The Woodsman's Journal Online: December 2025

Sunday, December 14, 2025

Severe Bleeding, STOP the Bleed – Direct Pressure©

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, 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!

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 Woodsman’s Journal Online, HERE, and subscribe to BandanaMan Productions on YouTube. If you have questions, as always, feel free to leave a comment on either site. I announce new articles on Facebook at Eric Reynolds, on Instagram at bandanamanaproductions, and on VK at Eric Reynolds, so watch for me.

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

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

Sunday, December 7, 2025

Severe Bleeding and You©

Author’s note –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!

Severe bleeding either from a penetrating gunshot wound, a knife slash, an axe chop, or whatever, KILLS, and if you don’t STOP it fast, it can kill QUICKLY!

Sure, but ‘normal’ people don’t have to worry about getting shot or hurt so badly that severe, uncontrolled bleeding is a concern. Right?

Wrong! Let’s do the math, in 2017, CNN replicated an analysis by the Educational Fund to Stop Gun Violence, and found that 39,773 people died by gunshot wounds (source HERE) and since 60% of gun deaths are from suicide, that leaves 37% that are from accident or from violence, and this number includes the 1% of mass shootings (source HERE). This mean that in 2017, approximately 14,700 people died of gunshot wounds in the US. That’s about 40 people dying from bleeding or the other effects of gunshot wounds every day!

Exsanguination, bleeding out, a loss of blood greater than 40%, which for the average adult takes between three to five minutes, and is a major cause of death for penetrating trauma victims. Specific percentages vary from study to study, but some show that over 50% of penetrating injury deaths, which don’t affect the heart brain or other vital organs, are due to severe bleeding and its accompanying shock, hypothermia, and acidosis.

Many of these deaths could have been prevented if someone knew what to do to control the severe bleeding associated with wounds, in the minutes before EMS arrives. Just like we learn CPR and the Heimlich Maneuver, we need to add stopping severe bleeding to the required list of basic first aid skills that everyone needs to know.

What is Severe Bleeding

Volume or amount and the flow are two ways to tell if bleeding is severe.

Volume is the amount of blood present. Think about a soda pop-can. Bleeding may be life-threatening when the amount of blood is equal to about half of what a soda pop-can contains, 6 fluid ounces or 178 ml. In children or infants, bleeding may be severe at a much lower amount.

The size of a 6 fluid ounce puddle of blood, if the victim is bleeding on a non-porous, flat surface, like tile, linoleum, or glass, which allows the blood to spread out more thinly, covering a larger area, around 12 to 16 inches (30 to 40 cm) long or in diameter. This will make the volume seem more than it is. On porous absorbent surfaces, like carpet, fabric, or soil, the blood quickly soaks in, leading to a much smaller, more concentrated, and less spread-out appearance. This makes the volume seem less than it is.

Don’t forget to come back next week and read “Severe Bleeding and STOP the Bleed©”, where we will talk about what to do to stop severe bleeding.

That is all for now, and as always, until next time, Happy Trails!

Sources

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

About Me

I live near Buffalo, New York and have more than 25 years of experience in the outdoors. I enjoy being in the wilderness, paddling a canoe or exploring the woods, when I am not researching survival, woodcraft, camping skills or life on the Old Northwest Frontier of the late 18th and early 19th centuries. I am a published author and I have been a guide for Birchbark Expeditions and an Outdoor Skills trainer for the Boy Scouts since 2014. I am also a martial artist, having studied several different combat arts over the past 30 years. Currently, I am the author of The Woodsman’s Journal Online and BandanaMan Productions on YouTube.

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Sunday, December 14, 2025

Severe Bleeding, STOP the Bleed – Direct Pressure©

Sunday, December 7, 2025

Severe Bleeding and You©

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