How To Stop Bleeding In An Emergency Until Help Arrives

Clothing can hide pools of blood, so be sure to check under there, too.

“Always check for multiple sources of bleeding,” especially before putting on a tourniquet, Inaba said. “Even feeling for wetness under clothing can be a very rapid check.”

Inaba offered a scenario in which someone notices a calf injury but does not see an injury between the knee and groin that is hidden by clothes. In this case, he said, putting a tourniquet below the knee could make things worse.

3. Apply direct pressure on the wound.

Once you spot severe bleeding, address it by applying direct pressure to the wound.

“The amount of pressure that’s required is whatever it takes to get that bleeding to stop,” Inaba said. “In the vast majority of cases, the application of pressure can be successful at stopping that bleeding.”

Ideally, you’ll have nitrile  or vinyl  gloves to protect yourself against bloodborne pathogens, Bates said. But if you don’t have gloves handy, find something like a piece of clothing a shirt, perhaps to put between your hands and the wound. “If you have gauze, fantastic,” he said.

One common mistake Bates sees people make is when they stop compressing the wound to check if the bleeding has stopped. It’s better to just keep constant pressure on until EMS arrives, he said.

Make sure to keep the bleeding person warm with blankets if necessary.

“Cold blood doesn’t clot,” Bates said. “People who are hypothermic or who are getting cold, they’ll continue to bleed.”

4. Pack the wound if the bleeding area is large.

If the wound is large and deep, applying direct pressure with your hands is not going to be enough. That’s when you want to pack the wound.

Hemostatic gauze  is designed to accelerate blood clotting and stop bleeding quickly. If you have it on you or in a nearby first aid kit, that’s an ideal item to pack into the wound.

If you don’t have any gauze, “try the best you can with what you have,” Bates said. “Look for some clean material, something that’s not full of dirt or grime. Maybe a napkin or a paper towel that is clean.”

5. Go straight to a tourniquet if you determine a limb injury is bleeding severely.

There are emergencies for which packing the wound or applying direct pressure is not going to be enough. Sometimes you try those steps, realize they aren’t working and move to a tourniquet. But if you see blood doing what Bates calls “squirt-squirt-squirt,” grab a tourniquet immediately.

“When you see the massive hemorrhage, it’s just pooling out, or it’s hitting the ceilings, and covering the walls ... you are going to bypass all of that and go straight to the tourniquet,” Bates said.

Inaba noted that tourniquets also work in cases where you have an extremity injury and you have to move and can’t keep applying constant direct pressure. “The benefit of the tourniquet is that once it’s applied, you just leave it on and you can remove your hands,” he said.

Keep in mind that tourniquets are meant only for arms and legs; keep applying direct pressure to any wounds on the torso and other parts of the body.

Commercial tourniquets  are more effective than those improvised in an emergency. When done right, commercial tourniquets effectively prevent blood loss by compressing the tissues in that area.

“It’s essentially flattening that blood vessel and preventing any of that blood from getting through. By doing that, you are interrupting the flow of blood from the heart to the fingers or the toes and you are stopping the bleeding or the blood loss from that cut vessel,” Inaba said.

Bates said the commonly available combat application tourniquet , or CAT, is “one of the best ones out there.” Both the CAT and SOF tactical tourniquet , called a SOFT-T, are recommended by the American College of Surgeons Committee on Trauma.

If you’re in a public building, you may be able to find a commercial tourniquet in a bleeding control kit next to an automated emergency defibrillator.

Improvised tourniquets should be a very last resort because they are a poor substitute for a commercial tourniquet, but research  from mass shootings has shown them to work in emergencies. Bates finds leather belts don’t work because they are not wide enough and do not get tight enough, but he has seen a nylon tie work effectively. A person injured in the 2007 Virginia Tech shooting made an effective tourniquet for his gunshot wound with an electrical cord . First Care Provider, a nonprofit run by veterans seeking to teach the public about first aid, recommends using a carabiner and a key ring if you have to make your own tourniquet.