Call 911 (or local emergency services) immediately. Arterial bleeding is a severe, life-threatening emergency where rapid blood loss can quickly lead to shock and death. This hemorrhage occurs when a damaged artery carries highly oxygenated blood under high pressure from the heart. This information provides immediate, temporary first aid measures only; professional medical intervention is required to stop the bleeding permanently and treat the underlying injury.
Identifying Arterial Bleeding and Calling for Help
Arterial bleeding is distinctive because the blood is bright red, due to its high oxygen content, and often spurts or gushes rhythmically with the heartbeat. This pulsatile flow results from the high pressure exerted by the heart’s contractions within the arterial system.
In contrast, venous bleeding involves deoxygenated blood returning to the heart, which appears darker red or maroon and flows in a steady, continuous stream due to lower pressure. Capillary bleeding, the least severe type, is a slow ooze or trickle from the smallest blood vessels, and it typically clots easily. Once arterial bleeding is identified, immediately call emergency services and communicate the nature of the injury to the dispatcher.
While waiting for help, have the injured person lie down to prevent a fall if they become dizzy from blood loss. If a limb is bleeding heavily and no fracture is suspected, elevating the injured area above the heart can help slow blood flow due to gravity. However, this should not delay the immediate and effective intervention: applying direct pressure.
Applying Direct Pressure and Wound Packing
Direct pressure is the universal first step for controlling any severe external bleeding, including arterial hemorrhage. Immediately cover the wound with the cleanest material available, such as sterile gauze, a clean cloth, or a piece of clothing. Apply continuous, firm pressure directly onto the wound site, pushing down hard enough to compress the damaged artery against the underlying bone.
Sustained pressure is necessary to allow the body’s clotting cascade to activate and physically seal the damaged blood vessel. If the initial material becomes soaked with blood, do not remove it, as this can disrupt any forming clot. Instead, place new layers of dressing material directly on top of the existing material and continue to maintain firm pressure.
If the wound is a deep cavity or puncture that cannot be controlled with pressure alone, wound packing may be required. This technique involves forcefully stuffing the wound cavity with gauze or clean cloth until the space is completely filled. The packing material must reach the deepest point of the wound to apply pressure directly to the source of the bleeding vessel.
Once the wound is packed, the final step is to apply and maintain direct, continuous pressure on top of the packed material. This combination of internal and external force maximizes compression and stops profuse bleeding. Pressure must be held for a minimum of three minutes without checking the wound, ensuring the nascent clot remains undisturbed.
When and How to Use a Tourniquet
A tourniquet is reserved for life-threatening bleeding on limbs that cannot be stopped by direct pressure alone. Its purpose is to completely stop all blood flow past the device. This carries the risk of tissue and nerve damage, making it a measure of last resort when the alternative is death from blood loss. The decision to use a tourniquet should be made quickly if direct pressure fails to control the hemorrhage or if the wound is an amputation.
If a commercial tourniquet is available, apply it two to three inches above the wound site, but never directly over a joint like the elbow or knee. The device should be applied directly to the skin if possible, or over clothing. Tighten it until the flow of blood from the wound stops completely. A properly applied tourniquet will cause considerable pain, which indicates the device is effectively restricting arterial flow.
Once tightened, the windlass or securing mechanism must be secured to prevent unwinding. Record the exact time the tourniquet was applied and communicate this information to arriving medical personnel. Improvised devices are often less effective and should only be used if a commercial tourniquet is unavailable.
Maintaining Control Until Professional Help Arrives
Once the bleeding is controlled, either through sustained pressure or a tourniquet, focus must shift to monitoring the injured person for signs of shock. Hemorrhagic shock is a dangerous condition that can develop rapidly from significant blood loss. Symptoms to watch for include pale, cool, or clammy skin, a weak and rapid pulse, and restlessness or confusion.
Help the person lie down, and if there are no leg injuries, raising the feet slightly can assist in returning blood flow to the body’s core. Maintain the person’s body temperature by covering them with a blanket or coat, as preventing hypothermia is important for managing shock. Reassure the injured person calmly and continuously monitor the dressing or tourniquet to ensure the bleeding does not restart. The pressure or the tourniquet must remain in place until emergency medical services take over care.