A stab wound is a severe form of penetrating trauma that demands immediate professional medical attention. The injury, often caused by a sharp object like a knife or glass shard, can breach the skin and underlying tissues, potentially damaging major blood vessels or internal organs. These first aid steps are designed to stabilize the person and manage the most immediate life-threatening complications, particularly massive blood loss. The objective is to bridge the time until emergency medical services (EMS) arrive, significantly increasing the chance of survival.
Initial Steps Scene Safety and Calling for Help
Before approaching a person with a stab wound, ensure the safety of the environment. Stabbing incidents can occur in volatile situations, and a rescuer must confirm the threat is no longer present to avoid becoming a second victim. Only when the scene is deemed safe should the rescuer move toward the injured person to begin providing assistance.
Immediately contact emergency services using the local number. This call should not be delayed to begin treatment, as definitive care requires professional resources. While speaking to the emergency dispatcher, state the location, the nature of the injury, and the victim’s current condition.
After the call is placed, quickly assess the victim’s level of consciousness and whether they are breathing normally. A person who is unresponsive or struggling to breathe requires immediate attention to their airway. However, life-threatening external bleeding often takes precedence. This rapid primary assessment helps prioritize the interventions needed while waiting for the EMS team to arrive.
Addressing an Impaled Object
If the object that caused the injury remains lodged in the body, it must never be removed by a first responder. The object acts as a mechanical plug, creating a tamponade effect that helps prevent severe hemorrhage from damaged vessels. Removing the object can release this pressure, leading to sudden, catastrophic blood loss.
Instead of pulling it out, the object must be secured to prevent any movement that could cause further internal damage to surrounding tissues. This stabilization is achieved by using bulky dressings, clean cloths, or rolled-up clothing placed around the object.
The goal is to physically immobilize the object so it cannot shift deeper or side-to-side, which reduces the risk of lacerating major blood vessels or puncturing organs. Once the padding is in place, secure it with tape or a bandage without putting pressure directly onto the impaled object itself. This careful stabilization minimizes secondary injury and maintains the object’s pressure until a surgical team can safely remove it.
Controlling Severe Bleeding
When the object is not present or has been stabilized, the focus shifts to controlling hemorrhage. The first and most effective technique is applying direct pressure firmly and continuously to the wound site. Use a sterile dressing, if available, or the cleanest cloth material possible to cover the entire wound.
Apply strong, direct force with the palm of the hand over the dressing, maintaining this pressure without checking the wound, as blood clotting takes several minutes to initiate. If the initial dressing becomes saturated with blood, do not remove it, as this can dislodge forming clots. Instead, place a new dressing directly on top and continue applying firm pressure. The application of pressure creates resistance against the bleeding vessel, which promotes hemostasis.
If the wound is deep and located in an area like the torso, groin, or armpit, and direct pressure alone is insufficient, wound packing may be necessary. This advanced first aid technique involves tightly stuffing the wound cavity with gauze or clean material to create internal pressure directly against the source of the bleeding. The packing material must be pressed deep into the wound, and external pressure maintained until professional help arrives.
For severe, life-threatening bleeding on an arm or a leg that cannot be stopped by direct pressure or wound packing, a tourniquet may be used as a last resort. Place the tourniquet high on the limb, about two to three inches above the wound, but not over a joint. It must be tightened until the arterial bleeding stops completely, which is necessary to prevent death from exsanguination.
Monitoring the Patient and Preparing for EMS
Once the bleeding is controlled, monitor the injured person closely for signs of hypovolemic shock, a life-threatening condition resulting from rapid blood loss. Signs of shock include pale, cool, or clammy skin, rapid and shallow breathing, and an increased heart rate. These symptoms occur because the body shunts blood away from the extremities to protect the heart and brain.
Keep the victim lying flat on their back to maximize blood flow to the vital organs. Unless the wound is in the chest or head, the legs should be elevated slightly, approximately six to twelve inches. This elevation aids the return of blood to the core circulation and helps manage the early stages of shock.
Keep the person warm using blankets, coats, or anything available, as maintaining body temperature helps the body’s clotting factors work effectively. Continue to offer calm reassurance and try to keep the victim still to prevent further injury and minimize metabolic demand. When EMS arrives, communicate the time of injury, the estimated amount of blood loss, and all interventions performed, including the use of a tourniquet or wound packing.