37 How can I recognize and control severe bleeding?

Severe bleeding is a life-threatening emergency that you must treat as soon as you have established that the victim is breathing and has a pulse. The loss of blood in excess of one pint is serious.* Dark-red flowing blood is venous bleeding and can be treated as second priority. Bright red spurting blood is arterial bleeding and must be stopped immediately. Every second counts; hesitation will kill! Immediately apply pressure with your hand or any immediately available cloth.

Direct Pressure over the Wound:

Place any kind of cloth or gauze pad on the wound and apply hand pressure. If the dressing soaks through, pile on more dressings but never remove the first cloth; only apply more. Firmly secure the dressings with tape or cloth but not so tight that it cuts off circulation to the limb. Check the distal pulse.

Credit: Ultimate Guide to US Army Survival: Skills, Tactics, and Techniques (Skyhorse, 2008).

Elevation of Bleeding Limb Above the Heart Level:

Usually used in combination with direct pressure. You may need to quickly splint limb if fractures are present.

If direct pressure fails to stop the bleeding or the patient must be moved or move on his/her own, apply a tourniquet as shown on page 63. They are seldom needed below the elbow or knee. Be sure it is visible and mark the time applied on the victim’s forehead.

Always carry a large bandana, or one of the many tourniquet devices, in your pocket and survival kits. You may also want to add blood-stopper compresses or powder. This is effective for most bleeding, but usually cannot be applied fast enough for initial stopping of spurting blood where the victim may die within a minute or less.

 

* Critical blood loss is much less for children. The loss of even 25 to 30 ml of blood can result in shock.