Bleeding and Trauma

Severe Bleeding

Severe bleeding is one of the most preventable causes of death — and one where a bystander's action matters most, because a person can bleed to death faster than an ambulance can arrive.

The response - Apply firm, direct pressure straight onto the wound with a cloth or your hands, and do not keep lifting off to look. - If a deep wound keeps bleeding, pack it firmly with cloth and press harder. - For a catastrophic limb wound that pressure cannot control, a tourniquet applied high and tight above the wound is a recognised last resort. - Keep the casualty still and warm, and get emergency help.

Direct pressure, maintained without peeking, controls the great majority of bleeding.

The instinct to repeatedly check the wound actually prevents the clot from forming. Understanding that clotting needs undisturbed time turns a frightening gush of blood into a problem you can hold under your own two hands until help arrives.

Recognising Shock

Shock, in the medical sense, is not emotional upset — it is a dangerous failure of the circulation to deliver enough blood to the body's organs. It often follows heavy bleeding, major burns, severe fluid loss or serious illness, and it can be fatal on its own.

Signs to recognise - Pale, cold, sweaty or clammy skin. - Rapid, shallow breathing and a fast, weak pulse. - Restlessness, confusion, thirst, then drowsiness.

What to do - Treat the cause — above all, stop any bleeding. - Lay the person down and keep them warm and calm. - Do not give food or drink. - Get urgent medical help and keep checking breathing.

Shock is dangerous precisely because it is a downward spiral: less circulation starves the organs, which worsens the circulation. Recognising the early signs — and simply keeping the person flat, warm and still while treating the cause — can interrupt that spiral long enough for professional care to take over.

Burns and Fractures

Two of the most common serious injuries — burns and broken bones — are each made worse or better by what is done in the first few minutes.

Burns - Cool the burn under clean, cool running water for a good length of time. - Do not use ice, butter, oils or toothpaste — they trap heat or cause infection. - Remove jewellery and loose clothing near the burn, but never peel off anything stuck to it. - Cover loosely with clean, non-fluffy material such as cling film. Large, deep, or airway burns are emergencies.

Fractures - Keep the injured part still, supported in the position you found it. - Pad and splint it only if you must move the person, and check that fingers or toes beyond the splint stay warm and pink. - Suspect a spinal injury after any big fall or impact, and do not move the person unless their life is in danger.

In both cases the principle is the same: do no further harm. Cooling stops a burn from deepening; immobilising stops broken ends from tearing tissue. Simple, gentle, correct action in the first minutes protects what the hospital will later repair.