Learn how to control severe bleeding. Severe bleeding is a critical situation which, if not taken care of, can lead to volume shock and death.
The information in this post is from the book “Wilderness and Travel Medicine” by Sam Fury.
How to Control Severe Bleeding
IMPORTANT: No amount of reading can compare to a medical course with a professional trainer. A standard first aid course is good. A Remote Area First Aid Course or higher is best.
Well-Aimed, Direct Pressure
This is the go-to method for controlling any type of bleeding. Apply well-aimed, direct pressure to the wound.
Elevate the wounded area above the patient’s heart (if possible).
Wait ten minutes then check if bleeding has stopped.
If it is spurting stick your finger down on the wound and hold it there.
Pressure Point Constriction
If bleeding doesn’t subside after 20 minutes, use pressure point constriction. Choose an arterial pressure point between the injury and the heart. The closer to the bleeding site the better.
Do not perform pressure point constriction for more than 10 minutes. Doing so can result in necrosis (death of body tissue). Be extra careful of the carotid artery, as it hinders oxygen to the brain.
If the patient is still bleeding, consider whether to apply a tourniquet.
Note: This is a last resort. Only use a tourniquet if it is severe, uncontrolled bleeding that will cause loss of life.
Long-term use of a tourniquet may cause loss of limb.
To apply an improvised tourniquet:
Find a length of strong, pliable cloth. It is best if it is no less than 5cm wide (2 inches), e.g., backpack strap, clothing, long sock.
Apply it on the limb. Use padding underneath if possible, e.g., rolled up clothing. Place it between the wound and the heart, approximately 5 to 10 cm (2 to 4 inches) from the wound.
If possible, wrap it around the limb several times keeping the material as flat as possible.
Tie a simple overhand knot.
Place a torsion device, e.g., a strong stick, on top of the knot, then secure it in place with two overhand knots.
Only twist the torsion device enough to stop arterial bleeding (bright red bleeding). Do not over-tighten. Continued dark bleeding for a short while is normal in cases of amputation.
Once tightened secure the torsion device in place. One way to do this is to loop the ends of the tourniquet over the ends of the stick and tie them together under the limb.
Note what time you applied it.
Do not cover it.
Check it after 20 minutes. Ensure a pressure dressing is in place and bleeding has stopped.
Very slowly loosen the tourniquet to restore circulation.
Leave the loosened tourniquet in position in case the bleeding resumes.
When you transfer the patient to other caregivers write the letters “TK” on the patient’s forehead. Also, write the time you applied the tourniquet.
Photo Credit: Steve Pivnick
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