Severe Bleeding & Deep Wounds
Uncontrolled bleeding can kill within minutes. Firm, direct, uninterrupted pressure is what stops it — not antiseptic, not elevation alone, and rarely a tourniquet.
When to call an ambulance immediately
- Blood spurting, pulsing, or soaking through dressings within minutes
- A pool of blood collecting on the ground
- Pale, cold, clammy skin with a fast, weak pulse
- Confusion, agitation, drowsiness or fainting
- An amputated or partially amputated limb
- A deep wound to the neck, chest, abdomen or groin
What to do
Work through these in order. If you are alone, put your phone on speaker so the 108 call handler can guide you while your hands stay free.
- 1
Protect yourself, then call 108
Wear gloves if any are available, or put a clean plastic bag over your hand. Call 108 on speaker so both of your hands stay free.
- 2
Apply firm direct pressure
Press hard on the wound with a clean cloth, gauze or your gloved hand, using the flat of your fingers or your palm. Firm and continuous beats gentle and intermittent. Hold for at least ten minutes without lifting to look.
- 3
Add dressings, never replace them
If blood soaks through, place another cloth on top and keep pressing. Removing a soaked dressing tears away the clot you have just worked to form.
- 4
Raise the limb if there is no fracture
Elevating a bleeding arm or leg above the level of the heart helps, but only if it causes no pain and you do not suspect a broken bone or a spinal injury.
- 5
Lay them down and keep them warm
Lie them flat and raise the legs slightly if they feel faint. Cover them with a blanket. Cold blood clots badly, and heat loss makes bleeding worse.
- 6
Tourniquet only for catastrophic limb bleeding
If an arm or leg is bleeding so heavily that direct pressure is clearly not controlling it, or the limb is amputated, apply a tourniquet 5 to 7 cm above the wound, tighten until the bleeding stops, and write down the time it was applied. Never loosen it once it is on. Hand that decision to the hospital.
Never do these
Most of these are well-intentioned and widely believed. All of them make the situation worse.
- Never remove an object embedded in a wound. It may be the only thing plugging a torn vessel. Pack firmly around it instead.
- Never keep lifting the dressing to check. Every peek restarts the bleeding.
- Never apply a tourniquet for ordinary bleeding that direct pressure can control.
- Never loosen or release a tourniquet periodically. That advice is outdated and dangerous.
- Never pour turmeric, ash, coffee powder, kerosene or cow dung into a deep wound. None of it stops bleeding, and it causes serious infection and tetanus.
Once the immediate danger has passed
- For an amputated part: wrap it in clean, damp gauze, seal it in a plastic bag, and place that bag on ice. Never let the tissue touch ice directly.
- Ask about tetanus immunisation. Any dirty or deep wound needs it reviewed.
- Deep wounds, wounds over joints, animal bites and anything with an embedded object need proper surgical assessment, not just a bandage.
Frequently asked
How long should I press before checking?
At least ten minutes of uninterrupted pressure. Most people give up after thirty seconds and then wonder why the bleeding restarts.
Is a tourniquet dangerous?
A correctly applied tourniquet left on for a couple of hours is far safer than bleeding to death. The real danger is applying one loosely, which blocks veins but not arteries and makes bleeding worse.
Reviewed and written by
Dr. Poonam Sekhon Chahal, MBBS, MEM
Senior Emergency Physician, Manipal Hospital, Patiala · Certified in ACLS, ATLS, PALS and PoCUS