- Minor bleeding can usually be treated at home with simple washing and bandaging the wound.
- Severe bleeding is a medical emergency. First aid focuses on applying pressure to the wound and treating for shock if necessary.
- With any wound, a doctor should be consulted if infection or circulation problems develop, or if there is a question that the wound is not minor.
- Internal bleeding should also be suspected after trauma like a car accident or falling from a height.
Minor and severe bleeding
Minor wounds can usually be treated with very basic first aid.
Large or severely bleeding wounds are a medical emergency as blood loss can rapidly lead to shock, loss of consciousness or death. This is usually the result of stabbing, gunshot, severe blow, deep cut, or a fractured pelvis or femur.
Never touch someone's blood without latex gloves unless you are certain of the person's HIV and hepatitis B status. If gloves aren't available, use plastic bags.
First aid for minor bleeding
- Wash your hands before handling a wound or wear sterile disposable gloves.
- Most minor wounds stop bleeding on their own, or afterdirect pressure applied for a few minutes with a gauze pad. Don't keep lifting the pad to check whether bleeding has stopped - this may hinder blood clot formation.
- Hold the wound under cool running water to clean it and assess its depth. Remove dirt particles with the corner of a sterile gauze pad or sterile tweezers. (These can be sterilized over an open flame; allow them to cool before using.)
- Clean the skin around the wound with gauze: wipe away from the wound and use a new pad for each wipe. Pat the area dry and apply antiseptic ointment to the wound. Applying alcohol, hydrogen peroxide, mercurochrome or iodine can delay healing.
- Consider putting a bandage, such as an adhesive strip, on the wound, especially if it is on the hands, legs or feet. Always put an adhesive strip across a cut, not lengthwise. Don't cover with cotton wool. Alternatively, close the wound with sterile wound closure strips. An antiseptic spray may be used for grazes.
- Change the bandage at least once a day or more often if it gets dirty or wet. When the wound forms a scab, a bandage is no longer necessary.
When to call a doctor
- A wound continues to bleed through the bandages, even after 15 minutes of applied pressure.
- The wound has removed all skin layers.
- Stitches are required. This may be necessary if the wound edges don't come together easily; the wound is deeper than 0.5 cm, gaping or has a jagged edge; muscle, fat or bone is visible; or there are deep cuts on the face, scalp, hands or joints.
- There is numbness in the area, weakness or loss of function in the fingers, toes or limb beyond a wound, or if the skin near the wound turns cold, blue or white.
- The wound has been heavily contaminated with dirt, and the injured person is elderly, diabetic or chronically ill.
- You are unsure that all foreign bodies, such as glass, splinters or dirt, have been removed.
- The injured person has not had a tetanus injection in the past ten years (five years in the case of a very dirty wound). A tetanus booster must be given within two days of injury.
- The wound is on the face or neck, if it is a puncture wound or caused by an animal or human bite.
- Signs of infection develop.
- The wound has not healed after two weeks.
First aid for severe bleeding
- Call an ambulance.
- Apply firm pressure directly on the wound with a clean pad, bandage or even a piece of clothing. Apply pressure around an embedded object.
- Lie the person down. Elevate an injured limb.
- Remove superficial dirt and debris from the wound. Don't attempt to clean or probe the wound. Don't remove any embedded object. If the wound is abdominal and organs have been displaced, don't try to reposition them. Cover with a wet dressing or cloth.
- If the bandage becomes soaked with blood, don't remove it. Apply a fresh bandage over it.
- Continue to apply pressure for 10 minutes. If bleeding stops, bind the original wound dressing tightly with a clean bandage. Check for circulation beyond the bandage every 10 minutes, and loosen the bandage slightly if circulation is restricted. Don't use a tourniquet.
- While waiting for help to arrive, immobilise the injured limb and don't give the person anything to eat or drink. Treat for shock if necessary.
Signs of internal bleeding
With internal bleeding, a person can lose a huge amount of blood with no visible bleeding. Suspect internal bleeding if a person has been in a car accident, suffered a severe blow to the body or head, or fallen from a height.
Signs include coughing up or vomiting blood; bleeding from the ears, nose, rectum or vagina; bruising on the chest, abdomen or neck; wounds that have penetrated the skull, chest or abdomen; abdominal tenderness or swelling; or fractures. Signs of shock may be present. Get help immediately if you suspect internal bleeding.