First aid - Severe bleeding

If possible, before you try to stop severe bleeding, wash your hands to avoid infection and put on synthetic gloves. Don't reposition displaced organs. If the wound is abdominal and organs have been displaced, don't try to push them back into place. Cover the wound with a dressing.

For other cases of severe bleeding, follow these steps:

1. Have the injured person lie down. If possible, position the person's head slightly lower than the trunk or elevate the legs. This position reduces the risk of fainting by increasing blood flow to the brain. If possible, elevate the site of bleeding.
2. While wearing gloves, remove any obvious dirt or debris from the wound. Don't remove any large or more deeply embedded objects. Don't probe the wound or attempt to clean it at this point. Your principal concern is to stop the bleeding.
3. Apply pressure directly on the wound. Use a sterile bandage, clean cloth or even a piece of clothing. If nothing else is available, use your hand.
4. Maintain pressure until the bleeding stops. Hold continuous pressure for at least 20 minutes without looking to see if the bleeding has stopped. You can maintain pressure by binding the wound tightly with a bandage (or even a piece of clean clothing) and adhesive tape.
5. Don't remove the gauze or bandage. If the bleeding continues and seeps through the gauze or other material you are holding on the wound, don't remove it. Instead, add more absorbent material on top of it.
6. Squeeze a main artery if necessary. If the bleeding doesn't stop with direct pressure, apply pressure to the artery delivering blood to the area of the wound. Pressure points of the arm are on the inside of the arm just above the elbow and just below the armpit. Pressure points of the leg are just behind the knee and in the groin. Squeeze the main artery in these areas against the bone. Keep your fingers flat. With your other hand, continue to exert pressure on the wound itself.
7. Immobilize the injured body part once the bleeding has stopped. Leave the bandages in place and get the injured person to the emergency room as soon as possible.

If you suspect internal bleeding, call your local emergency number. Signs of internal bleeding may include:

• Bleeding from body cavities (such as the ears, nose, rectum or vagina)
• Vomiting or coughing up blood
• Bruising on neck, chest, abdomen or side (between ribs and hip)
• Wounds that have penetrated the skull, chest or abdomen
• Abdominal tenderness, possibly accompanied by rigidity or spasm of abdominal muscles
• Fractures
• Shock, indicated by weakness, anxiety, thirst or skin that's cool to the touch