How to stop severe bleeding: what to do step by step

Severe bleeding does not wait. After a deep cut, a car crash or a workplace accident, blood can be lost so fast that by the time the ambulance arrives it may already be too late. The minutes until then depend on whoever is next to the casualty. With three actions — pressure, wound packing and a tourniquet — you can control bleeding that looks unstoppable.

First: safety and the call

• Make sure the scene is safe (traffic, electricity, fire, etc.). You are no help to anyone if you become a casualty too.
• Put on gloves without fail.
• Call 112 and put it on speaker so your hands are free.

Find the source of the bleeding

You cannot stop what you cannot see. Move aside or, if necessary, cut the clothing around the area so you can see the wound clearly. Identify the point bleeding most heavily — that is where you work.

1. Direct, firm pressure

The first and most basic action.

• Place a clean cloth or gauze over the wound and apply firm pressure, using your body weight if needed, with one or both palms.
• Maintain steady, uninterrupted pressure for at least 15 minutes. Do not lift the cloth to check progress; each time you do, clotting starts over.
• If the cloth soaks through, do not remove it. Add more material on top and keep pressing.

2. Wound packing

When the wound is deep and pressure alone is not enough — especially where a tourniquet cannot be applied, such as the groin, the armpit or the neck (junctional areas):

• Pack gauze, a bandage or clean cloth into the wound, filling it as tightly as possible, directing the material towards the bleeding point.
• Once packed, apply firm pressure on top for at least 15 minutes.
• Packing is also used on limbs when no tourniquet is available. Never on the chest or abdomen.

3. Tourniquet

Only for severe bleeding from a limb that pressure will not stop.

• Apply it 5–7 cm above the wound, never over a joint. If the wound is high, or there is no time to assess, apply it high and tight on the limb.
• Tighten it until the bleeding stops completely. Pain is expected and means it is working.
• Note the time of application on the tourniquet's white strip (marked TIME). This is critical information for the treating doctors.
• Once applied, do not loosen it. That is done only at the hospital.
• If the first one does not stop the bleeding, apply a second directly above it (side to side).

A manufactured tourniquet is always the best option. Improvise one (a wide strap with a rod twisted to tighten) only when nothing else is available and life is at risk.

If there is an embedded object

Do not remove it. It may be plugging the vessel, so removing it can restart the bleeding. Stabilise it with gauze all around and apply pressure beside it, not on it.

Signs of shock

Major blood loss leads to shock: pale, cold, sweaty skin, fast breathing, dizziness, confusion. Lay the casualty down, cover them so they do not get cold, reassure them and keep checking their breathing. If they stop breathing, start CPR.

What not to do

• Do not lift the gauze to see if it has stopped. Add more on top.
• Do not remove embedded objects.
• Do not loosen a tourniquet once applied.
• Do not use a tourniquet for minor bleeding. Pressure is enough.
• Do not waste time. The call and the pressure start together.

The most important thing

Apply firm pressure and do not stop. For most bleeding, steady pressure with your hands is enough. For severe cases, packing and a tourniquet buy the time needed until the ambulance arrives.

What you should always carry (gauze, a haemostatic dressing, gloves): First aid kit.

This article is for information only and does not replace hands-on training.