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One of my favorite activities is to walk the woods.
I especially like to explore off the trail. I have some rock climbing experience, so I can be more daring than some people I know.
But those rocks can be sharp and all it would take is one slip to cause a traumatic enough wound for me to bleed to death without expeditious care.
May is Stop the Bleed Month.
Even outside the wild, traumatic bleeding injuries are one of the highest causes of death in the United States.
Hemorraghing, or bleeding profusely, can cause someone to bleed to death in minutes.
EMTs can’t get to you within minutes if you’re miles into the wilderness.
Do you know how to stop traumatic bleeding by yourself?
Types of Bleeding
All major hemorrhages are dangerous, but some are lethal more quickly than others.
Traumatic wounds will be either arterial or venous. You want to stop it in both cases but some techniques won’t work with the wrong type of bleeding.
Your heart uses arteries to supply fresh blood to your body.
This type of blood will be a bright red and come out rapidly, often spurting along with the heartbeat.
Arterial bleeds are the most dangerous because they can cause your heart to push out all of your blood in minutes.
Or seconds, in the case of major arteries such as the abdominal aorta.
Veins are used to bring old blood back to the heart.
This type of blood will be a darker red (no, not blue!), and will be a constant, slower flow.
A traumatic injury to a vein can still cause death, but it will take a lot longer than an arterial cut.
Venous exsanguination can take hours, but it’s still a good idea to stop the bleeding as soon as possible.
The small blood vessels near the surface of your skin are called capillaries.
Capillary bleeds will be bright and bleed fast, but won’t be high in volume and often clots faster than other wounds.
Unless you have hemophilia, a capillary bleed is rarely a life-threatening event, though they can be very alarming.
Once a traumatic event has happened and you see blood spurting all over the place, it’s time to act.
First of all, sit the victim down, whether it’s you or someone else. Blood loss can cause weakness and fainting, so you don’t want them to fall over and hit their head.
Explain what you’re seeing and what you’re about to do. This will build up trust and provide comfort to the patient (even yourself!).
But don’t slow down the actual first-aid in order to comfort the victim.
Get out your medical gear. Then, get yourself sanitized if possible.
This means putting on rubber gloves or using hand sanitizer, if possible.
If that would slow you down, though, proceed immediately to stopping the bleeding. Stopping the bleeding is more important than preventing infection.
Ways to Stop Bleeding
A serious wound can cause death by exsanguination in minutes, whether arterial or venous.
This means that objective #1 is to stop the bleeding, by all means.
The following text, images, and videos are great resources to learn how to stop the bleed. But they are no replacement for hands-on experience.
So, I encourage you to take a course on bleeding control.
Until then, here’s what you can do to stop bleeding:
Apply Direct Pressure
The most effective and safest way to slow bleeding is to apply direct pressure on the wound.
This cuts off the blood vessels and gives you time to dress the wound.
Hand pressure is recommended, especially when holding gauze or cloth. However, this may not be possible if you’re alone in the woods.
In this case, use something else to apply pressure.
Your knee can be surprisingly useful for applying pressure. You can also hold the limb against another part of your body, especially if you are able to jam the far side against a rock, tree, or the ground. so you can put your body weight against the wound.
Slowing the blood flow this way will give the blood more time to clot before you bleed to death!
Use Digital Ligation
Sometimes, direct pressure outside the wound is not enough and you need to reach into the wound with your fingers to apply pressure directly to the blood vessels.
This is called digital ligation.
It’s best done when you have multiple sets of hands as removing the fingers can cause the blood to flow again.
Block Pressure Points
If you can’t stop the blood flow directly, then look up the body.
Pressure points are areas on the body where the blood vessels are close to the surface. If you know how to take a pulse, then you know several pressure points.
Apply pressure to these places to slow down blood flow and increase clotting, IF it’s an arterial bleed.
If you’re alone, lash a stick to a pressure point.
If the wound is on part of the body supplied by several arteries then these pressure points are less helpful.
Pressure points include:
- The sides of your neck
- Above the clavicles
- Inside your upper arm
- Crook of your elbow
- Inside your knee
If your head is bleeding then don’t hold down both pressure points! You still need blood flow to your brain!
Apply a Tourniquet
Tourniquets can be a touchy subject and many people say they are harmful and will kill your limbs in hours.
You still don’t want to wear a tourniquet for more six hours, but if the choice is between exsanguination or amputation, trade your limb for your life.
Use tourniquets under two circumstances:
- When you can’t stop arterial bleeding using other methods
- If you don’t have time to stop the bleeding before you need to move, such as during combat, a flood, or another time-sensitive emergency
I’d recommend the C.A.T. Gen 7 tourniquet. It’s tested in combat and easily applied with one hand.
You can also craft your own TQ in the woods, which I’ll cover later.
To use a tourniquet, position it on the limb between the wound in your heart, close the loop so you are unable to get three fingertips underneath the tourniquet, then twist the windlass until the bleeding has stopped.
If it hurts more than the wound, congratulations! You’ve done it right.
There are two schools of thought as to where to place the tourniquet:
- Shortly above the wound
- High and tight
Let’s look at those in detail:
Above the Wound
The “civilian” position to apply the tourniquet is 2-4 inches above the wound.
You don’t need to break out the ruler to get this right. Just put the TQ three fingers above the wound.
If you’re hemorrhaging from your forearm, put the TQ above your elbow.
Never put the tourniquet on a joint and never put the tourniquet below the wound! It should always be between the wound and your heart.
High and Tight
The “military” place to apply the tourniquet is very high on the limb.
Right next to your armpit for arm wounds and right next to the groin for leg wounds.
This is because stopping the bleeding is more important than finding the proper position.
High and Tight is also good for nasty gashes with damage that’s traveled under the skin, because sometimes blood vessels are damaged several inches above the visually damaged area.
Record the Application Time
The medical professionals will need to know how long the tourniquet has been on.
So, take a sharpie, and write the application time on the victim’s face, along with a large T.
If the victim has lots of hair then write the time on the neck or anywhere else that is conspicuous.
Releasing the Tourniquet
Older wisdom held that tourniquets should be released every 15 minutes or so for one minute to keep blood flowing to the extremity, preventing cellular death.
We now know that your limb can survive without blood for up to 6 hours.
Releasing the tourniquet will cause more bleeding and can damage the TQ and make it lose efficacy.
So, if you can make it to help before six hours, it’s safer to leave the tourniquet on.
It may even be safer to leave it on for longer because, again, it’s better to lose a limb than lose your life.
Pack the Wound
If the bleeding won’t respond to direct pressure and a tourniquet can’t be used, such as a deep torso wound, pack the wound and apply a pressure dressing.
Fill the wound with sterile gauze (or an alternative, see Field Expedient Medical Supplies below) and hold it tightly in place with a bandage if possible.
Make sure that the packing material pushes up against the blood vessels!
The idea is to apply pressure (sort of like digital ligation) to slow the bleeding and hold blood against the vessels so they can more easily clot. You can’t do this if the wound is loosely packed!
If you don’t have any medical bandages then wrap and tie a strip of clothing or a bandana over the dressing.
Don’t replace bloody dressing! Apply more as it gets soaked through or you’ll interrupt the clotting process.
Now that the wound isn’t bleeding as much, it’s time to do what you can to prevent infection, prevent further damage, and even hasten the healing process.
Clean the Wound
The wild is a dirty place, filled with bacteria and other little critters that see your exposed flesh as the perfect place to live.
Infections are no joke, so if it’s possible, clean your wound.
The easiest way to do this is to flush the wound with safe water. This is called irrigation.
Pressurized sterile saline water is best, but that’s in short supply in the woods.
Boiled then cooled water can also be used. Also, filtered water.
Don’t wash a wound directly with “raw” water, even if it’s from a clear, moving river. That water will still have contaminants.
Do not use iodine or hydrogen peroxide unless absolutely necessary. They can irritate the exposed flesh and cause further damage.
Protect the Wound
Once you’ve slowed or stopped the bleeding and have cleaned the wound, if possible, it’s time to protect it from further harm.
Apply antibiotic cream, if you have any.
Then cover it with a clean bandage or sterilized cloth.
Close the Wound
If you’ve experienced a cut that didn’t tear out a chunk of your skin then you may be able to close the wound.
If you can, use medical tape to close the cut.
Use two pieces, one on either side. Grasp them both and pull them to the opposite side so they pull the cut shut.
Duct tape can also be used for this.
As a last resort, you can super glue the cut shut.
Never do this to a dirty wound because it traps bacteria inside. It also won’t work for long if your cut is over a joint or other often-flexed body part.
Watch for Shock
Finally, a large amount of blood loss can cause shock.
This is called hypovolemic shock and happens when your body loses a fifth of its blood supply.
Watch out for these symptoms:
- Cold, clammy, or pale skin
- Rapid heart rate
- Blue lips or fingernails
If you notice these symptoms, then do these three things:
- Keep the patient warm
- Raise the patient’s feet above the heart (if conscious) or turn the patient on their side (if unconscious)
- Replace fluids, if conscious
Water high in electrolytes is preferred but any potable water is better than none. Just don’t force liquid down an unconscious person’s throat!
How to Sterilize Medical Supplies in the Wild
The woods aren’t great at keeping your medical gear sterile.
So, what do you do when you need to dress your wound but don’t have another packet of sterile gauze?
You can use heat or alcohol.
Boil what you need to sterilize for several minutes to kill all the bad stuff.
If it won’t survive boiling then you can hold it close to a fire. Get it as close as possible without catching it on fire.
Failing that, immerse the object in alcohol. It needs to be at least 40% ABV, preferably higher.
Whiskey is acceptable, though something like gin or absinthe would be better because of the antiseptic herbs used as flavoring.
However, keep in mind that exsanguination kills in minutes while infections kill in days and are easily fought with antibiotics. If the choice is between using unsanitary medical supplies or saving a life, save the life!
Field Expedient Supplies
Yeah, yeah, all of this knowledge is well and good, but what if you don’t have sterile gauze or a C.A.T. tourniquet with you?
Here are some medical supplies you can craft or even find in the wild.
You can make a tourniquet yourself.
A rope is good, as is a bandana or torn piece of clothing. Tie it into a square knot!
Then, stick a branch under the expedient tourniquet.
Spin it around and it will pull the rope or cloth and tighten the tourniquet.
Once it’s tight enough, lash it to your body to hold it in place.
Sphagnum moss has been used through the ages as a safe and effective wound dressing.
It’s very absorbent, so it holds plenty of blood. More than cotton, in fact, if you start with dried moss.
Sphagnum moss also has antibacterial properties!
That’s part of why some sphagnum mosses form bogs and peat.
This moss doesn’t like to grow in nasty areas. You can harvest it, remove all debris squeeze it by hand (gently!) to dry it out somewhat, then use it to pack your wound.
If you can let it air dry completely, all the better. Then it’ll be able to absorb even more blood.
Just make sure to positively identify sphagnum moss. Not all mosses can be used as wound dressing!
Also, dried sphagnum moss can be used as tinder for firestarting.
Some herbs have properties which can help staunch a wound.
Astringent herbs, such as yarrow and witch hazel, help your body close up and stop the bleeding.
Other herbs are antibacterial or antiseptic, such as garlic, sage, wormwood, and more.
You can make an herbal poultice by making a strong “tea” using the herbs, soaking a bandage in that tea, then applying it to the wound.
Modern medications are more powerful, but Neosporin doesn’t grow wild.
Honey has also historically been used to protect and heal wounds. It’s used to this day, in fact!
Honey is antibacterial, has a pH which promotes healing, reduces swelling, and acts as a physical barrier to contaminants.
Apply honey to the dressing and then put that on the wound.
Manuka honey is best, followed by medical-grade honey.
You can smoke out a honeybee hive and take some honey for yourself if you absolutely need to, though.
If you’ve suffered a major wound in the wild, you need to do three things in this order:
- Stop the bleeding
- Dress the wound
- Protect against shock
Of these, the first step is the most important. You don’t want to exsanguinate and die.
However, don’t neglect caring for the wound and for the victim. Infection or shock can cause death even after the bleeding is under control.
However, with the knowledge you’ve gained from this article, you now know how to respond swiftly to a traumatic incident in the wild.
I’d still recommend finding a class and getting some hands-on experience. Practice applying a tourniquet to yourself with one hand, and know how to apply a wound dressing.
That way, if something unthinkable does happen, you just may save a life.
Can I apply a tourniquet over clothes?
It’s generally recommended to apply a tourniquet to bare skin for maximum efficiency.
However, if you’re using a tourniquet, chance are you’re racing against fatal blood loss. If you don’t have trauma shears to cut off the clothes then apply the TQ over clothes.
In this case, I’d go High and Tight in case the clothes are obscuring part of the wound.
What if a tourniquet doesn’t stop the bleeding?
Then use a second tourniquet! Put the second one higher than the first and make sure it’s tight enough.
Should I remove objects from a wound?
Is the object in your wound what’s caused the wound in the first place?
If so, no! Leave it there!
It’s physically blocking some blood vessels and is actually holding some bleeding in check. Pulling it out will cause more bleeding and can cause more physical damage.
However, if you’re talking about other debris that fell into the wound later, such as leaves, twigs, or insects, by all means, remove it to help prevent infection.
What’s the difference between dressing and bandages?
Most people think of Band-Aids when they think of bandages, which can cause confusion as to the difference between a dressing and a bandage.
I know I was confused when I started learning this stuff!
The dressing is the part that’s held against the wound, which protects it and absorbs blood.
The bandage goes over the dressing to hold it in place.
So, Band-Aids are an adhesive bandage with a little pad dressing in the middle.