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Bleeding: Severe

What is severe bleeding?

Severe bleeding can come from an artery (arterial bleeding) or from a vein (venous bleeding). In arterial bleeding, the blood pumps or spurts from the wound with each heartbeat. In major venous bleeding, the blood just runs out of the wound at a steady rate. The arterial bleeding is bright red compared to the dark red of venous bleeding. Minor bleeding (from capillaries), however, can also be bright red.

First Aid for Arterial Bleeding

  • Do not remove objects

    Remove any obvious loose debris or dirt from a wound. However, DO NOT remove an object such as a knife, stick, or arrow from the body. Doing so may cause more damage and increase the amount of bleeding. Place pads and bandages around the object and tape the object in place.

  • Apply direct pressure

    Immediately place several sterile dressings or the first clean cloth at hand (towels, sheets, shirts, or handkerchiefs) over the wound and apply direct pressure. The pressure must be forceful and continuous. You can often apply this pressure with the palm of your hand. Act quickly because the ongoing blood loss can cause shock. Continue the pressure until help arrives. DO NOT remove a dressing if it becomes soaked with blood. Instead, add a new one on top. DO NOT try to clean a large wound. This can cause heavier bleeding. DO NOT apply a tourniquet to control arterial bleeding, except as a last resort.

  • Rescue squad (911)

    Have someone call a rescue squad immediately while you tend to the bleeding.

  • Prevent shock

    Have your child lie down with the feet elevated 10 to 12 inches to prevent symptoms of shock (low blood pressure). If your child is pale and the hands and feet are cold, shock is imminent.

First Aid for Venous Bleeding

  • Apply direct pressure
    • Place two or three sterile dressings (or a clean towel or sheet) over the wound.
    • Apply direct pressure to the wound for 8 to 10 minutes, using your entire hand. Direct pressure can always stop venous bleeding if it is applied to the right spot.
    • Bandage the dressings tightly in place (elastic wrap gives excellent compression) and leave them there until arrival at the emergency room.
    • A tourniquet is never needed to control venous bleeding. Doing so may cause more harm than good.
  • Seek emergency care

    Drive to the nearest emergency room. Call the rescue squad (911) for major bleeding or if your child is clearly in shock.

  • Prevent shock

    Have your child lie down with the feet elevated 10 to 12 inches to prevent symptoms of shock.

Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2018.1 published by Change Healthcare.
Last modified: 2009-06-18
Last reviewed: 2017-06-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2018 Barton D. Schmitt, MD FAAP. All rights reserved.
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