External Bleeding

The use of pressure on or around the wound is usually the fastest, easiest, and most effective way to stop external bleeding. Other methods should be used if direct pressure alone does not control severe bleeding. The aim is to stop further bleeding whilst waiting for help to arrive. There is no evidence that elevating a bleeding part will help control bleeding and there is the potential to cause more pain or injury.

Management

accident, bleed, bleeding

  • Use standard precautions (e.g., gloves, protective glasses) if readily available.
  • Management of all bleeding begins with application of pressure on or around the wound.
  • If bleeding is severe or life-threatening, controlling the bleeding takes priority over airway and breathing interventions. Lie the person down, apply pressure and call for an ambulance.
  • If there is severe, life threatening bleeding from a limb, not controlled by pressure, we suggest applying an arterial tourniquet above the bleeding point, if trained in its use and one is available.
  • If there is severe, life-threatening bleeding from a wound site not suitable for tourniquet, or from a limb when a tourniquet is not available or has failed to stop the bleeding, we suggest applying a haemostatic dressing, if trained in its use and one is available.
  • For the majority of non-life-threatening cases, first aiders should follow the sequence of DRSABCD, where control of bleeding follows establishing airway and commencing CPR if required.

Direct Pressure method

Where the bleeding point is identified, the rescuer, a bystander or the injured person should control bleeding by:

  • Applying firm, direct pressure sufficient to stop the bleeding. Pressure can be applied using hands or a pad over the bleeding point.
    • If bleeding continues, apply a second pad and a tighter bandage over the wound. If bleeding continues, check that the pad and bandage are correctly applied directly over the bleeding. If not, it may be necessary to remove the pad to ensure that a specific bleeding point has not been missed. Applying firmer pressure, only using 1 to 2 pads over a small area, will achieve greater pressure over the bleeding point than continuing to layer up further pads.

To assist in controlling bleeding, where possible:

  • Advise the person to lie down and remain still.
    • Restrict movement by immobilising a bleeding limb.