What does a life-threatening bleed look like, and how should it be treated? Many people assume an arterial bleed is the main concern, but recognising any catastrophic or life-threatening bleed is crucial. A bleed does not need to be arterial to be life-threatening; venous bleeding can also become critical if left untreated. Key warning signs include a large amount of blood, the circumstances of the incident, and eyewitness accounts that suggest severe bleeding.
I was once told that “All bleeding stops eventually” and that is true as eventually, the blood circulating around the system will run out!
So, which type of bleed could you come across and how would you deal with each?
Arterial bleeding will always be problematic and needs to be dealt with as soon as possible. Arterial bleeds can be identified as being bright red bleeding and spurting in time to the heartbeat.
Initially direct pressure should be applied to the wound for 10 minutes (if the wound can be accessed). Bleeds to the neck, armpits and abdomen can be tricky and may need packing with the exception of an abdominal or a torso bleed which should not be packed.
As a last resort, a tourniquet can be used on an arm or a leg and should be placed on the single bone of the limb.
It is vitally important to recognise life threatening bleeds regardless of it being from an artery or a vein as losing around 30% of our blood supply can be catastrophic.
Bright red blood spurting in time to the heartbeat will most probably be arterial, dark red blood oozing is probably a bleed from a vein, capillary bleeds are the small droplets of blood resulting from a graze, which are the least life threatening but, still need attention.
So, what should you do if applying direct pressure doesn’t stop the bleeding? A tourniquet should be used as a last resort; however, stopping further blood loss is extremely important.
A tourniquet should first be applied as high as possible on a single-boned limb (the upper arm or upper leg). This allows the arteries to be compressed against the bone, helping to slow and, ideally, stop blood flow to the injured part of the limb.
There are a variety of manufactured tourniquets on the market; in our opinion, the best is the CAT (Combat Application Tourniquet). Widely used in battlefield situations, it is seen as the easiest and best-designed tourniquet, with ease of application as its biggest advantage. The CAT can be applied with one hand, which is always useful if you are a lone worker or find yourself far from help.
You can also improvise a tourniquet with the contents of your first aid kit. All you need is a triangular bandage, scissors, or a sturdy rod to tighten the bandage; this technique is demonstrated in our catastrophic bleed sessions and used as a practical exercise.
This topic cannot be fully covered in just a few pages, but we address all key aspects in our First Aid at Work and Catastrophic Bleed sessions. We also provide bespoke training tailored to your industry and specific requirements.
Be Prepared
Many of us assume a life-threatening bleed will not happen to us. However, serious incidents can occur unexpectedly, and afterwards people often wonder whether they could, and should have been better prepared.