What to do
Control the bleeding
- 1Check the scene for hazards; put on gloves if you have them. If bleeding is life-threatening and you have none, give care anyway and wash thoroughly afterward.
- 2Find the source. A person may have more than one wound — treat the worst bleeding first.
- 3Apply firm, direct pressure right on the wound with gauze or clean cloth, pressing hard. Hold steadily. If blood soaks through, add another pad on top — don't remove the first (pulling it off disturbs the forming clot).
- 4Call 911, or send someone to call, for any life-threatening bleeding.
- 5If it's a limb and pressure isn't controlling it, apply a tourniquet; or use wound packing if trained and it's somewhere a tourniquet can't go (scalp, neck, shoulder, groin, back).
- 6Treat for shock: keep the person from getting cold or overheated, reassure them, and monitor breathing until EMS arrives.
Apply a tourniquet (arm or leg)
- 1Place it 2–3 inches above the wound, between the wound and the heart. Never on the wound itself or over a joint.
- 2Warn the person it will hurt — the pain is expected and necessary.
- 3Tighten fully. On a windlass tourniquet: PULL the strap tight, TWIST the rod until the bleeding stops, then CLIP the rod so it can't unwind.
- 4If it's as tight as it goes and bleeding continues, apply a second tourniquet just above the first, closer to the heart.
- 5Once applied, do not loosen or remove it — only a medical professional should.
When to use it
- Any major cut or traumatic wound where blood is spurting or flowing freely — axe or saw wounds, deep knife cuts, severe lacerations from a fall.
- Amputations and crush injuries to a limb — tourniquet territory.
- The reason "Stop the Bleed" kits (tourniquet + hemostatic gauze) are carried on high-adventure treks.
- A hurry case a scout may face before EMS can reach a backcountry site.
Common mistakes & safety
- Direct pressure is the first and most important action. Get pressure on right away, even with a bare hand and a t-shirt, rather than hunting for the "right" supplies.
- A tourniquet is for life-threatening limb bleeding pressure won't stop. Not the first move for every cut — but for a true arterial bleed it's the correct, life-saving tool, and hesitation costs lives.
- Never place a tourniquet on a joint or on the wound, and never loosen one once it's on. Loosening restarts the bleeding, which can be fatal. Only a medical professional removes it.
- Don't remove the original dressing. Lifting it disturbs the clot — add another pad on top if it soaks through.
- Watch for shock, which can develop even after bleeding is controlled: rapid weak heartbeat, rapid breathing, pale/gray/cool/moist skin, confusion or reduced responsiveness, nausea, excessive thirst. Keep the person comfortable and keep monitoring — shock needs immediate medical care.
- Improvised tourniquets are a last resort. A manufactured one is far more reliable; a too-narrow band can fail to stop arterial flow or cause extra injury.
Going deeper
- Why a tourniquet works when pressure can't. It compresses the whole limb above the wound, squeezing the artery shut against the bone — which is also why it must never sit on a joint.
- Note the time it went on. "Stop the Bleed" training teaches noting when a tourniquet was applied, so the medical team knows how long the limb has been without blood flow.
- Hemostatic dressings contain agents that speed clotting and are packed into a wound — they supplement, not replace, direct pressure.
- Looks can deceive. Dramatic blood loss isn't always life-threatening, and some deadly internal bleeding shows little external blood — which is why signs of shock matter as much as visible volume.
Official source
Life-threatening external bleeding — American Red Cross →This is general first-aid information, not a substitute for hands-on training. Take a certified first-aid course; Scouting America groups serious bleeding among its hurry cases.