What to do in the event of external bleeding

• protect your hands by wearing disposable gloves;
• stop the bleeding immediately:
  • move clothes out of the way if necessary;
  • to perform manual compression in the absence of a foreign body, regardless of the location of the wound;
  • if direct compression, by the first-aider or the victim, to a limb is ineffective or impossible (victim with multiple injuries, multiple victims, or where access to the wound is impossible) or in certain situations (disasters, military operations or similar situations, or situations of isolation), apply a tourniquet. In such cases, note the time the tourniquet was applied so that this information can be passed on to the team that will take over the victim’s care.
  • if direct compression is effective, apply a pressure dressing:
    • if the compression dressing is ineffective, resume direct compression and use:
      • or a tourniquet depending on whether the bleeding is in the upper or lower limbs. This area is commonly referred to as the ‘tourniquet area’.
      • or a dressing soaked in a haemostatic agent, held in place by a pressure dressing, when the bleeding occurs at the junction of the limbs and the trunk (groin, armpit), on the buttocks, the trunk, the neck or the head. This corresponds to what is known as the ‘non-tourniquetable area’
  • Complete the critical emergency assessment; if the casualty shows signs of circulatory distress, follow the appropriate procedure.
  • forward the critical emergency assessment for medical advice and follow the instructions received;
  • carry out a further assessment to look for any other signs or injuries and administer the necessary first aid;
  • protect the victim from the cold or bad weather and keep them off the ground, as hypothermia makes the victim’s condition worse;
  • reassure the victim;
  • Keep an eye on the victim. In particular:
    • check that the bleeding has stopped without releasing the pressure;
    • check for signs of circulatory deterioration.

Special case: open fracture and foreign body

If the victim has an open fracture, with a piece of bone visible, or if the bleeding wound contains a visible foreign object:

• Do not touch either the piece of bone or the foreign body, as their presence may help to stem the bleeding and moving them could make the injury worse;

If the bleeding remains heavy and profuse, apply a tourniquet.