Looking at blood can often lead to squeamishness and nausea in most people who are not used to seeing blood but bleeding is one of the commonest medical emergencies. It is most frequent among children below 15 years and reduces thereafter. Almost 37.9 million visits to the emergency department are for injuries.           

Bleeding or haemorrhage is oozing of blood from any body part. An injury to the skin, like a cut, wound or blunt trauma like being hit by a ball can lead to bleeding. In the case of a cut, the bleeding is visible externally as oozing and is termed as external bleeding. In cases of blunt trauma, there might be an injury to deeper tissues and organs leading to internal bleeding. This might be appreciable as a bluish black swelling at the site of injury and is called as a haematoma.  

Humans have been blessed by a chemical mechanism wherein once there is an injury the enzymes automatically start making the blood thicker to stop bleeding. This is called as clotting. The thickened blood (clot) seals off the wound and prevents further blood loss. But this mechanism gets affected by various factors including the weather and thus is not completely reliable. Since too much blood loss can lead to shock and fainting, it is necessary that bleeding be stopped at the earliest by all possible measures. Thus, immediate action is a must; a wait and watch policy must not be adopted under any circumstance. Knowing the reasons behind the actions helps understand why it is being performed and helps in customisation in an emergency. 

Causes of bleeding:

•Cuts with sharp or pointed instruments like knives, razors, sharp metal edges, nails, animal bites etc. •Bruises with blunt instruments like heavy objects, hitting a wall/vehicle, falls, etc. 

•Internal bleeding due to blunt blow causing the haematoma.

 How to arrest bleeding

1. Clean

Wash your hands before handling the wound, as far as possible. If the wound looks dirty, wash it a little under cold, running water with soap and mild rubbing.

2. Pressure

Press down a clean towel or any cloth directly on the oozing wound and apply firm pressure for 20 minutes to stop the bleed. If no cloth is available, then press the site of bleeding with the palm. Press till bleeding stops. Do not remove the cloth even if it gets soaked and blood oozes through. Add another cloth on top and continue applying pressure.   

3. Avoid movement

Hold the limb/part still to reduce bleeding. Make the person lie down on flat ground. 

4. Elevation

Raise the injured limb/ part whenever possible. Elevate the lower half of the body slightly above the head to prevent fainting.

5. Tourniquet

In the case of an injured limb, tie tightly a cloth/wire/tube etc 2-3 inches above the wound, around the limb. This will act as a tourniquet and stop blood flow to the wound. Make sure you untie it within 30 minutes. If bleeding has stopped, remove it. Repeat this after a 5-minute interval if the wound continues to bleeds. Keeping the tourniquet on for too long will cause the limb to start swelling; thus, untying every few minutes is a must.  

6. Ice pack

Apply ice on the wound on and off throughout the next 24 to 48 hours. This will reduce the blood flow to the site of injury and slow down the bleed. It will reduce the swelling that forms later.  

7. Pain medication

Take a painkiller like paracetamol (acetaminophen) if there is a pain. Do not take aspirin or ibuprofen. They will increase the bleeding.   

8. Calling help

Call for help or rush to the nearest doctor or hospital if the bleeding is severe or accompanied by intense pain/swelling. If the victim takes blood-thinning medications, then see a doctor immediately. If the bleeding was due to an animal/human bite or from junked instrument, you might need to get a tetanus shot too.  

9. Post-bleeding care

Once the bleeding stops and is followed by a haematoma or bruise the next day, apply hot water packs daily to promote wound healing. If there is a scab, apply the antibiotic treatment and fresh gauze dressing each day.  Recovery Pain, tenderness subsides in 2-3 days while the bruise will take about 2 weeks to clear out.