Bleeding Control: Stop the Bleed – “You are the Help Until Help Arrives”

By Sarah V. Gillen, President, Emergency Skills. Inc.

According to the National Trauma Institute, trauma alone is the leading cause of death for individuals aged 1-44, and accounts for 30% of all lives lost in the U.S. Responders to a severe bleeding emergency must take action quickly, often within 5 minutes, to save a life.

While it is human nature to want to help during any emergency, without knowledge, equipment and practice, most people unfortunately hesitate, wasting valuable minutes. In order to save lives, immediate bystander care has been proven to be critical.

Following the devastating shooting at Sandy Hook Elementary School in Connecticut, a committee of healthcare and government leaders convened in Hartford, CT to discuss the issues and make recommendations for emergency response. The strategies released following the meeting are known as the Hartford Consensus and their main recommendation dealt with making prompt bleeding control a priority. “Unfortunately, uncontrolled hemorrhage remains the single most preventable cause of death after both military and civilian injuries. One of the most important lessons learned in the last 14 years of war is that using tourniquets and hemostatic dressings as soon as possible after injury is absolutely lifesaving.”

In order to provide bleeding control, The Hartford Consensus recommended ensuring that lay rescuers would have quick access to bleeding control tools. These tools include pressure bandages, safe and effective hemostatic dressings, effective tourniquets, and personal protective gloves. Here is a summary of how you would use each of these items would be used and how they fit into your emergency response steps:

Steps to follow in a bleeding emergency:

Call 911: In all emergencies, alert 911 of your status and location. If this is an active shooter emergency remain quiet to avoid alerting shooter of your location. Turn the sound off of your phone keys and text someone to call 911 for you, if needed.

Personal protective gloves: All First Aid kits must contain gloves. Protect yourself first. A bleeding victim may be able to assist with applying pressure until rescuer’s gloves are applied properly.

Tourniquets: For serious bleeding on a limb, use a tourniquet. Severe bleeding is defined as continuously flowing and possible squirting and a large amount of blood loss i.e. 6oz (1/2 can of soda) or more. Tourniquets are commercially available but may also be created in the field. The commercially available ones are more effective. If you are making a tourniquet during an emergency, find a long piece of fabric such as a necktie and use a stick (or pencil) as a windless. Follow these steps to use a tourniquet:

Hemostatic dressings: Hemostatic dressings contain a clotting agent to improve clotting. These dressings may be used in conjunction with a tourniquet but are especially helpful for severe bleeding in parts of the body other than the limbs. For example, injuries to the torso, groin or armpit area. If the victim is bleeding from an injury in the shoulder, for example, following these steps:

Hemostatic bandage proper application.

Pressure Bandages: A pressure bandage is a thick pad of gauze placed over a wound and attached firmly, so that it will exert pressure. A pressure bandage may be used in conjunction with gauze or a hemostatic dressing.

Monitor Victim: Ensure bleeding has stopped. Watch for signs of shock. Shock is the failure of the circulatory system to provide an adequate blood supply, especially to the heart, brain, and kidneys. Rigorous pumping of the heart, an infection, or loss of body fluid may cause shock. Severe bleeding will cause shock. Be SHARP to PREVENT SHOCK. Warning signs of shock include:


Skin: Pale, cold, clammy

Head: Dizzy, dazed, unconscious

Abdomen: Nauseous

Respiration: Shallow, rapid

Pulse: Weak, rapid


Protection: Apply Barrier Protection for example gloves

Reassure: Calm them

Elevate: Raise legs, approximately 12 inches with victim lying on his/her back

Very: Gentle handling

Exception: Do not raise legs if there are head, spinal or abdominal injuries or breathing difficulty

Nothing: Give nothing by mouth

Temp: Maintain normal body temperature. Cover, if chilled

There are several ways to prepare your workplace for major bleeding emergencies.


Additional Resources:

Hemorrhage control devices: Tourniquets and hemostatic dressings

Harford Consensus

Infographic from Department of Homeland Security

emergency training