Preparation and awareness are key to treating any wound properly. This starts with having a fully stocked first aid kit close at hand wherever you are. It is equally important to recognize when bleeding requires emergency care.
Bleeding Emergencies
People don’t always know if a wound is serious enough to warrant a call to 911. Or, they may be reluctant to make the call because of a lack of insurance. If in doubt, though, it is always best to err on the side of caution and make the call.
As a general rule, you need to call 911 or rush the injured party to the nearest emergency room if:
The wound is deep enough to reveal the underlying dermis or fatty subcutaneous layer. The bleeding can’t be stopped with 10 minutes of firm, steady pressure. The injured party is showing signs of shock.
Even if you are able to stop the bleeding, don’t assume that medical care is no longer needed. The wound may still require stitches to heal properly. Certain wounds require vaccination to reduce the risk of tetanus or rabies. Lacerations or puncture wounds on the joints and other vulnerable parts of the body can cause permanent nerve, ligament, or tendon damage if not treated appropriately.
It is therefore important to seek immediate medical care if:
A wound is gaping, and you can’t press the edges together with gentle pressure. There is a deep laceration or puncture wound on a joint. The wound has been contaminated with a very dirty or rusty object. The wound was caused by a human or animal bite. The wound is on or around the genitals.
Symptoms to Watch For
Even if the bleeding is stopped, it should almost invariably be seen by a healthcare provider if the wound is deep or there was profuse, spurting blood. The same applies if there was a significant loss of blood, which could lead to a potentially life-threatening condition known as hypovolemic shock.
Call 911 if the injured party experiences signs of shock, including:
Pale, cold, clammy skin Shallow, rapid breathing Difficulty breathing Rapid heartbeat Irregular heartbeats or palpitations Disorientation or confusion Dry mouth or unusual thirst Dark urine or no urine output
You should also seek care if the wound becomes infected. See a healthcare provider immediately if the injured party experiences a high fever, chills, nausea or vomiting, and a rapidly expanding area of hot, swollen, and tender skin. These could be signs of a potentially deadly infection known as cellulitis.
How to Stock a First Aid Kit
While you can certainly purchase a fully stocked first aid kit online and in most drugstores, you can put one together on your own. If you do decide to make your own kit (for the house, car, office, etc.), the American Red Cross suggests that you include the following:
Two 5 x 9-inch absorbent compress dressingsFive 4 x 4-inch sterile gauze padsFive 3 x 3-inch sterile gauze padsTwo triangular bandagesAdhesive bandages in assorted sizesA roll of adhesive cloth tape (10 yards x 1 inch)Five antibiotic ointment packetsFive antiseptic wipesHydrocortisone ointmentOne roller bandage (4 inches wide)Tweezers
The best way to stop it is to:
Put pressure directly on the wound. If you have some type of gauze, use it. Gauze pads hold the blood on the wound and help the components of the blood to stick together, promoting clotting. If you don’t have gauze, terrycloth towels work almost as well.
If the gauze or towel soaks through with blood, add another layer. Never take off the gauze. Peeling blood-soaked gauze off a wound removes vital clotting agents and encourages bleeding to resume.
Once bleeding is controlled, take steps to treat the victim for shock.
Step two to control bleeding uses this principle.
Elevate the wound above the heart to slow the flow of blood. As the blood slows, it becomes easier to stop it with direct pressure. Remember, the wound must be above the heart and you must keep direct pressure on it.
When using pressure points, make sure you are pressing on a point closer to the heart than the wound. Pressing on a blood vessel farther from the heart than the wound will have no effect on the bleeding.
Remember to also keep the wound elevated above the heart and keep pressure directly on the wound.
Arm between shoulder and elbow - brachial artery Groin area along bikini line - femoral artery Behind the knee - popliteal artery
Tourniquets severely restrict or occlude blood flow to the arm or leg to which they are applied. Using a tourniquet to stop bleeding has the potential to damage the entire arm or leg. People lose limbs from the use of tourniquets.
If a tourniquet doesn’t cause a loss of function in the extremity, then it probably wasn’t applied correctly.
To use a tourniquet:
Wrap a cravat (nonstretchy material like terry cloth or linen) around an extremity and tighten it with a windlass stuck through the bandage (see photo). Tighten until the wound stops bleeding. If there’s any bleeding at the wound after placing a tourniquet, then the tourniquet must be tightened. It’s important to note the time a tourniquet was applied and write it down somewhere handy.
Applying a wet green tea bag against bleeding gumsDabbing minor cuts or scrapes with witch hazelSucking on a zinc lozenge to reduce gum bleeding
