Based on a video by St John Ambulance.
Severe bleeding can kill in minutes. The body holds about 10 pints of blood; losing 2 puts an adult into shock, and 5 is usually fatal. Direct pressure stops most bleeding, and you don't need any special supplies to start - your hands and a clean cloth will do until paramedics arrive.
This walkthrough from St John Ambulance covers the 7 essential steps. Practice the sequence mentally so you can act without thinking when it matters. The most important moves happen in the first 60 seconds.
Put on disposable gloves if you have them - they protect both you from blood-borne infection and the wound from contamination from your hands.
If clothing is covering the wound, remove it or cut it away to see the bleeding clearly. Don't worry about ruining the clothes - exposure beats fabric every time. You can't treat what you can't see.
Look at the wound. If there's an object embedded in it (glass, metal, wood, knife), DO NOT pull it out.
The object may be acting as a plug to reduce bleeding - removing it can make the bleeding catastrophic. Leave it in and apply pressure on either side of it to push the wound edges together. Tell the paramedics about the embedded object the moment they arrive.
If there's no embedded object, press a sterile dressing or clean non-fluffy pad firmly onto the wound. Press hard enough that you can feel resistance.
If you don't have a dressing, use any clean cloth - or have the casualty press their own hand against the wound while you handle the next steps. Most bleeding stops within 5-10 minutes of firm direct pressure.
Get a helper to call emergency services. If you're alone, put your phone on speaker so you can keep applying pressure while you talk.
Tell the dispatcher where the bleeding is coming from, how much blood you're seeing, and your exact location. Don't hang up until they tell you to - they may walk you through additional steps.
Severe blood loss can trigger shock - low blood pressure, pale clammy skin, rapid weak pulse, confusion. Help the casualty lie down on a blanket or rug to insulate them from the cold ground.
Raise and support their legs above the level of their heart - this keeps blood flowing to vital organs. Don't raise the leg if it's the injured one. Cover them loosely to maintain body temperature.
Wrap a bandage over the dressing firmly enough to maintain pressure but not so tight that it cuts off circulation.
Test by pressing the nail bed or skin beyond the bandage for 5 seconds, then release - color should return within 2 seconds. If it doesn't, loosen the bandage. If blood soaks through, add a second bandage on top - don't remove the first or you'll restart the bleeding.
Tip
If blood soaks through both dressings, then remove them and apply a fresh one - the original may not have been positioned over the actual point of bleeding.
Support the injured area with a sling or extra padding. Re-check circulation every 10 minutes by checking the nail bed beyond the bandage.
Keep talking to the casualty - their level of consciousness tells you how the blood loss is affecting them. If they become unresponsive, open the airway and check breathing; if they stop breathing, start CPR.
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