Severe bleeding, small cuts and nosebleeds

Most cuts are minor and easy to treat at home, but heavy bleeding can become life-threatening within minutes. This lesson covers both, plus the right way to stop a nosebleed.

Severe bleeding: press hard

• Protect yourself: put on disposable gloves if you have them.
• Remove or cut clothing so you can see the wound.
• Press firmly on the wound with a sterile dressing or a clean, non-fluffy cloth. If you have nothing, ask the casualty to press on it themselves.
• If an object is stuck in the wound, do not pull it out, as it may be slowing the bleeding. Press on either side of it instead.
• Get someone to call 998 and describe the location and how heavy the bleeding is; if you are alone, use speakerphone and keep pressing.

Keep pressure on and watch for shock

• Bandage the dressing firmly to keep pressure on, but not so tightly that it cuts off circulation.
• Circulation check: press a fingernail or the skin beyond the bandage for five seconds and release; colour should return within two seconds. If not, loosen and reapply. Repeat every 10 minutes.
• If blood soaks through, St John Ambulance says remove the old pad, apply a new one and rebandage firmly over the wound.
• Shock (not enough circulating blood) is life-threatening: lie them down, raise and support the legs above heart level, loosen tight clothing and keep them warm with a blanket.
• If pressure does not control the bleeding, the call handler may guide you to improvise a tourniquet; follow their instructions exactly.

Treating a small cut or graze

• Wash and dry your hands, and use gloves if you have them.
• Press on the cut with a clean folded cloth or bandage. Raise a hand or arm above the head, or a leg above heart level, to help slow bleeding.
• Once bleeding stops, rinse the wound with tap or bottled water, or use sterile wipes, then pat dry.
• Clean the skin around it with soap and water, wiping away from the wound.
• Cover with a plaster or sterile dressing, keep it clean and dry, and remove it after a few days once the wound has closed.

When a cut needs a doctor

• Go to A&E or call 998 if bleeding will not stop, blood is spurting and bright red, there is numbness or the area will not move properly, or the cut is deep, very large or a bad cut on the face or palm.
• Get urgent medical advice if the wound has soil or pus in it, came from a human or animal bite, is longer than about 5 cm, or becomes swollen, red, more painful or oozes pus.
• A clinician may close the wound with stitches, staples, adhesive strips or skin glue.
• The NHS notes you may also need an injection to prevent tetanus, so know when you last had a tetanus vaccine.
• Do not drive yourself to A&E with a serious wound; ask someone else to drive or call an ambulance.

Stopping a nosebleed

• Sit down and lean forward, with your head tilted forward and your mouth open. Do not tip your head back, which makes you swallow blood.
• Pinch the soft part of your nose, just above the nostrils, for 10 to 15 minutes, breathing through your mouth.
• For 24 hours afterwards, avoid blowing or picking your nose, hot drinks, heavy lifting, strenuous exercise and lying flat.
• Go to A&E if it lasts longer than 10 to 15 minutes, the bleeding seems excessive, you are swallowing so much blood that you vomit, it started after a blow to the head, or you feel weak, dizzy or short of breath.
• Dry air-conditioned rooms can make noses feel dry; that is common in the Gulf, but frequent nosebleeds are worth mentioning to a doctor.