Controlling Bleeding in the Wilderness: Expert Tips for Emergencies

Controlling bleeding in a wilderness setting is an essential skill for anyone venturing into the great outdoors. Accidents can happen, and knowing how to manage severe bleeding during a hike, camping trip, or any outdoor adventure is crucial in preventing severe consequences. In this article, we’ll discuss the principles of first aid for bleeding injuries in the wilderness, focusing on key techniques and approaches to stopping blood loss and promoting wound healing.

When faced with a bleeding injury in the wilderness, the priority is to assess the situation and differentiate between minor and life-threatening blood loss. Understanding the type of injury, such as a small scrape or a more severe deep wound, will determine the appropriate first aid measures to take. Quick and decisive action can prevent potentially dangerous complications, such as shock or infection.

Key Takeaways

• Assessing the bleeding scenario in the wilderness is crucial in determining the appropriate first aid response
• Direct pressure, elevation, and the use of tourniquets are essential methods to control blood loss
• Prompt wound cleaning, dressing, and effective infection prevention measures contribute to a speedy recovery

Recognizing Types of Bleeding

Bleeding can occur in different forms and severities, which requires different approaches for treatment in a wilderness setting. Understanding the different types of bleeding can help you properly address the situation and prevent life-threatening complications. This section will cover capillary, venous, and arterial bleeding.

Capillary Bleeding

Capillary bleeding is the most common and least severe type of bleeding. It occurs when the smallest blood vessels, known as capillaries, are damaged. Capillary bleeding typically appears as oozing or slow seepage of blood from superficial wounds, such as scratches, abrasions, or minor cuts.

To manage capillary bleeding, apply direct pressure to the wound with a sterile dressing or a clean cloth. Elevate the affected area if possible. It usually stops on its own within a few minutes as blood begins to clot, forming a scab.

Venous Bleeding

Venous bleeding is caused by damage to veins, which are larger blood vessels that carry blood back to the heart. This type of bleeding is characterized by a steady flow of dark red or maroon-colored blood, and it requires a little more intervention since it can lead to a more significant blood loss.

To control venous bleeding, apply direct pressure to the wound and elevate the affected area above the heart level. This helps reduce blood flow and encourages clotting. Maintain the pressure until the bleeding stops, which may take longer than with capillary bleeding. If the blood soaks through the dressing, do not remove it. Instead, apply more dressings and continue applying pressure.

Arterial Bleeding

Arterial bleeding is the most severe and life-threatening type of bleeding. It occurs when an artery is damaged. Arteries are responsible for transporting oxygen-rich blood under high pressure from the heart to the rest of the body. Arterial bleeding presents as bright red blood spurting or pulsating from the wound, and it can lead to rapid blood loss and hemorrhage.

To control arterial bleeding, immediate and sustained direct pressure should be applied to the wound with a sterile dressing or clean cloth. If possible, elevate the affected area above the heart level. You may also need to apply a tourniquet to the limb, above the wound, to prevent further blood loss. It’s crucial to seek medical help as quickly as possible, as arterial bleeding can quickly become life-threatening if not controlled.

By recognizing the types of bleeding and understanding how to manage them in a wilderness setting, you can efficiently address bleeding injuries while reducing the risk of life-threatening complications.

Initial Response to Bleeding

Ensuring Scene Safety

Before approaching a person who is bleeding, it is important to ensure the scene is safe. This may involve assessing the surrounding area for potential hazards, such as traffic, unstable terrain, or wildlife. If the scene is unsafe, wait for professional help like EMS to arrive, as your safety must take priority.

Assessing the Wound

Once you have determined that the scene is safe, it is time to assess the wound. First, put on protective gloves if available to reduce the risk of infection. Check for any foreign objects in the wound, such as splinters or pieces of glass, and do not attempt to remove them as this may worsen the injury. Depending on the severity and location of the bleeding, different methods of control may be required.

1. Direct Pressure: For most wounds, applying direct pressure with a clean cloth, gauze, or even your hand should be the first step in controlling bleeding. The pressure helps to slow down the blood flow, allowing natural clotting to occur.
2. Tourniquets: In cases of severe bleeding, especially on limbs where direct pressure is not sufficient to control the blood loss, a tourniquet may be necessary. Only use a tourniquet as a last resort when other methods are not effective, as it can cause serious complications if applied incorrectly or left on for too long.
3. Elevation: When possible, elevate the injured area above the heart level, which can help to reduce blood flow to the wound and improve the effectiveness of direct pressure.

Once you have managed to control the bleeding, clean the wound with clean water or a mild antiseptic solution if available, and cover it with a sterile dressing. It is essential to keep an eye on the injured person for signs of shock or other complications, as well as seek professional medical help as soon as possible to ensure proper treatment and care.

Direct Pressure and Elevation

Controlling bleeding in a wilderness setting is crucial in managing wounds and preventing further complications. Two essential techniques for controlling bleeding are the application of direct pressure and elevation of the wound.

Applying Direct Pressure

Direct pressure is the first and most important step in controlling bleeding from a wound. Using clean and absorbent materials such as gauze, cravats, or rags, firmly press down on the wounded area (source). Although it is not necessary for the materials to be sterile, using the cleanest option available is vital to minimize the risk of infection. The pressure should be applied continuously and firmly enough to slow down the blood flow. Direct pressure not only controls the blood loss but also helps in clot formation, promoting the natural healing process.

Elevating the Wound

In addition to applying direct pressure, elevating the wound above the level of the heart can further assist in controlling bleeding, as it uses gravity to your advantage (source). When elevating the wound, it is crucial to maintain direct pressure, not disrupting any clots that might be forming. Elevated positioning must be adjusted according to the type and location of the wound to ensure the most effective outcome.

Combining direct pressure and elevation in managing bleeding wounds in the wilderness can make a significant difference in reducing blood loss and preventing further complications. As every situation is unique, it is essential to adapt these techniques to the specific circumstances and the severity of the wound to ensure the most effective and safe wound management.

Using Tourniquets

Tourniquets are essential tools for controlling extremity bleeding, especially in wilderness settings where proper medical care may be difficult to access. This section will discuss the use of commercial tourniquets and improvised tourniquets for managing life-threatening bleeding injuries in the wilderness.

Commercial Tourniquets

Commercial tourniquets have been widely used in military settings and have since transitioned into civilian use due to their proven effectiveness in controlling extremity bleeding. One of the most commonly used models is the Combat Application Tourniquet (C-A-T), which is pre-made, easy to apply, and provides uniform pressure distribution.

While using a commercial tourniquet, the following steps should be taken:

1. Position the tourniquet two to three inches above the injury site.
2. Ensure that the tourniquet is tight enough to occlude blood flow.
3. Secure the tourniquet in place and monitor the injured individual for changes in their condition.

In some situations, a hemostatic agent may also be used in conjunction with a commercial tourniquet to enhance clotting and further control blood loss.

Improvised Tourniquets

When commercial tourniquets are not available, an improvised tourniquet can be used to control extremity bleeding. However, improvised tourniquets are generally less effective than commercial ones and should only be used as a last resort. It is crucial to remember that improper use of an improvised tourniquet can cause more harm than good.

To create an improvised tourniquet, the user can follow these steps:

1. Identify a strong, flexible material such as cloth, a belt, or a bandana.
2. Fold or twist the material to create a strip that is approximately 1 to 2 inches wide.
3. Position the improvised tourniquet above the injury site like a commercial one.
4. Tighten the tourniquet using a winding object such as a stick or pen until blood flow is controlled.
5. Secure the winding object in place to maintain consistent pressure on the injured limb.

Both commercial and improvised tourniquets can be effective in controlling life-threatening extremity bleeding in the wilderness. However, it is essential to remain cautious, stay informed, and employ proper techniques to ensure the best possible outcome in these challenging situations.

Hemostatic Dressings and Agents

Hemostatic dressings and agents are essential tools for controlling bleeding in the wilderness. These products help to quickly stop bleeding by promoting the formation of clots, which are crucial for preventing further blood loss and avoiding complications.

Applying Hemostatic Agents

Hemostatic agents come in various forms like granules or powders such as QuikClot. To apply them effectively, follow these steps:

1. Expose the wound: Visually locate the source of bleeding and remove any debris or clothing covering the wound.
2. Apply the hemostatic agent: Pour the granules or powder directly onto the wound, making sure to cover the entire bleeding area.
3. Apply pressure: Firmly press a clean dressing or cloth over the wound and the applied agent for at least 3-5 minutes.
4. Secure the dressing: Once the bleeding has stopped or significantly slowed down, wrap a bandage around the wound to hold the dressing in place.

Using Hemostatic Dressings

Hemostatic dressings are impregnated with substances that promote clotting, such as kaolin or chitosan. Examples of these dressings include ChitoGauze and QuikClot Combat Gauze. To use hemostatic dressings, follow these steps:

1. Expose the wound: Locate the bleeding source and remove any debris or clothing covering the wound.
2. Pack the wound: If the wound is deep, gently but firmly pack the hemostatic dressing inside the wound cavity using your fingers. For superficial wounds, simply press the dressing against the bleeding area.
3. Apply pressure: Hold the dressing firmly in place for at least 3-5 minutes, ensuring direct contact between the dressing and the wound to promote clotting.
4. Secure the dressing: Once the bleeding has stopped or significantly slowed down, wrap a bandage or elastic wrap around the wound to hold the dressing securely in place.

Both hemostatic dressings and agents are invaluable tools for controlling bleeding in the wilderness when traditional methods such as applying direct pressure alone may not be sufficient. Their proper use can be the difference between life and death in emergency situations. By understanding the correct application techniques and having the right products on hand, one can effectively manage bleeding in the backcountry.

Wound Cleaning and Dressing

Cleaning and dressing a wound in the wilderness is an essential skill to prevent infections and promote healing. It involves a series of steps that include debris removal, irrigation techniques, and bandaging techniques to ensure an effective treatment process.

Debris Removal

The first step in wound cleaning is removing any visible debris such as dirt, rocks, or splinters from the wound. You can use sterile tweezers or your fingers (with clean gloves) to gently remove larger particles. For smaller, more embedded particles, you can use the irrigation technique. Always ensure your hands and any tools used are clean and sanitized.

Irrigation Techniques

Irrigation is a crucial aspect of wound cleaning. Rinsing the wound with clean water or a saline solution can help remove remaining debris that may not be visible to the naked eye. You can use a syringe to apply pressure when irrigating the wound, which effectively removes particles and reduces the risk of infection. It is advised to avoid using soap directly on the wound, as it can cause irritation.

When clean water is not available, you can use a water purification method such as boiling, filtering, or using chemical treatments. However, never use untreated water from lakes or rivers to irrigate a wound, as it may introduce harmful bacteria.

Bandaging Techniques

After the wound is properly cleaned, it’s time to apply a suitable dressing. Dressings play a critical role in protecting the wound from contamination, absorbing fluids, and preventing bacterial infections. Choose a dressing that is appropriate for the type and size of the wound, such as gauze, adhesive bandages, or non-stick pads. Sterile materials should always be a priority.

Start by applying an antibiotic ointment or wound care cream on the wound, ensuring it is spread evenly. Then, gently cover the wound with the selected dressing. Wrap a bandage around the dressing to secure it in place and provide support. In some cases, you may need to use additional medical tape to further hold the dressing in place.

Finally, continuously monitor the wound for signs of infection, such as swelling, increased pain, or a foul smell. If you notice any of these indicators, you should clean the wound again following the aforementioned steps and consider seeking professional medical help.

Addressing Specific Wound Types

Abrasion Wound Care

Abrasion wounds are common in the wilderness and are typically caused by friction against rough surfaces. They can be painful and may get infected if not properly treated. To care for an abrasion wound, follow these steps:

1. Clean the wound with a copious amount of water to remove any foreign material like dirt, clothing, or gravel.
2. Apply an antiseptic solution to prevent infection. Use a 1% povidone iodine solution if available.
3. Cover the wound with a sterile dressing or bandage to protect it from further injury and contamination.

Puncture Wound Treatment

Puncture wounds occur when an object penetrates the skin and may introduce bacteria deep into tissues. Proper treatment of puncture wounds is crucial to minimize the risk of infection. Follow these guidelines for puncture wound care:

1. Control bleeding by applying direct pressure on the wound. If the bleeding is severe, controlling the bleeding is a higher priority than cleaning the wound.
2. Clean the wound thoroughly with water to remove foreign material such as dirt, splinters, or insects. You may use a syringe to flush the wound if necessary.
3. Apply an antibiotic ointment to the wound and cover with a sterile dressing. Avoid closing the wound with sutures or adhesive strips, as this may increase the risk of infection in a puncture wound.

Open Fracture Management

Open fractures occur when a bone pierces the skin, often resulting in severe bleeding and a high risk of infection. To manage an open fracture in the wilderness, adhere to the following precautions:

1. Immobilize the fracture: Use a splint or makeshift immobilization device to stabilize the fracture and prevent further injury.
2. Control bleeding: Apply direct pressure to the wound and elevate the injured limb, if possible. Severe bleeding should be controlled before moving on to wound cleaning.
3. Clean the wound: Remove any visible foreign material and irrigate the wound with a copious amount of clean water. Use a 1% povidone iodine solution if available.
4. Dress the wound: Apply a sterile dressing and bandage to the wound. Refrain from using adhesive dressings or wound closure techniques that could trap bacteria in the wound, increasing the risk of infection.

While following these guidelines can help manage specific wound types in the wilderness, it is important to seek professional medical treatment as soon as possible to ensure optimal healing and prevent complications.

Complications and Infection Prevention

Controlling bleeding in the wilderness is essential for survival. Aside from immediate complications such as excessive blood loss, infections pose a risk to the long-term safety and well-being of the individual. In this section, we will discuss Recognizing Signs of Infection and Preventing Wound Infection.

Recognizing Signs of Infection

Infections can occur in any type of wound, but they are particularly worrisome in the wilderness where managing wounds may be more challenging. The following are some signs that a wound might be developing an infection:

• Increased pain
• Redness and swelling around the wound
• Warmth in the area surrounding the wound
• Pus or discharge from the wound
• Fever, chills, or malaise

It is important to recognize these signs early and take appropriate action to prevent the infection from worsening.

Preventing Wound Infection

There are several steps to take to prevent infections in wilderness wounds. They include:

1. Cleaning the wound: Thoroughly clean the wound with clean water and/or povidone-iodine if available. Avoid using alcohol or hydrogen peroxide as they may damage healthy tissue.
2. Antibacterial treatment: Apply an antibacterial ointment or cream to the wound. Topical treatments like Neosporin can provide a barrier against bacteria and promote healing.
3. Dressing the wound: Cover the wound with a sterile dressing, such as gauze or a bandage. Secure the dressing in place with medical tape to ensure it stays in place and provides adequate protection.
4. Keeping the wound dry: Moist environments can promote bacterial growth, so it’s essential to keep the dressing dry. Change the dressing if it becomes wet or dirty.
5. Protecting the surrounding skin: Keep the skin around the wound clean and dry. Apply a barrier cream to the surrounding skin to minimize irritation and reduce the risk of infection spreading.
6. Maintaining overall health: Adequate hydration, nutrition, and rest can support the immune system, allowing the body to heal and fight off potential infections.

By following these steps, individuals in a wilderness setting can minimize the risk of infection and improve the chances of recovering from injuries while avoiding complications related to infection.

Evacuation and Seeking Definitive Care

When to Evacuate

In wilderness situations, it is crucial to recognize when an injured individual needs to be evacuated for definitive medical care. Factors to consider include the severity of the bleeding, the location of the injury, and the potential for complications. Generally, evacuations should be initiated in the following circumstances:

• Uncontrolled or life-threatening bleeding
• Bleeding that does not improve with basic wound care and pressure
• Inability to clean and close the wound appropriately
• Signs of infection or worsening complications

It is always better to err on the side of caution when deciding whether to evacuate. Transporting someone to a hospital or clinic can provide them with more comprehensive care, such as access to an EMT or advanced medical procedures.

Accessing Medical Care

Once the decision to evacuate has been made, it is important to establish a plan for accessing medical care. In wilderness settings, this may involve several steps:

1. Communicate: Use whatever communication tools are available (cell phone, satellite phone, radio, etc.) to notify emergency services and give them your location and the nature of the injury. This will help them to prepare for your arrival and provide information on the appropriate care center to head for.
2. Transport: Seek the most efficient and safest means of transportation, whether it be on foot, by vehicle, or helicopter. Prioritize the injured individual’s stability and comfort during transportation. If possible, find someone trained in wilderness first aid to provide care during the journey.
3. Navigate: Familiarize yourself with the location of local medical facilities, such as hospitals and clinics. This may require consulting a map, GPS device, or advice from emergency services. Be prepared for possible obstacles, such as rough terrain or limited access roads, and be ready to adapt your route if necessary.

Upon reaching a medical facility, the injured person will be assessed by a healthcare professional, who will determine the appropriate course of action for definitive care. This may include further wound cleaning, stitches, or even surgery, depending on the severity and location of the bleeding. The Center for Wilderness Safety provides guidelines on wound management in wilderness scenarios that can be helpful during evacuation efforts.

Remember, in wilderness emergencies, early recognition and action can save lives. Do not hesitate to evacuate if you are concerned about an individual’s well-being or if basic wound care is not sufficient.