Instructors showing how to apply a bandage during a St John Ambulance Cymru first aid at work training course

How to Perform First Aid on Someone with Severe Bleeding

If the bleeding isn’t controlled quickly, they may lose a lot of blood, become unresponsive and possibly develop shock. Shock does not mean emotional shock; it is a life-threatening condition, often caused by loss of blood. You also want to avoid the possibility of sepsis (sepsis in children has different guidance)

Your priority is to stop the bleeding. 

What to do

Follow the steps below:

Step 1 

With open wounds, there’s a risk of infection, so wear protective first aid gloves (if available) to help prevent any infection passing between you both. 

Step 2 

Apply direct pressure to the wound using a sterile dressing if possible or a clean non-fluffy cloth, to stop the bleeding. If you don't have a dressing you can ask the casualty to do this themselves. 

If the wound is covered by the casualty's clothing, remove or cut the clothes to uncover the wound.  

If there’s an object in the wound, don’t pull it out. It may be acting as a plug to reduce the bleeding. Instead apply pressure on either side of the object to push the edges together. 

Step 3  

Ask a helper to call 999 or 112 for emergency help and give Ambulance Control details of where the wound is and the extent of the bleeding. If you are on your own, use the hands-free speaker on a phone so that you can treat while speaking to ambulance control. 

Step 4 

Firmly secure the dressing with a bandage to maintain pressure on the wound. Make it firm enough to maintain pressure but not so tight that it restricts their circulation. 

Step 5 

Check their circulation beyond the bandage. Press one of the nails or the skin beyond the bandage for five seconds until it turns pale, then release the pressure. If the colour does not return within two seconds, the bandage is too tight. If necessary, loosen and reapply the bandage. 

Step 6 

The loss of blood could cause the casualty to develop shock. Treat them for this by helping them to lie down, on a rug or blanket. Raise and support their legs, so they are above the level of their heart. You should then loosen any tight clothing around their neck, chest and waist and cover the casualty with a blanket to keep them warm. 

Step 7 

If blood comes through the dressing, remove it and reapply pressure with a new dressing or pad to control the bleeding. Once the bleed is under control, secure in place with the bandage, tying the knot over the wound to keep the pressure on.

Step 8 

Support the injured part with a sling or bandage and keep checking the circulation beyond the bandage every 10 minutes. 

Step 9 

Keep monitoring their level of response until help arrives. If they become unresponsive at any point, prepare to start CPR.

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