Bleeding

Bleeding from a wound usually stops with simple first aid. Bleeding from elsewhere — inside the body, or from the gut, urinary tract, airway, or a bleeding disorder — needs medical attention. Knowing basic bleeding control can save a life while waiting for help.

First aid for a bleeding wound

• Apply firm, steady pressure directly on the wound with a clean cloth or gauze
• Keep pressing — don't keep peeking. If blood soaks through, add more layers on top; don't remove the first layer
• Elevate the injured part above heart level, if possible
• Once bleeding stops, clean around the wound gently with water (don't scrub into the wound)
• Cover with a clean dressing
• For large, deep, or heavily-bleeding wounds — go to hospital urgently. Dial 112 if severe.
• Do NOT use a tourniquet unless bleeding is catastrophic and pressure isn't enough (limb about to be lost) — tourniquets are last-resort tools
• Get a tetanus booster if not up to date, especially for contaminated wounds

When bleeding is an emergency

• Bleeding that doesn't stop after 15-20 minutes of firm pressure
• Spurting (arterial) bleeding
• Large pool of blood loss
• Bleeding with weakness, dizziness, fainting, confusion, cold clammy skin, fast pulse — signs of shock
• Severe vomiting blood, or passing black tarry or bright red blood in stools
• Coughing up significant blood
• Heavy menstrual bleeding that soaks through pads very quickly or causes faintness
• Bleeding in pregnancy
• Bleeding after surgery or from a fistula site
• Head injury with bleeding from nose, ears, or confusion
• Any bleeding in a person on blood thinners or with a bleeding disorder

Unusual bleeding — causes to check

Bleeding that happens spontaneously, repeatedly, or out of proportion to injury needs investigation:

• Bleeding disorders — haemophilia, von Willebrand disease, low platelets
• Medicines — blood thinners, antiplatelets, some pain/inflammation drugs (NSAIDs)
• Liver disease
• Vitamin K deficiency
• Leukaemia or other cancers
• Infections — severe dengue can cause bleeding
• Gum bleeding — often from dental plaque, but sometimes a sign of a bleeding disorder

See a doctor for easy bruising, frequent nosebleeds, heavy periods, blood in urine or stool, or prolonged bleeding from minor cuts. A simple blood test can identify most causes.