skull fracture.

Wrap the wound with a thick bandage or clean cloth and tape. Lift the wound above heart level if possible.
Help the injured person lie down. If possible, place the person on a rug or blanket to prevent loss of body heat. Elevate the feet if you notice signs of shock, such as weakness, clammy skin or a rapid pulse. Calmly reassure the injured person.
Add more bandages as needed. If the blood seeps through the bandage, add more gauze or cloth on top of the existing bandage. Then keep pressing firmly on the area.
Tourniquets: A tourniquet is effective in controlling life-threatening bleeding from a limb. If needed, apply a commercially made tourniquet if it's available and you're trained in how to use it. Don't use an improvised tourniquet, such as a scarf or a belt.

When emergency help arrives, tell them how long the tourniquet has been in place.
Keep the person still. If you're waiting for emergency help to arrive, try to keep the injured person from moving.

If you haven't called for emergency help, get the injured person to an emergency room as soon as possible.
Wash your hands. After helping the injured person, wash your hands, even if it doesn't look like any blood got on your hands.

External Bleeding

What is it?

Bleeding due to breaking of the skin from cuts, scrapes, etc.

With all bleeding injuries, first identify:

The amount of bleeding
The location of bleeding

If the flow of blood is continuous, steady, and heavy, consider the wound to be life-threatening.

Plan of Action:

For non-life-threatening bleeding:

Apply dressings over the bleeding area, and put direct pressure on the dressings using the heel of your hand
Direct pressure should be firm, steady, and constant
Do not remove pressure from the wound to add more dressings
Do not remove a dressing once it's placed because it could cause the wound to bleed more
Do not remove pressure until help arrives or the bleeding stops
If the bleeding is not stopping, press harder
Once the bleeding stops or you cannot keep pressure on the wound, wrap a bandage firmly over the dressings to hold them in place
A person who is bleeding should be seen by a healthcare provider ASAP because they may need stitches or a tetanus shot

When to Seek Emergency Care:

There is a lot of bleeding
You cannot stop the bleeding
You see signs of shock
You suspect a head, neck, or spine injury
You are not sure what to do

Internal Bleeding

What is it?

Bleeding inside the body.

When bleeding occurs inside the body, you may be able to see a bruise under the skin or you may not be able to see anything.

You should suspect internal bleeding if someone:

Was injured in a car crash or was hit by a car
Fell from a height
Was injured in the abdomen or chest (including bruises such as seat belt marks)
Was injured in a sporting event, such as slamming into other people or being hit with a ball
Has pain in the abdomen or chest after an injury
Has shortness of breath after an injury
Is coughing up or vomiting blood after an injury
Shows signs of shock without external bleeding
Was stabbed or shot

Plan of Action:

Call 911, and get a first aid kit and AED
If the person is responsive, have them lie down and keep still while you treat any external injuries
Check for signs of shock and provide first aid as needed
Be prepared to provide CPR if they become unresponsive and stops breathing normally

Bleeding

Severe Bleeding

What is it?

Blood pumping from a wound, bleeding that does not slow down with pressure, and/or bleeding that is quickly soaking through bandage after bandage.

Plan of Action:

Call 911 or your local emergency number if the wound is deep or you're not sure how serious it is. Don't move the injured person except if needed to avoid further injury.

Before checking for the source of the wound, put on disposable gloves and other personal protective equipment if you have them.

Remove any clothing or debris from the wound. Look for the source of the bleeding. There could be more than one injury. Remove any obvious debris but don't try to clean the wound. Don't remove large or deeply embedded objects, and don't probe the wound.

Stop the bleeding. Cover the wound with sterile gauze or a clean cloth. Press on it firmly with the palm of your hand until bleeding stops. But don't press on an eye injury or embedded object. Don't press on a head wound if you suspect a skull fracture.

Wrap the wound with a thick bandage or clean cloth and tape. Lift the wound above heart level if possible.

Help the injured person lie down. If possible, place the person on a rug or blanket to prevent loss of body heat. Elevate the feet if you notice signs of shock, such as weakness, clammy skin or a rapid pulse. Calmly reassure the injured person.

Add more bandages as needed. If the blood seeps through the bandage, add more gauze or cloth on top of the existing bandage. Then keep pressing firmly on the area.

Tourniquets: A tourniquet is effective in controlling life-threatening bleeding from a limb. If needed, apply a commercially made tourniquet if it's available and you're trained in how to use it. Don't use an improvised tourniquet, such as a scarf or a belt.

When emergency help arrives, tell them how long the tourniquet has been in place.

Keep the person still. If you're waiting for emergency help to arrive, try to keep the injured person from moving.

If you haven't called for emergency help, get the injured person to an emergency room as soon as possible.

Wash your hands. After helping the injured person, wash your hands, even if it doesn't look like any blood got on your hands.

External Bleeding

What is it?

Bleeding due to breaking of the skin from cuts, scrapes, etc.

With all bleeding injuries, first identify:

The amount of bleeding

The location of bleeding

If the flow of blood is continuous, steady, and heavy, consider the wound to be life-threatening.

Plan of Action:

For non-life-threatening bleeding:

Apply dressings over the bleeding area, and put direct pressure on the dressings using the heel of your hand

Direct pressure should be firm, steady, and constant

Do not remove pressure from the wound to add more dressings

Do not remove a dressing once it's placed because it could cause the wound to bleed more

Do not remove pressure until help arrives or the bleeding stops

If the bleeding is not stopping, press harder

Once the bleeding stops or you cannot keep pressure on the wound, wrap a bandage firmly over the dressings to hold them in place

A person who is bleeding should be seen by a healthcare provider ASAP because they may need stitches or a tetanus shot

When to Seek Emergency Care:

There is a lot of bleeding

You cannot stop the bleeding

You see signs of shock

You suspect a head, neck, or spine injury

You are not sure what to do

Internal Bleeding

What is it?

Bleeding inside the body.

When bleeding occurs inside the body, you may be able to see a bruise under the skin or you may not be able to see anything.

You should suspect internal bleeding if someone:

Was injured in a car crash or was hit by a car

Fell from a height

Was injured in the abdomen or chest (including bruises such as seat belt marks)

Was injured in a sporting event, such as slamming into other people or being hit with a ball

Has pain in the abdomen or chest after an injury

Has shortness of breath after an injury

Is coughing up or vomiting blood after an injury

Shows signs of shock without external bleeding

Was stabbed or shot

Plan of Action:

Call 911, and get a first aid kit and AED

If the person is responsive, have them lie down and keep still while you treat any external injuries

Check for signs of shock and provide first aid as needed

Be prepared to provide CPR if they become unresponsive and stops breathing normally