Severe Bleeding: First Aid Steps to Take Before Help Arrives

Unlike many emergencies where the best thing you can do is wait for help, uncontrolled bleeding needs action straight away from whoever is there. Most people understand that in theory. Fewer know exactly what to do in the moment, and fewer still have practised it under pressure.

You do not need medical training to help. You need a small number of clear actions and the confidence to take them.

Who this guide is for

Workplace first aiders, parents, tradies, farmers, remote workers, sporting coaches and everyday Australians who spend time where injury is possible.

What makes bleeding life-threatening

Not all bleeding is an emergency. A minor cut, even a dramatic-looking one, is rarely dangerous. Act urgently when:

• The wound is large or deep
• Blood is spurting or flowing and not slowing
• Blood is soaking through dressings or pooling
• A limb has been partly or fully cut off
• The person looks pale, sweaty, faint or confused

The body responds to rapid blood loss by going into shock (hypovolaemic shock). Blood pressure drops, the heart works harder and vital organs, including the brain, get less oxygen. Controlling the bleeding gives the body time to keep circulation going until professional help arrives.

Severe bleeding first aid steps

1. Check for danger. Look for traffic, machinery, sharp objects or other hazards. Do not put yourself at risk.
2. Call 000. Ask a bystander to call, or put your phone on speaker and call while you help.
3. Apply firm, continuous pressure. Use a clean cloth, dressing or your gloved hand directly on the wound. Press hard.
4. Do not lift the dressing to check. Peeking breaks clots that are forming. If blood soaks through, add more material on top and keep pressing.
5. Bandage firmly once the bleeding slows, with a pressure bandage over the dressing. Keep checking that it stays firm.
6. Lay the person down and keep them calm and warm. If a limb is injured, keep it still.
7. Stay with them and keep watching their breathing and responsiveness until paramedics arrive.

When to use a tourniquet

ANZCOR suggests a tourniquet for life-threatening bleeding from an arm or leg that pressure cannot control, if you are trained and have one available. Use one straight away if the injury is severe, such as a limb that has been cut off or bleeding that is heavy and not slowing.

1. Place the tourniquet on the limb, above the wound and between the wound and the heart. Follow the maker's instructions. If you can, put it on bare skin and not over a joint.
2. Pull the strap tight and twist or tighten the windlass until the bleeding stops.
3. Secure it in place and write down the time it was applied.
4. Do not loosen or remove it. Leave that to paramedics.
5. If the bleeding does not stop, apply a second tourniquet just above the first and keep pressing on the wound.

A commercial tourniquet is best. If you do not have one, keep up firm direct pressure. If you have nothing purpose-made, a wide band of material is better than something narrow, and a belt or cord is a last resort. Keep pressing on the wound while you improvise, because narrow items are less effective and can damage tissue. Tourniquets are only for arms and legs, not the neck, chest or abdomen. Practising on a trainer is what makes this feel natural.

What to do if the person goes unconscious or stops breathing

If the person becomes unresponsive and is not breathing normally, call 000 if you have not already, and start CPR. Keep any pressure or tourniquet in place if you can. If you are on your own, follow the dispatcher's instructions. Use an AED if one is available.

Common mistakes

• Lifting the dressing to check. It disturbs clots and restarts bleeding.
• Pressing too lightly. Pressure needs to be firm and continuous.
• Waiting to call 000. Make the call early.
• Hesitating to use a tourniquet when pressure is failing on a limb.
• Loosening a tourniquet to see if it is still needed.
• Forgetting to note the time the tourniquet went on.
• Leaving the person alone or letting them walk around.

Learn it hands-on

Bleeding control, wound management and tourniquet application are covered in HLTAID011 Provide First Aid, HLTAID013 Provide First Aid in Remote or Isolated Site and HLTAID014 Provide Advanced First Aid. Reading is a good first step. Practising in a realistic setting is what builds the confidence to act when it counts. You can also read about how to tell life-threatening bleeding from minor bleeding.

Frequently asked questions

This article is general first aid information based on ANZCOR guidance current at the time of writing. It does not replace a first aid course. In an emergency, call 000.