Which is the best treatment for a severe bleeding injury?

For severe bleeding, take these first-aid steps.

Table of Contents Show

From Mayo Clinic to your inbox
Advertisement
Mayo Clinic Footer
External bleeding
Wounds that need special care
Crush injury
Other wounds
An abrasion (graze)
A puncture wound
Internal bleeding
What is the first method used to control severe bleeding?
Which is the best treatment for a severe bleeding injury a wash the wound with mild soap and cool water?
How do doctors treat severe bleeding?

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.

From Mayo Clinic to your inbox

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Oct. 08, 2022

Thompson DA. Skin injury. In: Adult Telephone Protocols: Office Version. 5th ed. American Academy of Pediatrics; 2022.
Auerbach PS, et al., eds. Wilderness trauma and surgical emergencies. In: Field Guide to Wilderness Medicine. 5th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Aug. 11, 2022.
Auerbach PS, et al., eds. Wound management. In: Field Guide to Wilderness Medicine. 5th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Aug. 11, 2022.
Kermott CA, et al., eds. Emergency and urgent care. In: Mayo Clinic Guide to Self-Care. 7th ed. Mayo Clinic; 2017.
Piazza GM, ed. Severe bleeding. In: First Aid Manual: The Step-by-Step Guide for Everyone. 5th ed. Dorling Kindersley; 2014.
American College of Surgeons. Stop the bleed. https://www.stopthebleed.org. Accessed Aug. 18, 2022.

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

Advertising & Sponsorship

Policy
Opportunities
Ad Choices

Bleeding is usually minor in nature but can sometimes impose serious threat if a large vein or artery has been injured.

External Bleeding

Amputation

Crush injury

Nose Bleed

Abrasion (Graze)

Punture wound

Internal Bleeding

External bleeding

Background
Generally, bleeding is of a minor nature and includes small cuts, grazes, etc.

However, bleeding may be severe and life threatening if a large vein or artery has been injured – e.g. the jugular vein in the neck.

Some wounds are associated with other injuries beneath the skin – e.g. an organ injured by a stabbing; broken bones which have pierced the skin.

Symptoms and signs – Not all may be present

a wound with, or without, an embedded foreign object
pain from skin surface wounds
bruising or discolouration of the skin
loss of normal function in the injured area
pale, cold, sweaty skin

External bleeding

How you can help

1. Apply direct pressure to the bleeding wound

Apply firm pressure over the wound. Use a sterile or clean bulky pad and apply it firmly with hand pressure. Apply a bandage to keep the dressing in place.
If bleeding is severe, DO NOT waste time looking for suitable padding, but be prepared to use the patient’s hand or your hand to hold the wound together if the patient is unable to do this unaided.

Apply direct pressure to the bleeding wound

2. Raise the injured area

If the wound is on a limb, raise it in a supported position to reduce blood flow to the injured area.
If an arm is injured, you could apply an arm sling or elevation sling.

Try to avoid any direct contact with the patient’s blood or other body fluids. Use disposable gloves if possible. If gloves are not available, place your hands inside a plastic bag.

If there has been any contact with blood or any other body fluids, wash your hands or any blood splashed on the skin thoroughly with soap and water as soon as possible after the incident.
If you are concerned about a possible risk of infection, obtain advice from your doctor as soon as possible.

Raise the injured area

3. If a foreign body is embedded in the wound

DO NOT remove it but apply padding on either side of the object and build it up to avoid pressure on the foreign body.
Hold the padding firmly in place with a roller bandage or folded triangular bandage applied in a criss-cross method to avoid pressure on the object.

DO NOT remove the foreign object, but apply padding on either side.

4. Keep the patient at total rest

Even if the injury involves the arm or upper part of the body, the patient should rest in a position of greatest comfort for at least 10 minutes to help control the bleeding.

5. Seek medical assistance

If the wound appears to be minor and the patient is able to travel by car, arrange an urgent appointment with a local doctor to assess and treat the injury.

If the injury is severe or the patient is very unwell – call 111 for an ambulance as soon as possible.

While waiting for an ambulance to arrive, observe the patient closely for any change in condition.

6. If blood leaks through the pressure pad and bandage

Apply a second pad over the first. Use a tea towel or similar bulky fabric and apply maximum pressure to the area.
For major uncontrolled bleeding quickly remove the blood-soaked pad and bandage and replace with a fresh bulky pad and bandage. The continuing bleeding may be due to the pad slipping out of position when the first bandage was applied.

If blood leaks through the pressure pad and bandage

Wounds that need special care

Amputation

How you can help

Call 111 for an ambulance.

1. Control any bleeding

Use a bulky pad and apply it firmly to the bleeding area. Raise if possible.

Control any bleeding

2. Recover the severed part

If possible, gently place it into a plastic bag. Seal the bag with a little air inside to protect the severed part with a ‘cushion’ of air.
Place the inflated bag into a container or bucket of cold water to which several ice cubes have been added.
Ensure the severed part is transferred to hospital with the patient.

Recover the severed part

Crush injury

Background

A crush injury occurs from compression of large muscle groups and soft tissues by a heavy weight. The most serious sites for a crush injury to occur are the head, neck, chest, abdomen and thigh.

How you can help

Call 111 for an ambulance.

1. Remove the crushing force

Remove the crushing force if possible because permanent tissue damage may occur with severe crushing force.
If the crushing force has been in place for some time, be prepared to give prompt first aid, because removal of the crushing force may cause a sudden collapse or deterioration in the patient’s condition.

2. Treat the patient’s injuries

Assess and treat any injuries in order of their importance.
Control any bleeding with a sterile pad applied firmly to the injured area.
Assist the patient into the position of greatest comfort and use soft padding to provide support for the injured part.
If a limb is involved, support and immobilise the injured area.
While waiting for the ambulance to arrive, observe the patient closely for any change in condition.

Nose bleed

Background

A blow to the nose, flying at high altitude, or scuba diving may all cause a bleeding nose.

For a child, always check whether there is a foreign body present – e.g. a bead or coin. If this has occurred, seek prompt medical advice and DO NOT try to remove the object yourself because this may cause further damage.

If bleeding is due to a head injury – e.g. a fracturedskull – call 111 for an ambulance urgently.

How you can help

1. Apply firm pressure, elevation and rest

The patient needs to hold the head well forward and breathe through the mouth while pinching the entire soft part of the nose for 10 to 20 minutes.
The patient must be sitting down and at total rest until the bleeding stops.

Apply firm pressure, elevation and rest

If bleeding continues after 20 minutes ofpressure, continue the pressure and call foran ambulance.

A cold compress can be used.

2. Once the bleeding has stopped

Tell the patient not to blow their nose for a few hours because this may restart the bleeding.

Other wounds

An abrasion (graze)

How you can help

Gently clean with soapy water or saline. If there are pieces of gravel embedded in the wound, ask the patient to try to remove them while the area is soaking in soapy water.
Dry the area well by blotting with gauze swabs or a pad of tissues.
If a protective dressing is necessary, apply a non-adherent sterile dressing and fix it in place with a light roller bandage or tape.

An abrasion (graze)

A puncture wound

How you can help

Clean the wound with warm soapy water and allow it to penetrate the puncture track because tetanus spores may be trapped deep in the wound.
Allow the wound to dry thoroughly in the air before covering it.
If a protective dressing is needed, use a porous adhesive dressing and change it daily to keep the wound healthy and dry.

Contact a local doctor for advice about tetanus immunisation.

A puncture wound

Internal bleeding

Background

Internal bleeding is often difficult for the first aider to recognise. This type of bleeding can

occur without an obvious wound and can be very serious as it is difficult to stop without surgical intervention.

Internal bleeding occurs when blood vessels within the body are ruptured and blood escapes

out of the circulatory system. It may follow such incidents as a blow to the head, chest, or

abdomen due to a fall or being struck by a vehicle. Internal bleeding should be suspected when blood is seen in vomit, urine, sputum or faeces.

Symptoms and signs – Not all may be present

rapid and ‘gasping’ breaths
increasing thirst
frothy red blood coughed up from the lungs, blood-stained vomit like ‘coffee grounds’, red or rust-coloured urine, or dark faeces like tar
pale, cold, sweaty skin

How you can help

Place the patient at total rest

Assist the patient into the position of greatest comfort.
Cover the patient with a blanket to maintain body heat.
Place protective fabric underneath the patient if the surface is rough, cold or hot – e.g. a coat if the patient is lying on a road.

Call 111 for an ambulance.

While waiting for the ambulance

Manage any other injuries.
Ensure that all restrictive clothing has been loosened, especially at the neck and waist.
Keep any bystanders clear.
Reassure the patient.
DO NOT allow the patient to eat, drink or smoke.

Have the information on hand when you need it the most.
Buy the First Aid Handbook >>

Learn the practical skills to help save a life.
Book a first aid course >>

What is the first method used to control severe bleeding?

To care for a major open wound (bleeding freely or severely), you must act at once. Begin by applying direct pressure over the wound with a clean, sterile dressing to slow the flow of blood and promote clotting. If a sterile dressing is not available, use any clean cloth such as a towel, handkerchief, or shirt.

Which is the best treatment for a severe bleeding injury a wash the wound with mild soap and cool water?

Even if the bleeding has stopped, it is important to keep the wound clean to prevent an infection. Rinse the wound itself with cool water and use soap to wash the surrounding area. Avoid getting soap in the wound. If possible, remove any dirt or debris inside the wound with tweezers.

How do doctors treat severe bleeding?

Seek medical treatment for heavy external bleeding that does not stop after five minutes of constant pressure. Call 9-1-1 immediately for internal bleeding and wounds from severe trauma, such as car accident injuries. Medical care is necessary to stop internal bleeding.