Severe Bleeding Control: Pressure, Packing, and Tourniquet

Arterial bleeding spurts in bright-red pulses matching heartbeat. Venous bleeding flows steadily in dark-red. Capillary bleeding oozes slowly. Arterial and heavy venous bleeding require immediate control or death occurs in minutes.

Arterial bleeding in neck, groin, or axilla kills in 60 seconds. Act immediately.

Use bare hand, cloth, or bandage. Press firmly over wound with full palm or multiple fingers. Do not peek or remove pressure to check. Maintain constant, unrelenting pressure for minimum 3 minutes. If bleeding soaks through, add more cloth on top—do not remove first layer. Wrap firmly with elastic bandage or torn cloth to secure pressure while you assess next steps.

Removing pressure resets clotting. Once applied, pressure stays until wound seals or tourniquet/packing replaces it.

Use tourniquet if bleeding is on limb (arm or leg above elbow or knee), is severe, cannot be controlled after 3 minutes of direct pressure, or comes from artery. Use packing if bleeding is on torso, neck, face, or groin, and direct pressure controls it. Packing also works for deep wounds that cannot be tourniqueted.

Place tourniquet 2–3 inches (5 cm) above wound, between wound and body. Skip any joints—never place over knee or elbow. Tighten until bleeding stops, then turn tighter one full rotation beyond that point. Secure strap. Mark tourniquet with time applied using pen on skin or cloth. Recheck that pulse below tourniquet is gone (feel wrist or ankle). If no commercial tourniquet available, use belt, rope, or cloth strip twisted tight with a stick as windlass.

Tourniquet left on >2 hours risks permanent nerve and tissue damage. Loosen only if bleeding stops and wound is sealed, or if rescuer arrives. Without rescuer, keep tourniquet on indefinitely rather than bleed to death.

If wound is deep and bleeding continues despite pressure, pack inside with gauze, cloth strips, or clean cloth. Push material deep into wound to reach bleeding source. Pack tightly and systematically, filling entire cavity. Once packed, apply direct pressure over wound opening with cloth and elastic wrap. Packing succeeds only if you reach the bleeding vessel.

Keep pressure on wound continuously. Do not move victim until wound is stable. Elevate bleeding limb above heart if possible without breaking pressure seal. Watch for shock: pale skin, rapid shallow breathing, confusion. Lay victim flat, cover with blanket, give water only if conscious and not vomiting. Check tourniquet time every 30 minutes. If tourniquet was applied, do not remove it—once off, rebleeding occurs and reapplying is harder.

Shock kills as fast as bleeding. Prevent by keeping victim calm, warm, and horizontal.