Bleeding That Won't Stop: What to Do Right Now

When should I call 911 for a bleeding wound?

Call 911 immediately if any of these apply 1Ref 1Hewett Brumberg EK, Douma MJ, Alibertis K, Charlton NP, Goldman MP, Harper-Kirksey K, Hawkins SC, Hoover A, Leichtle S, Kule A, McClure SF, Wang GS, Whelchel M, White L, Lavonas EJ; American Heart Association and American Red Cross (2024).2024 American Heart Association and American Red Cross Guidelines for First Aid.Direct pressure as first step for life-threatening bleeding; tourniquet or wound packing when direct pressure alone is insufficient for limb wounds; do not remove embedded objects; considerations for blood-thinner users and wound location risk:

• Blood is spurting or pulsing — this suggests arterial bleeding
• Bleeding has not slowed after 10 minutes of continuous, firm direct pressure
• The wound is very deep, wide, or gaping with visible tissue
• The wound is to the neck, chest, abdomen, or groin
• The person is pale, confused, lightheaded, or loses consciousness
• The person takes blood thinners (warfarin, apixaban, rivaroxaban, clopidogrel) or has a clotting disorder
• A large body area is involved, or you cannot see the full extent of the wound
• The wound involves an animal or human bite

What do I do while waiting for help?

1. Apply firm, continuous direct pressure. Use the cleanest cloth available — a shirt, towel, or bandage. Press hard. Do not lift to check every few minutes — this disturbs clot formation. Hold pressure steadily 1Ref 1Hewett Brumberg EK, Douma MJ, Alibertis K, Charlton NP, Goldman MP, Harper-Kirksey K, Hawkins SC, Hoover A, Leichtle S, Kule A, McClure SF, Wang GS, Whelchel M, White L, Lavonas EJ; American Heart Association and American Red Cross (2024).2024 American Heart Association and American Red Cross Guidelines for First Aid.Direct pressure as first step for life-threatening bleeding; tourniquet or wound packing when direct pressure alone is insufficient for limb wounds; do not remove embedded objects; considerations for blood-thinner users and wound location risk.

2. Do not remove an embedded object. If something is stuck in the wound, press firmly around it — not on it — and leave it in place for emergency providers 1Ref 1Hewett Brumberg EK, Douma MJ, Alibertis K, Charlton NP, Goldman MP, Harper-Kirksey K, Hawkins SC, Hoover A, Leichtle S, Kule A, McClure SF, Wang GS, Whelchel M, White L, Lavonas EJ; American Heart Association and American Red Cross (2024).2024 American Heart Association and American Red Cross Guidelines for First Aid.Direct pressure as first step for life-threatening bleeding; tourniquet or wound packing when direct pressure alone is insufficient for limb wounds; do not remove embedded objects; considerations for blood-thinner users and wound location risk.

3. Elevate the injured area above the level of the heart if possible, to slow blood flow.

4. If a tourniquet is available and bleeding from an arm or leg is life-threatening: apply it 2–3 inches above the wound, tighten until bleeding stops, and note the exact time of application. The 2024 AHA/Red Cross guidelines recommend applying a tourniquet or wound packing when direct pressure alone does not control life-threatening limb bleeding 1Ref 1Hewett Brumberg EK, Douma MJ, Alibertis K, Charlton NP, Goldman MP, Harper-Kirksey K, Hawkins SC, Hoover A, Leichtle S, Kule A, McClure SF, Wang GS, Whelchel M, White L, Lavonas EJ; American Heart Association and American Red Cross (2024).2024 American Heart Association and American Red Cross Guidelines for First Aid.Direct pressure as first step for life-threatening bleeding; tourniquet or wound packing when direct pressure alone is insufficient for limb wounds; do not remove embedded objects; considerations for blood-thinner users and wound location risk. Tell the paramedics the exact time the tourniquet was applied.

5. Keep the person still, warm, and calm. Lay them down if they feel faint.

6. Stay on the phone with 911. The dispatcher will guide you step by step.

Does every cut need emergency care?

Even when bleeding slows or stops, a deep wound may still need professional evaluation. Consider urgent care or the emergency department if:

• The wound gapes or edges do not come together on their own
• The wound is longer than about half an inch
• You can see fat, tissue, or deeper structures
• The wound is from a puncture, bite, or dirty object — tetanus and infection risk are higher 2Ref 2Centers for Disease Control and Prevention (2024).Tetanus: For Clinicians.Puncture wounds, bite wounds, and wounds contaminated with soil or organic material carry elevated tetanus risk and require evaluation for tetanus prophylaxis regardless of wound size
• The wound is near a joint, the hand, or the foot — tendon or nerve involvement is possible

Wounds that appear minor can hide deeper injury. When in doubt, have it evaluated.

What will a clinician check for?

When you reach care, the clinician will typically:

• Explore and irrigate the wound to assess depth, look for embedded material, and clean it before closure
• Order a complete blood count (CBC) if blood loss was significant
• Check coagulation studies (PT/INR, PTT) if a clotting disorder or anticoagulant use is suspected
• Take an X-ray if glass, metal, or another foreign body may be present

Bring the medication list and know your tetanus vaccination date if possible — these directly affect wound management 2Ref 2Centers for Disease Control and Prevention (2024).Tetanus: For Clinicians.Puncture wounds, bite wounds, and wounds contaminated with soil or organic material carry elevated tetanus risk and require evaluation for tetanus prophylaxis regardless of wound size.

How do blood thinners and other factors affect bleeding?

Blood thinners and antiplatelet medications — Warfarin, rivaroxaban, apixaban, clopidogrel, and high-dose aspirin can all significantly prolong bleeding from any wound, even a minor one. Tell 911 dispatchers and emergency providers immediately 1Ref 1Hewett Brumberg EK, Douma MJ, Alibertis K, Charlton NP, Goldman MP, Harper-Kirksey K, Hawkins SC, Hoover A, Leichtle S, Kule A, McClure SF, Wang GS, Whelchel M, White L, Lavonas EJ; American Heart Association and American Red Cross (2024).2024 American Heart Association and American Red Cross Guidelines for First Aid.Direct pressure as first step for life-threatening bleeding; tourniquet or wound packing when direct pressure alone is insufficient for limb wounds; do not remove embedded objects; considerations for blood-thinner users and wound location risk.

Age — Older adults on anticoagulants for atrial fibrillation or clots have a higher bleeding risk. In children, a smaller blood volume means that even moderate blood loss can be proportionally more significant.

Liver disease — The liver produces clotting factors; liver disease impairs this process and can prolong bleeding from any wound.

Wound location — Scalp and face wounds bleed heavily due to rich blood supply but often heal well. Wounds near the inner wrist, inner arm, inner thigh, neck, or groin are at higher risk for major vessel involvement 1Ref 1Hewett Brumberg EK, Douma MJ, Alibertis K, Charlton NP, Goldman MP, Harper-Kirksey K, Hawkins SC, Hoover A, Leichtle S, Kule A, McClure SF, Wang GS, Whelchel M, White L, Lavonas EJ; American Heart Association and American Red Cross (2024).2024 American Heart Association and American Red Cross Guidelines for First Aid.Direct pressure as first step for life-threatening bleeding; tourniquet or wound packing when direct pressure alone is insufficient for limb wounds; do not remove embedded objects; considerations for blood-thinner users and wound location risk.