Severe bleeding, shock, and traumatic injuries

Address life-threatening bleeding and scene hazards first, then protect the injured person while rescue is arranged.

General field reference, not medical advice. Use it to support immediate decisions, then follow 911, rescue coordinators, medical professionals, current warnings, and local agency guidance.

Act now

1. Make the scene safe and use protective gloves when available.

2. Expose the wound and apply firm, continuous direct pressure.

3. Pack a deep wound with appropriate gauze when trained and maintain pressure.

4. Apply a commercial tourniquet for life-threatening limb bleeding when direct pressure is ineffective or impractical.

5. Call 911 or activate SOS and protect the person from exposure.

Control life-threatening bleeding first

Life-threatening bleeding may be continuous or spurting, pool on the ground, soak clothing or bandages, or accompany partial or complete amputation. The person may become pale, confused, weak, thirsty, or unresponsive.

Press directly on the bleeding site with gauze or clean cloth. If material becomes soaked, add more without removing the material already helping clot formation. Maintain pressure until bleeding stops or trained rescuers take over.

For a deep wound in an area that can be packed, trained responders can fill the wound firmly with bleeding-control gauze or plain gauze, then maintain direct pressure.

Tourniquets

Use a commercial tourniquet for life-threatening bleeding from an arm or leg when indicated. Place it above the wound and not over a joint, tighten until bleeding stops, secure it, and note the time. Do not loosen or remove it in the field unless directed by qualified medical personnel.

Improvised tourniquets can fail or cause harm. Hands-on Stop the Bleed or equivalent training is strongly recommended before the trip.

Protect against shock and exposure

After bleeding control, keep the person lying in the safest comfortable position unless breathing, vomiting, terrain, or another injury requires something different. Insulate from the ground, add shelter, and monitor breathing and responsiveness.

Do not give food or drink to an unconscious, confused, vomiting, or severely injured person. Do not delay evacuation because the person temporarily looks better.

Suspected fractures, head injuries, and spinal injuries

Support an injured limb in the position found unless circulation is absent and trained guidance directs otherwise. Pad around the injury and check color, warmth, sensation, and movement beyond it before and after splinting. Do not force a deformed limb straight.

Urgent evacuation is warranted for worsening headache, repeated vomiting, seizure, unusual behavior, loss of consciousness, unequal pupils, weakness, numbness, breathing difficulty, chest or abdominal trauma, an open fracture, absent circulation, or an injury the group cannot protect.

Avoid moving a person with a possible spinal injury unless the scene is unsafe, breathing must be managed, or trained rescuers direct movement.