Stop the bleed: Learn what to do in an emergency

How to stop severe bleeding: What to do in an emergency


May 20, 2019

Accidents and injuries can happen anywhere. Knowing how to stop bleeding on the spot could save a life.


A fall on a hiking trail, a bicycling accident, a shooting or stabbing, even an incident in the workplace — severe bleeding can occur anywhere at anytime. If you saw someone with such a life-threatening wound, would you know how to help?

Stop the bleed: That’s the message medical caregivers want to spread, and there are simple steps that any layperson can take to stop bleeding in an emergency situation. Much like training and awareness for choking and heart attack victims, teaching people how to control bleeding can save lives.

“Tourniquet training is helpful to have because accidents or injuries can happen anytime, anywhere. We see people coming into Vanderbilt’s emergency department bleeding from motorcycle crashes, farming accidents — it could be anything,” said Cathy Wilson, MSN, RN, ACNP-BC, Vanderbilt University Medical Center’s Trauma Outreach/Injury Prevention Coordinator.

When to use a tourniquet

There are certain types of injuries that lend themselves to tourniquets, Wilson said. Tourniquets should only be used on arms and legs, so a general rule of thumb is to locate the injury on an extremity from the armpits down or from the groin down.

Spurting or pooling blood indicate that a victim may need a tourniquet to help stop the bleed until emergency workers arrive. Ideally, a tourniquet will compress the artery against bone.

If a wound is on the trunk or neck, Wilson said, “all you can do is apply and hold pressure on the wound, or possibly pack the wound, and get to the hospital as quickly as possible.”

Wilson believes widespread training is important, even though any publicly available tourniquet kit would include basic illustrated instructions. With uncontrolled, life-threatening bleeding, time is of the essence. “When we train, we want people to know what’s life-threatening and what’s not. We don’t want anyone to unnecessarily use a tourniquet.”

How to stop severe bleeding

In an emergency, Wilson said, you can apply a tourniquet to yourself if necessary. Here are some basic steps when providing first aid to someone else until emergency responders arrive:

  • Ensure you own safety first; Call 911 immediately.
  • Put on gloves if available.
  • Locate the injury and expose the wound.
  • Cover with something clean.
  • Apply compression. Pack wound if needed.
  • Apply tourniquet, if applicable.

‘It can happen anywhere’

There was a time when we left things like mouth-to-mouth resuscitation, the Heimlich maneuver and CPR to the medical professionals. If something happened to you in public, you just had to hope there was, as they say, a doctor in the house. But intensive efforts to educate and train the public, making people aware of the likelihood of encountering everyday emergencies and stocking public spaces with things like CPR kits and automated external defibrillators, have made a difference.

Now, Wilson and others want to do the same for bleeding emergencies. Anything from a kitchen injury to a car crash can lead to uncontrolled bleeding, she said. Commercial tourniquet kits are increasingly available, and medical professionals like Wilson are taking the lead on increasing awareness and training. She often travels to schools and other groups to conduct basic training.

“It can happen anywhere,” she said. “Like I tell my attendees in class, it’s not just something you can run into at home or at school or your place of work, you could be in any public place and something could happen. If you see a kit, once you are trained in bleeding-control techniques, you’ll know how to use it.”

The basic components of a tourniquet kit would be gloves, the tourniquet and gauze. Some may also include a lightweight thermal blanket.