Author’s note – If you do not like gore,
be warned due to the subject matter, some of the photos in this article are
graphic.
Also,
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free content, please consider showing your appreciation by leaving a donation HERE.
Thank you and Happy Trails!
Step One: Observe the Scene
First,
ALWAYS, observe the accident scene and make sure it’s safe for the
rescuer. One casualty is bad enough, two
is worse, especially when one is the rescuer.
If
the scene is safe, find the source of the bleeding. You might have to open, remove, tear, or cut away
clothing to locate the wound. Observe
the flow of blood, look to see how the blood is spilling out. Locate the specific area that is bleeding most
heavily. Blood that flows continuously,
or spurts out, is a sign of severe, life-threatening bleeding, and must be
controlled FAST!
Step Two: Apply Direct Pressure
A
typical blood pressure of 120 mm Hg signifies a forward pressure flow of blood
through your arterial system driven
by the heart's pumping action, pushing blood from high pressure in the aorta to
lower pressure areas. Putting it in more
practical terms, that forward pressure represents about 2.5 pounds per square
inch, which is a very minimal pressure. Failure
to control bleeding is rarely related to the amount of pressure required to occlude
the bleeding blood vessel but rather getting that minimal pressure to the
source of the bleeding.
To
get enough pressure to the point of bleeding often requires much larger
pressures on the outside of the body, so by the time the outside pressure
dissipates through the overlying soft tissue and muscle, there is still enough
pressure deep down to close the bleeding vessel.
Direct
pressure can be applied either with your hands or if the wound is large or deep
by packing the dressing into the wound first, before applying pressure, then
pressing down. This helps to focus the
pressure on the bleeding vessel deep inside the limb.
To
reach the necessary level of pressure, make sure the injured body part is on a hard,
flat surface, and push down hard, using your body weight if needed by kneeling
and leaning over the wound.
If
there is not a flat, hard surface to push against use the ‘clamshell direct pressure’ technique, where
your fingers are interlaced. This method
when used over the wound is very effective, quickly applied, needs little
training, and requires no additional equipment.
You can stop severe bleeding in nearly any limb, you can get your
fingers and hands wrapped around, with this method.
Whichever
method you use continue the direct pressure, DO NOT peek to check if bleeding
stopped; keep pushing down hard for at least 3-5 minutes, until bleeding stops,
a tourniquet becomes available, or help arrives and emergency responders take
over.
Also,
if possible, elevate the limb by raising the injured arm or leg above the heart
to help slow blood flow, ONLY if it doesn't cause more pain. This works well with the ‘clamshell’
technique.
Direct
pressure is the primary way to control severe bleeding of the limbs, groin and
shoulder regions, or when a tourniquet isn't needed or immediately available.
· Apply
steady, firm continuous, direct pressure directly onto the wound, with one or
both hands.
· Place
gauze dressings or any clean cloth on or in the wound. If available use a hemostatic dressing, over
the bleeding site. If no dressings are available,
use your bare hands.
· If
blood soaks through, DO NOT remove saturated
dressings, that just removes any clotting that might have started, keep adding
more layers on top and keep pressing down on the wound.
To
wrap up, if there is an accident first check to make sure the scene is
safe. Then, if there is evidence of
severe bleeding, immediately apply direct pressure to slow or stop the
bleeding, while emergency help is called and supplies are gathered or
prepared.
Don’t forget to come back next week and read “Severe
Bleeding, STOP the Bleed – Tourniquets©”, where we will talk about using a premade
or improvised tourniquet to stop severe bleeding that direct pressure cannot stop.
I hope that you enjoy
learning from this resource! To help me
to continue to provide valuable free content, please consider showing your
appreciation by leaving a donation HERE.
Thank you and Happy Trails!
I
hope that you continue to enjoy The Woodsman’s Journal Online and look for me
on YouTube at BandanaMan Productions for other related videos, HERE. Don’t forget to follow me on both The
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and subscribe to BandanaMan Productions on YouTube. If you have questions, as always, feel free
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That
is all for now, and as always, until next time, Happy Trails!
Disclaimer:
All content and media on The Woodsman’s Journal Online is created and published
for informational purposes only. It is
not intended to be a substitute for professional medical advice and should not
be relied on as health or personal advice. Use of the information on this site is AT YOUR
OWN RISK, intended solely for self-help, in times of emergency, when medical
help is not available, and does not create a doctor-patient relationship. Always get professional help if available.
Sources
American
Red Cross; “Bleeding, Life-Threating External”, © [2025 The American Red Cross],
https://www.redcross.org/take-a-class/resources/learn-first-aid/bleeding-life-threatening-external?srsltid=AfmBOoruukIMCkbnGCNWGd3QY5C2xHdip6lYe1NlsTuzRMF7j7trgnYI,
accessed December 6, 2025
DHA,
“Deployed Medicine”, January 2024, [© 2024 Primal Survivor™], https://books.allogy.com/web/tenant/8/books/a30c619d-7270-4bfe-be4f-eb4d27adc783/,
accessed December 6, 2025
Shertz, Mike, MD; “Clamshell
Direct Pressure: A Simple, Hands-On Hemorrhage Control Technique When
Tourniquets Aren’t Available”, [©2025 Crisis Medicine], https://www.crisis-medicine.com/clamshell-direct-pressure/?srsltid=AfmBOopsv8B-c8iZd8We8JIfkUlBULjWi5-BfPjislJqLFPq5I-rUtHC,
accessed December 13, 2025
Vuković,
Diane; “How to Treat and Pack a Bullet Wound in the Wilderness”, September 11,
2023, https://www.primalsurvivor.net/treat-gunshot-wound/,
accessed December 6, 2025
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