Stopping heavy bleeding: direct pressure

The body has its own repair system for bleeding: clotting. At the injured spot the blood clumps together and forms a plug that seals the hole. For small wounds that is enough. With heavy bleeding, however, this plug is washed away again and again before it can become firm.

This is where your pressure comes in. When you press firmly on the wound, you squeeze the injured vessels together. Less blood flows, and clotting gets the chance to do its work. That is why it is so important not to keep releasing the pressure to look – every time you let go, the bleeding can start up again.

Someone who loses a lot of blood has less fluid in their circulation. The body tries to compensate, and you can see it: the person becomes pale, gets a cold sweat, becomes restless, confused or increasingly drowsy. These signs are warning signs and must be reported to the dispatcher immediately.

The pressure must be firm, sit exactly on the spot that is bleeding and be held without interruption. Use a dressing from the first-aid kit or, if there is nothing else, a clean cloth. If nothing at all is to hand, the injured person can press themselves, or you press with your gloved hand.

If blood soaks through the dressing, do not remove it, because that would disturb the clotting that has begun. Instead put more material on top and press harder. If you have learned to apply a pressure bandage on a course, you can use one to keep up the pressure; afterwards check whether it is still bleeding and press with your hand again if needed.

While you press, have the person lie down. Cover them and protect them from ground cold. Talk to them calmly, stay with them and give them nothing to eat or drink. Report every change to the dispatcher.

Other people's blood can contain pathogens. That is why you put on disposable gloves if they are immediately to hand – but you do not search for them for long, because with heavy bleeding time counts. If necessary, a plastic bag over your hand helps. Afterwards wash your hands thoroughly.

If something is stuck in the wound, for example a shard of glass, a piece of metal or a piece of wood, do not pull it out. The object may be sealing the bleeding like a cork; once pulled out, it can suddenly bleed heavily. Instead pad around it and press beside the object, not on it.

You may have heard of tourniquets. They are taught on some courses for life-threatening bleeding from arms or legs when direct pressure is not enough – but only with appropriate training and a purpose-made product. Improvised tying-off with a belt or cord is not part of lay first aid. For all lay people: direct pressure is the first and most important measure.

Direct pressure helps with most external bleeding, whether on arms, legs, head or trunk. It needs hardly any material and anyone can learn it. Its drawback: it keeps one hand occupied until the ambulance crew takes over. That is why it is good if other bystanders take care of the emergency call and a blanket and guide the responders in.

Wound care, stitching or closing wounds are not jobs for first aiders. Professionals take care of that. Your only task is to contain the bleeding as well as possible until then and to look after the person.

Internal bleeding, for example after a fall or traffic accident, often cannot be seen from outside – and pressing does not help against it. If someone becomes pale, restless or drowsy after an accident, they therefore always need the ambulance service, even without a visible wound.

An ordinary nosebleed is usually harmless. Courses teach: sit upright, lean the head slightly forward so the blood does not run into the throat, and pinch the soft part of the nose. If it does not stop, if it happened after a blow to the head or if the person takes blood-thinning medication, get medical help.

Some people feel dizzy or sick themselves at the sight of blood. That is a completely normal bodily reaction. If that happens to you, kneel down before you help and breathe calmly. Sometimes it also helps to let someone else press while you make the emergency call.

You become most confident on a first-aid course. There you practise how firmly you really have to press, how a pressure bandage is applied and how to work with gloves. A first-aid kit with gloves and dressings that you can find quickly makes you even better prepared.