A stab wound is a life-threatening medical emergency requiring immediate, decisive action. The primary danger is rapid blood loss, which can lead to hypovolemic shock within minutes. Penetrating trauma can cause significant internal damage to organs or major blood vessels that may not be visible on the skin’s surface. Recognizing the severity of the injury and initiating correct first-aid procedures is paramount to stabilize the injured person until professional medical help arrives.
Secure the Scene and Call Emergency Services
Before approaching an injured person, confirm the safety of the surrounding environment to prevent further harm. If the incident resulted from violence, remove yourself and the injured person from the immediate area of danger, such as traffic or an assailant. Your safety must be established before you can effectively provide assistance.
As soon as the scene is secure, immediately contact emergency services (e.g., 911). Provide the operator with an exact and clear description of your location and the nature of the emergency, specifically mentioning the penetrating trauma. Clear communication helps ensure responders arrive with the necessary equipment.
Encourage the injured person to lie flat and remain as still as possible. Movement increases heart rate, accelerating blood loss and potentially aggravating internal injuries. Reassure the person calmly to manage their anxiety and keep their heart rate down. Remaining still conserves the body’s resources and maximizes the time available before severe blood loss becomes irreversible.
Immediate Wound Management: Controlling Bleeding and Impaled Objects
The primary goal of managing a stab wound is to control external hemorrhage, as severe blood loss is the fastest path to fatality. The technique applied depends on whether the object that caused the injury is still embedded in the wound.
Controlling Hemorrhage
If the object is not present, or the wound is actively bleeding, apply firm, direct, and continuous pressure to the injury site. Use the cleanest material available, such as a sterile dressing, a clean cloth, or even clothing, to cover the entire wound. Press down with significant force and maintain this pressure without interruption.
Do not lift the dressing to check if the bleeding has stopped, as this disrupts the forming clot and can restart the hemorrhage. If the material becomes soaked, place a fresh layer directly over the existing material and continue applying pressure. If the injury is on a limb, elevating it above the level of the heart can help reduce blood flow. Pressure must be maintained until medical personnel take over.
Handling Penetrating Objects
If the object remains lodged within the body, it acts as a temporary internal plug, or tamponade, to contain blood. You must never remove an impaled object, as its withdrawal can unleash rapid, uncontrollable bleeding. Removing the object can also cause further tissue, nerve, or vascular damage.
Focus on stabilization of the object to prevent movement during transport. Stabilize the object by placing bulky dressings or clean cloths around the entry point to create a protective ring or doughnut-shaped padding. This padding should entirely surround the object and be built up to the height of the protruding portion.
Secure the padding firmly with tape or a bandage to prevent the impaled object from shifting or moving deeper into the wound. Any movement could tear internal structures and worsen the injury. The only exceptions to non-removal are if the object obstructs the person’s airway or prevents chest compressions during CPR.
Monitoring for Traumatic Shock and Preparing for Medical Transport
Even with controlled external bleeding, a severe stab wound can rapidly lead to traumatic shock. This is a life-threatening condition where the circulatory system fails to provide enough oxygenated blood to vital organs (hypovolemia). Actively monitor for observable changes in the injured person’s physical state.
Signs of developing shock occur as blood is shunted away from the extremities to the core organs. These include:
- The skin becoming pale, cool, and clammy to the touch.
- A pulse that is rapid and weak.
- Fast and shallow breathing.
- Changes in mental status, such as disorientation, anxiety, or confusion.
To manage the onset of shock, keep the victim lying flat on their back to maximize blood flow to the brain and heart. If there is no suspicion of head, neck, or back injury, gently raising the feet six to twelve inches can assist circulation. Maintain the person’s body temperature by covering them with a blanket or coat to prevent heat loss, which can worsen shock.
Do not give the injured person anything to eat or drink, even if they complain of thirst. Food or liquids in the stomach complicate potential emergency surgery requiring a general anesthetic. Continue to monitor the person’s responsiveness and breathing until medical transport arrives, providing reassurance and keeping them calm.