How to Pack a Severely Bleeding Wound

Key takeaways proper use of hemostatic gauze

Five-step wound packing process. 1. Apply direct pressure to the wound Use your hand, gauze, knee, rag, or whatever it takes to "stem the flow while you get your supplies." 2. Get in the wound Next put your hand or finger in the wound and push hard to begin stopping the bleed. 3. Pack, pack, and pack some more Pack gauze into the wound and keep packing gauze into the wound until no more goes in. Then pack some more gauze into the wound. 4. More pressure After packing as much gauze and more into the wound apply very firm pressure for three minutes. The combination of gauze packed into the wound and more direct pressure "will stop bleeding in almost every case." 5. Reassess, immobilize and transport After three minutes reassess the wound for bleeding. If the bleeding has stopped start transport, obtain intravenous access and immobilize or splint the injured area. If the wound is still bleeding pack in more gauze, apply more pressure and transport emergently. Other important points:

• A hemostatic agent is recommended to be applied in the form of a gauze and not as a powder applied directly to the wound.

• Gauze without a hemostatic agent may be just as effective for wound packing as gauze treated with a hemostatic agent.

• Large wounds may require multiple gauze dressings to fully pack the wound. Pack in as much gauze as will fit into the wound and push in even more if you can.