First Aid for Severe Bleeding Certification Manual: Recognizing Severe Bleeding

How to Recognize Severe Bleeding

Bleeding may be severe or life-threatening when blood is flowing continuously or spurting, pooling on the ground, rapidly soaking through clothing or dressings, or coming from a partial or complete amputation. Blood loss equal to approximately half the contents of a standard soda can may be life-threatening. A smaller amount may be life-threatening for an infant or young child.

Signs of shock—such as pale, gray, cool, or moist skin; rapid breathing; a rapid, weak pulse; dizziness; confusion; or decreased responsiveness—also indicate an emergency. Serious internal bleeding may occur after blunt trauma even when little or no blood is visible.

Do not delay care while attempting to estimate the exact amount of blood lost or measure the person’s pulse. Call 911 and immediately begin bleeding control when severe bleeding is present or suspected.

Common signs of severe bleeding include:

• Blood flowing continuously or spurting
• Blood pooling on the ground
• Clothing or dressings rapidly becoming soaked with blood
• A partial or complete amputation
• Bleeding that does not stop with firm direct pressure
• Signs of shock
• Significant trauma with suspected internal bleeding

Types of Open Wounds

Abrasion

An abrasion is a scrape involving the outer layers of skin. Bleeding is usually minor, although a large or deep abrasion may require medical evaluation.

Amputation

An amputation is the complete or partial separation of a body part. Treat bleeding from an amputation as life-threatening, call 911, and begin immediate bleeding control.

Avulsion

An avulsion occurs when skin or other tissue is partially or completely torn away. An avulsion may cause severe, life-threatening bleeding.

Laceration

A laceration is a cut or tear in the skin or underlying tissue. Severity depends on the wound’s depth, location, and amount of bleeding.

Puncture

A puncture occurs when an object penetrates the skin and underlying tissue. The visible wound may be small even when deeper structures are injured. Do not remove a deeply embedded object. Apply pressure around the object and call 911 for severe bleeding or significant trauma.