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Backpacker Magazine – May 2011

Summer Trail Smarts: Staunch a Bleeding Wound

Use these first aid techniques to control and treat a bleeding wound.

by: Molly Absolon, excerpted with permission from Trailside First Aid: Recognition, Treatment, and Prevention; Illustration by Supercorn


First Aid 101 For more first aid tips and how-to slideshows and videos visit backpacker.com/firstaidcenter
Whether gouged, poked, sliced, or diced, your first mission is to control bleeding. Follow these pointers, and wear gloves (or put your hand in a plastic bag or stuffsack) when exposed to someone else’s blood to avoid possible pathogens.

Apply direct pressure. Press firmly on the wound using gauze or the cleanest cloth available. You may need to press for a long time before the bleeding stops. Check the wound after a minimum of five minutes to see if clotting has occurred; if not, hold the dressing in place for another 10 to 15 minutes and then check again.

Elevate the wound. Back up your direct pressure by raising the affected area above heart level, so gravity works in your favor, slowing blood loss.

Use pressure points. At left are spots where major arteries run close to bones. You can reduce blood flow to the lower limb below a pressure point by pushing the artery against the bone. Once bleeding has stopped, gradually decrease pressure on the artery, letting blood flow slowly return to normal. If bleeding resumes, start the process again. For serious wounds, it can take five to 20 minutes, so be patient.

Tie a tourniquet as a last resort. In extreme situations (like tears of major arteries), you may need a tourniquet to cut off circulation to the limb and avoid major blood loss, but you risk permanent tissue damage from loss of blood supply if it remains on for long (e.g., a couple hours). Wrap a wide band (like a strip of cloth; rope could cut skin) around the limb, two inches above the wound. Tie an overhand knot, place a stick on the knot, and tie it in place with another overhand knot. Twist the stick until bleeding stops, then tie one or both ends of the stick to the limb to secure it. Write the time and “TK” on your patient’s forehead so docs know immediately to look for the tourniquet. Slowly loosen it after an hour to check bleeding.

Only clean minor wounds. Washing serious ones will restart bleeding, so simply bandage these after you’ve staunched bleeding, then get to a doctor. Otherwise, flush the area with water safe to drink. To achieve sufficient pressure, use a needle-nosed syringe or squirt water from a clean plastic bag with a tiny hole in one corner. Hold the wound’s edges apart, and slightly tilt the limb so water can flow out. Use .5 liter, then pick out dirt, gravel, or sticks with sterilized tweezers. For scrapes, you may need to scrub with sterile gauze or a sponge. Flush the area again with .5 liter. Repeat until it’s clean. Apply antibiotic to infection-prone animal bites, then rinse.

Bandage the injury with gauze and tape. For a gaping cut, fasten it together with steri-strips or tape, starting in the middle. If bleeding resumes, add more dressing, rather than removing the dressing, which will obliterate any remnant clotting.

Three new BACKPACKER Falcon Guides cover knots, medical emergencies, and backpacking fundamentals. This is a sampling of an essential skill you get in a pocket-size, battery-free form ($13, falcon.com).

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READERS COMMENTS

Clark McClendon
Jun 10, 2011

Most current EMS protocols skip pressure points and go straight to the tourniquet, and once applied should only be removed when the patient is in a hospital setting. The reasoning is on a major arterial bleed you may have less than 2 minutes to stop the bleeding. If you apply direct pressure and elevation and cannot stop the bleed. You would have less than 1 minute to apply another intervention and that intervention should be a known method of stopping the bleed, i.e. a tourniquet. At this point it would be a life or limb decision, either the patient dies or loses a limb.

Also on the diagram the pressure point for the femoral arteries is too high. The pressure point is on the inter thigh in the crease where the torso and thigh meet.

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