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Backpacker Magazine – November 2009

The Ultimate First-Aid Manual: Heavy Bleeding

Check out what to do when it's much more than a simple scrape or puncture wound.

by: Buck Tilton, Illustrations by Supercorn

Survival
Health & First Aid

LEARN MORE
The Ultimate First-Aid Manual
Wilderness Medicine Institute cofounder Buck Tilton boils down a lifetime's worth of experience into 62 tips

Photo Tutorials: First Aid Center
From splinting a broken leg to duct taping a bloody wound, the BACKPACKER First Aid Center is an invaluable resource for backcountry first aid.

Apply direct pressure until bleeding stops. Pack the wound with absorbent gauze, apply direct pressure on top, and elevate it above the heart. If it soaks through, add more gauze on top and keep applying pressure. When bleeding stops, clean the wound thoroughly with a high-pressure stream of water. Apply antibiotic ointment to a sterile dressing and completely cover the wound, securing it with tape or roll gauze. Gaping wound? Press the edges together gently and hold them there with wound closure strips. Then apply the ointment and sterile dressing.

Check all wounds (including burns and abrasions) regularly for signs of infection:

1) increasing pain, heat, redness, and swelling; 2) more than a little white pus; 3) appearance of red streaks just under the skin near the wound; and 4) fever. If these signs appear and grow steadily worse, find a doctor.

NOTE: Do not close wounds caused by animal bites or crushing injuries; anything involving damaged tendons, ligaments, or bones; or those too heavily contaminated to clean thoroughly. All have a high risk of infection. Instead, pack the wound with moist gauze, cover with dry gauze, and evacuate the patient.

PHOTO SLIDESHOW: How to Treat a Gaping Wound
Here's how to stop the bleeding, close the wound, and prevent infection.

VIDEO: Treating Bloody Wounds
Learn how to treat bleeding cuts, and you just might save your hiking partner's life–or your own.

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READERS COMMENTS

The leaves of the yarrow or achillea plant were used in ancient times to stop bleeding in war times. From my own personal experience it clots the blood by turning it into a rubbery consistensy. Simply press the leaves onto the wound but with caution, some people are known to have had allergic reactions. If you are hiking anywhere in the US and don't happen to have any other resources available to help stop your bleeding, this healing plant is found from coast to coast and is easy to spot. Read on here http://en.wikipedia.org/wiki/Yarrow
Posted: Mar 04, 2011 Mark Thompson

I'm an EMT. Tourniquets are a last ditch effort. Don't use them unless the bleeding absolutely will not stop. If the direct pressure on the wound doesn't work, try putting pressure on arteries closer to the body than the wound. Look up where the femoral arteries are and where the brachial arteries are. If that does not work, then a tourniquet can be used. They should not be loosened until definitive care can be given, such as a hospital.
Posted: Jan 09, 2011 Rusty

Do not remove the initial bandaging over a wound you are trying to keep from bleeding until you are completely sure it has stopped bleeding. Doing so will just open it back up and you will have to start all over again trying to get it to stop. What about a tourniquet for bleeding you can't stop?
Posted: Jan 07, 2011 FuzzyBear