Bleeding Control: Direct Pressure, Wound Packing, and Tourniquets
Severe bleeding is a life-threatening emergency that requires immediate action. The Stop the Bleed campaign, launched after the 2012 Sandy Hook shooting, trained millions of Americans in three core skills. Step 1: Apply direct pressure. Use a clean cloth, gauze pad, or your gloved hands to apply firm, continuous pressure directly to the wound. Do not lift the cloth to check — this disrupts clot formation. If blood soaks through, add more material on top and press harder. Press for at least 10 minutes continuously for most wounds. Step 2: Pack deep wounds. For wounds too deep for surface pressure (junctional wounds to groin, armpit, or neck where a tourniquet cannot be applied), pack the wound cavity tightly with gauze, then apply firm pressure on top. Step 3: Apply a tourniquet for uncontrolled limb bleeding. A commercial tourniquet (CAT — Combat Application Tourniquet, or SOFT-T Wide) placed 2–3 inches above the wound and tightened until bleeding stops, then twisted and locked, can stop fatal limb bleeding in seconds. Note the time of application. Despite historical concerns, tourniquets are safe for up to 2 hours and are now recommended by the American College of Surgeons as first-line treatment for severe limb bleeding. The Hartford Consensus (TECC protocol) recommends every public space stock a bleeding control kit.