Bleeding: First aid

In most cases, when your child scrapes or cuts themselves, the bleeding will stop quickly. Although the amount of bleeding may seem like a lot, most minor wounds do not result in major blood loss or complications. However, if the bleeding does not stop, you will have to act quickly to prevent too much blood loss and maybe even shock. 

Severe bleeding is a medical emergency. In cases of serious injury, a person can lose a dangerous amount of blood in just minutes. Knowing how to control bleeding can save a life, whether the injured person is a child, teen or adult.

This page describes how to treat moderate bleeding and the three most effective ways to stop life-threatening bleeding, based on internationally recognized Stop the Bleed training principles.

Why bleeding control matters

The human body relies on circulating blood to carry oxygen to vital organs. When a large amount of blood is lost quickly, it is important to act quickly. 

The most dangerous bleeding:

• is heavy and continuous
  
• soaks through clothing or bandages
  
• pools on the ground.
  

If you see this type of bleeding, act right away.

Shock

Shock occurs when the circulatory system fails to provide enough blood to all parts of the body.

Signs of shock may include:

• pallor (an unusual paleness or loss of colour) of the skin
  
  • individuals with light skin tones may appear white or blueish in appearance 
    
  • individuals with medium or dark skin tones may not look typically “pale.” Their skin may appear grey or yellow; their lower eye lids may appear very pale or white; their lips, gums, or tongues may be pale; and their palms may lose their normal colour.
    
• cool, clammy skin
  
• sweating
  
• fast breathing
  
• loss of consciousness or confusion.
  

How to treat moderate bleeding

Rest

When treating any type of wound, encourage the person to sit or lie down.

Elevate

Be sure to raise the wounded area above their heart. This will reduce the amount of blood flowing to the wound. If the wound is dirty, you can rinse it gently with clean, cool or warm tap water. Do not use hot water. You can also use bottled water or a saline wound spray to clean the wound. Do not use alcohol, iodine, mercurochrome, hydrogen peroxide or other similar agents to clean the wound. These solutions will cause pain and/or irritation.

Direct pressure

Before you try to stop the bleeding, clean your hands to reduce the risk of infection. Wear gloves if you are able. Take sterile gauze or a clean cloth and press firmly on the wound to stop the bleeding. Continue to apply pressure to the area for at least five minutes. When the bleeding has slowed or stopped, secure the dressing with tape.

If the bleeding continues for more than five minutes (despite applying firm pressure to the area), or the person is showing any signs of shock, call 911 right away.

Embedded Object

If an object is embedded, or stuck in the person's body, do not take it out. Pulling it out could cause the bleeding to worsen. Instead, protect and cover the area with sterile gauze. Make sure to not push the object deeper into the wound. Wrap bandage rolls over the wound. Secure the bandage rolls above and below the wound. Seek medical attention right away to have the object removed and the wound cared for.

How to stop severe bleeding

Stop the Bleed is an international awareness campaign that aims to train the public on how to stop life-threatening bleeding. You can respond to a severe bleeding situation by following the steps below.

Step 1: Call for help first

Before you begin first aid:

• Call 911 right away.
  
• If available, ask someone nearby to help you.
  
• If possible, put on protective gloves to reduce the risk of infection.
  

If you are safe and comfortable, start bleeding control techniques while you wait for help to arrive. 

Step 2: Apply direct pressure

Direct pressure is the fastest and most effective way to slow or stop most bleeding.

How to apply pressure:

• Use clean hands, gloves or cloth if available.
  
• Place a clean towel, clothing or gauze directly on the wound.
  
• Press hard and steady using both hands.
  
• Do not keep lifting the cloth to look at the wound, stay firm on the wound.
  
• If blood soaks through, place more cloth on top and keep pressing.
  

Step 3: Use wound packing for deep wounds

Some injuries, such as deep cuts to the arms, legs, neck or groin, may not respond to pressure alone. These wounds may need wound packing. Wound packing means filling the wound with cloth or gauze so that pressure can be applied directly at the source of bleeding.

How to pack a wound:

• Use sterile gauze if available. If not, clean cloth may be used.
  
• Press the gauze firmly into the wound cavity, layer by layer.
  
• Once the wound is filled, apply strong direct pressure over the packed wound.
  
• Continue pressure until emergency services arrive.
  

Step 4: Use a tourniquet for severe arm or leg bleeding

A tourniquet is a device that stops blood flow to control life-threatening bleeding from an arm or leg. Tourniquets should be used when:

• bleeding is heavy and cannot be controlled with direct pressure, or
  
• the injury is severe, such as an amputation.
  

How to apply a tourniquet:

• Place the tourniquet 5-8 cm (2-3 inches) above the wound, closer to the body.
  
• Do not place over a joint, or on the head, neck or torso.
  
• Tighten until bleeding stops.
  
• Leave the tourniquet in place and note the time of application.
  

Once applied, a tourniquet should not be loosened or removed by anyone except medical professionals.

Preparing for emergencies

You can prepare for bleeding emergencies by:

• learning first aid and Stop the Bleed techniques
  
• keeping a first aid kit at home
  
• knowing where bleeding control kits are located in public spaces and advocating to have bleeding control kits in your community. 
  

When to go to the nearest emergency department

• If the bleeding continues for more than five minutes, despite applying firm pressure to the area.
  
• If you are unable to properly clean the wound or if it appears dirty.
  
• If there are signs of shock.
  
• If the wound is on the person's neck or face.
  
• If the injury was caused by an electrical burn, an animal or human bite, a burn or a puncture wound (e.g., a nail piercing the skin).
  
• If there is an object embedded in the wound.
  
• If the cut is deep and looks like it might need stitches.
  
• If the person has not had a shot for tetanus or if it has been longer than 10 years since the last tetanus shot.
  

At SickKids

If you are interested in learning more about stopping severe bleeding, SickKids offers Stop the Bleed Training Classes that provide hands-on learning from certified instructors. You can register for an upcoming session by visiting the Injury Prevention Programs section of the Trauma Program Webpage.