2 Bleeding, Wounds, and Shock
Learn to recognize life-threatening external or internal bleeding, control visible bleeding safely, and respond to possible shock while waiting for emergency responders.
Recognize an emergency
Treat bleeding as life-threatening if blood is spurting or flowing continuously, a large amount is pooling or accumulating quickly, or firm pressure does not stop it. Dizziness, weakness, confusion, fainting, or other signs of also make the situation an emergency. Call 911 or your local emergency number immediately.
Blood loss can also be internal, without a visible wound. After an injury, worsening weakness, dizziness, confusion, or pale, cool, clammy skin may indicate and requires emergency care.
Control external bleeding
First check that the scene is safe. Use gloves or another barrier to avoid contact with blood when available. Ask someone to call emergency services and bring a first-aid kit. Expose the wound if needed to locate where the blood is coming from.
Apply firm, continuous with clean gauze or another clean cloth. Keep pressing until the bleeding stops, help takes over, or you must respond to another immediate danger. Once bleeding is controlled, secure a dressing with a bandage and watch for bleeding to start again. If something is embedded in the wound, do not remove it; press around it instead.
For a life-threatening wound on an arm or leg that does not control, use a commercial if available and you know how to use it. Tighten it until the bleeding stops and leave it in place for emergency responders. A hemostatic dressing may help when available; use it with firm . Follow your training for wound packing and specialized dressings, because not every wound is suitable for packing.
Recognize and respond to
occurs when the body's organs do not receive enough oxygen-rich blood. Possible signs include pale, gray, cool, or moist skin; a rapid, weak pulse; rapid breathing; thirst; nausea; and confusion, restlessness, or reduced responsiveness. Treat as a medical emergency: call 911, control the cause of blood loss if possible, reassure the person, and keep them under observation.
If the person is alert and breathing normally, have them lie on their back if that is comfortable and safe. If trauma may involve the neck, back, hip, or pelvis, avoid unnecessary movement and leave the person in the position found unless the scene is unsafe. Do not raise the legs when there is evidence of trauma.
If the person becomes less alert, vomits, or may not keep their airway clear, place them on their side if it is safe to do so. With a suspected spinal injury, avoid moving them unless movement is needed for safety or to protect the airway. Keep the person from getting cold or overheated, and give them nothing to eat or drink. Continue watching their breathing and responsiveness while waiting for help.