5 Ways to Control Bleeding in Extreme Emergencies

Feb 17
2025

5 Ways to Control Bleeding in Extreme Emergencies

Knowing how to control bleeding quickly and effectively—and having the right equipment on hand—saves lives in the case of a traumatic accident. There are several effective ways to control bleeding in an emergency.

How you control bleeding largely depends on the severity and source of the bleeding. Informing yourself about how to treat a penetrating chest wound, head injury, or an injured limb prepares you for different critical situations.

Important: Assess the Situation Before Giving Emergency Care

Bystander emergency care is critical to the outcome of a bleeding emergency. As the first responder, the actions you take between calling 9-1-1 and the EMTs arriving will potentially save a life. Take the following steps to assess the gravity of the situation and decide what care to give:

• Examine the wound(s) and the injured person: Quickly assess the nature and severity of the injury, including the size and depth of the wound. Look for signs of shock like pale skin, a rapid heartbeat, or shallow breathing. Check for any other injuries or conditions that may be contributing to the bleeding. Remember that severe wounds may not be immediately obvious.
• Identify the severity of the bleeding: Determine if the bleeding is severe, moderate, or minor based on the amount of blood loss and the injured person’s condition. Consider the location and type of injury and which of the following strategies you should use to control the bleeding.

Apply Direct Pressure

Using gauze or a cloth to apply direct pressure to the wound is sometimes enough to control moderate bleeding. The best bleeding control kits contain different types of gauze and bandages to pack and maintain pressure on wounds.

How to Apply Direct Pressure to a Wound

• Use sterile gauze (or a clean cloth) to apply direct pressure to the wound site.
• Apply steady, firm pressure for at least 5-10 minutes or until the bleeding stops (if this occurs sooner).
• Raise the wound above heart level to reduce blood flow if possible.
• If the bleeding doesn’t slow to a trickle after a minute or so, proceed to wound packing and/or tourniquet application (depending on the location of the wound).

Wound Packing

Wound packing is a technique used to control severe bleeding, particularly from deep wounds. It involves filling a wound cavity with sterile gauze or other absorbent material to apply direct pressure to the bleeding source and promote clotting.

Wound packing is particularly effective for controlling bleeding from deep wounds like gunshot or stab wounds or other penetrating injuries that prove difficult to control with only direct pressure.

How to Pack a Wound

To pack a wound, stuff a deep wound with regular or hemostatic gauze or a clean cloth if gauze isn’t available. Apply pressure directly to the top of the wound with both hands. Push down as hard as you can until an EMT relieves you.

Wound packing can be highly effective. However, as Brian Graddon, ex-firefighter paramedic, SWAT medic, and CEO of True Rescue explains, wound packing isn’t always the best course of action for treating certain wounds: 

“Wound packing isn’t usually recommended for wounds to the chest, abdomen, or pelvis because the bleeding is typically coming from a source that is too deep to reach from the outside and the bleeding can only be stopped with surgical intervention. In these cases, apply direct pressure, call 9-1-1, and follow the operator’s instructions.”

This underlines the importance not only of having a bleeding control kit on hand but also of investing time in learning how to use your life-saving equipment so you know when (and when not) to apply each technique.

Pressure Points

Pressure points are specific locations on the body where major arteries pass close to the skin’s surface. Applying direct pressure to these points alongside applying direct pressure to the wound and elevating the injured area can significantly reduce blood flow to a specific area of the body.

When you apply pressure to a pressure point, you compress the underlying artery, restricting blood flow to the area beyond the pressure point. This reduction in blood flow can help to slow or stop bleeding, especially in situations where direct pressure on the wound itself is not effective.

Common pressure points used to control bleeding:

• Brachial artery: Located on the internal side of the upper arm.
• Femoral artery: Located in the groin area.
• Carotid artery: Located on the side of the neck.

It’s important to note that applying pressure to a pressure point should only be done as a temporary measure to control bleeding until more definitive care can be provided. 

Use a Tourniquet

Severe bleeding from an extremity (arm or leg) must be treated as a priority with direct pressure and then a tourniquet if bleeding doesn’t stop after around a minute. When a casualty is suffering from a hemorrhage from an extremity, the number one priority must be to stem the bleeding as quickly as possible.

Follow these steps to slow bleeding from an extremity with a tourniquet:

1. Apply direct pressure: Firstly, apply firm pressure on the wound, ideally with a sterile dressing. This will help the blood clot around the wound and slow bleeding down. Call the emergency services while applying pressure or ask someone else to do so.
2. Elevate the extremity: Lift the area of the hemorrhage above the heart to reduce blood flow to the site of the wound (and therefore blood loss from the wound).
3. Tourniquet application: If these first two steps don’t decrease bleeding within a minute or two, apply a tourniquet. This quickly decreases circulation to the limb. Place the tourniquet a few inches from the wound on the heart side of the wound (not over a joint) and tighten it until the bleeding stops. Secure the tourniquet and mark the time of application on a visible place on the casualty’s body.

Many tourniquets are available online or in retail stores. However, it’s critical to purchase your tourniquet from a reputable retailer as a poor-quality tourniquet could let you down at a critical time.

Apply Hemostatic Agents

There are two types of hemostatic agents: granular powder and impregnated dressings. As we’ve already seen, hemostatic dressings are used to pack wounds and accelerate blood clotting at the wound site. Hemostatic agents work in two ways. Through the first mechanism, hemostatic agents adhere to damaged tissue, seal injured vessels to prevent further blood loss, and speed up blood clotting to produce hemostasis.

The second way involves the rapid absorption of water from blood at the wound site. This concentrates all the clotting factors on the injured tissues. Chemical reactions then activate the coagulation pathway and platelets to produce clot formation. 

Please note: Bystanders without medical training will generally only use hemostatic gauze. It’s best to leave the application of other kinds of hemostatic products to the professionals.

What to Do When You Suspect Internal Bleeding

Responding to life-threatening bleeding is more intuitive when the source of bleeding is obvious. However, treating internal bleeding quickly and effectively is also critical. The first step in helping a casualty with suspected internal bleeding is to check for the signs. These are:

• Coughing up, vomiting, or urinating blood
• An extremely tender, swollen, or ridged area where a blunt trauma occurred
• Bruising on the abdomen, chest, or skull
• Signs that the patient has gone into shock

If you suspect a patient is suffering from internal bleeding, call 9-1-1 immediately. Your actions in the time before medical professionals arrive are critical. Take the following steps:

1. Position the casualty appropriately:
   • Leave the patient in the position you found them if you suspect a head, neck, or back injury. The exception to this is to perform CPR or control external bleeding.
   • If the casualty is showing signs of shock, lie them flat on their back.
2. Give care for shock when necessary. Use the emergency blanket in your trauma kit to keep them warm and elevate their legs around 12 inches off the ground.
3. Apply a tourniquet on the heart side of the bleeding if the internal bleeding is clearly coming from somewhere inside an arm or leg, such as in a crush injury.
4. Stay with the patient until an EMT arrives. Comfort them and reassure them help is on the way.
5. Keep checking the patient to determine if any extra care is required.

Bleeding Control Equipment Saves Lives

Quick and effective bleeding control can be lifesaving in critical situations. Mastering these five techniques empowers you to respond to bleeding emergencies with confidence.

Choose high-quality medical equipment and look into receiving at least basic training on how to use it. Every second counts in a life-threatening situation and your actions can save lives.