When the Red Stuff Won't Stop: Controlling Severe Bleeding

A 3-minute read on the life-saving skill everyone should know.

The workshop accident happened in seconds. A piece of machinery malfunctioned, and suddenly there was blood everywhere. The injured worker was conscious but pale, and the bleeding wasn't stopping. In situations like this, what you do in the first few minutes can literally be the difference between life and death.

This scene immediately reminded me of a training exercise during my 22 years in the Army when a piece of equipment malfunctioned and caused a serious laceration to one of my soldiers. We were miles from the nearest medical facility, and I had to rely on the pressure point techniques and improvised tourniquets we'd drilled countless times.

That military experience, combined with numerous road traffic accidents during my 14 years in the police, taught me that severe bleeding control is one of the most critical skills you can possess. Now, as founder of Typhon Training Solutions, I make sure every student understands that when someone is bleeding severely, your immediate actions can literally save their life.

The Body's Amazing but Limited Response

Here's something that fascinates me after all these years teaching first aid with Typhon Training Solutions: the human body can lose up to 15% of its blood volume and still function normally. But beyond that, things get serious very quickly. Lose 30-40% of your blood, and you're looking at life-threatening shock.

The body tries to help itself by constricting blood vessels and increasing heart rate, but sometimes it needs a hand. That's where proper bleeding control comes in.

Pressure, Pressure, Pressure

In our HSE-approved First Aid at Work courses, I hammer home one simple principle: direct pressure stops bleeding. It sounds obvious, but you'd be amazed how many people panic and forget this basic rule.

Find the source of bleeding and apply firm, direct pressure with whatever clean material you have available. A clean cloth is ideal, but in an emergency, use whatever's to hand – even your bare hands if necessary. Don't worry about infection at this stage; stopping the bleeding is the priority.

Keep the pressure constant and firm. I know it's hard when someone's in pain, but gentle pressure won't work on severe bleeding. You need to compress the blood vessels enough to allow clotting to begin.

The Elevation Myth

Here's where I have to correct some outdated advice. For years, people were taught to elevate bleeding limbs above the heart. We now know this doesn't help much and can actually make things worse if there are fractures involved. Focus on direct pressure instead.

The only time elevation really helps is with minor bleeding from cuts and scrapes. For severe bleeding, pressure is what counts.

When Direct Pressure Isn't Enough

Sometimes, despite your best efforts, bleeding continues. This is when you need to think about pressure points – places where you can compress arteries against bone to reduce blood flow to the area.

The most useful pressure point for arm injuries is the brachial artery, about halfway down the upper arm on the inside. For leg injuries, it's the femoral artery in the groin. But honestly, these techniques require proper training to be effective. Don't rely on half-remembered descriptions from the internet.

The Tourniquet Question

Tourniquets have made a comeback in recent years, particularly after lessons learned from military medicine. They can be life-saving for severe limb bleeding that won't respond to direct pressure. But they're not something to improvise with belts or rope – you need proper equipment and training.

I've started including tourniquet training in some of our advanced courses, particularly for high-risk industries. But for most workplace situations, direct pressure and calling 999 will be your best approach.

Recognising Shock

Severe bleeding often leads to shock, and recognising the signs is crucial. The person might become pale, cold, and clammy. Their pulse becomes rapid and weak. They might feel dizzy, nauseous, or anxious. In severe cases, they can become confused or lose consciousness.

Keep them lying down if possible, with their legs slightly raised (unless you suspect spinal injuries). Keep them warm with blankets or coats, but don't apply direct heat. Most importantly, keep talking to them and monitor their condition constantly.

The Psychological Challenge

Here's something they don't prepare you for in basic training: severe bleeding is psychologically challenging for everyone involved. The casualty might panic, and so might you. Blood looks dramatic, and there always seems to be more of it than you expect.

I remember training a office manager who later had to deal with a colleague who'd put their hand through a glass door. She told me the hardest part wasn't the technical aspects – it was staying calm when everything looked so serious. That's why we practice these scenarios repeatedly in training.

Internal Bleeding: The Hidden Danger

Not all severe bleeding is visible. Internal bleeding from trauma can be just as dangerous but much harder to recognise. Look for signs like abdominal pain and rigidity, bruising around the navel or flanks, or the casualty coughing up or vomiting blood.

You can't treat internal bleeding with first aid – these casualties need immediate hospital care. Your job is to recognise the signs, call 999, and monitor their condition while waiting for help.

Documentation Matters

In workplace incidents involving severe bleeding, proper documentation is crucial. Note the time of injury, what happened, how much blood was lost (estimate), and what treatment was given. This information helps medical professionals and is important for accident reporting.

Your Responsibility

Severe bleeding emergencies don't wait for convenient moments. They happen during busy periods, when you're short-staffed, or when the trained first aider is off sick. That's why I believe everyone should know the basics of bleeding control.

If you want to ensure your team can respond effectively to bleeding emergencies, get in touch with Typhon Training Solutions. Call me on 07939557029 or email mark.phillips@typhontrainingsolutions.co.uk to discuss practical training that builds real Skills, Knowledge and Confidence.

Because when someone's bleeding severely, hesitation isn't an option.

Mark Phillips provides hands-on first aid training through Typhon Training Solutions, preparing workplaces across the UK for real emergency situations.