Initial advice to save lives: Severe bleeding

Control Measure Knowledge

This control measure should be read in conjunction with Share information with other agencies: People at risk


The advice that fire control personnel give to callers about casualties losing a lot of blood is designed to help callers take on a zero responder role to help themselves or others. However, zero responders should only provide casualty care if doing so does not place them in danger.

Firm direct pressure

Severe bleeding can be controlled without specialist medical equipment by applying firm direct pressure.

Fire control personnel should advise callers to check if there is anything embedded in the wound, such as bladed weapons, shrapnel, broken glass or bullets. If the caller finds something embedded in the wound, they should be advised not to pull it out (it may make the bleeding worse) but to:

  • Fully expose the wound, looking for any obvious source of bleeding
  • Take care not to press down on the object
  • Apply firm direct pressure to either side of the object if possible, pushing the edges of the wound together to reduce blood loss

If there is nothing obviously embedded in the wound, fire control should advise callers to:

  • Apply firm direct pressure to the wound by:
    • Using a gloved thumb or heel of the hand to reduce bleeding from single bleeding points
    • Using rolled bandages (if available) or any clean cloth material (such as clothing) to act as a dressing; the aim is to apply pressure with the whole roll of bandage rather than wrap the bandage around the wound
  • Keep applying firm direct pressure until emergency responders take over
  • Check for other wounds that may also be bleeding heavily, if possible

If blood soaks through the pressure dressing or bandage, fire control personnel should advise callers to:

  • Leave the original dressings in place
  • Apply another dressing over the top
  • Reassess where they are applying pressure (changing the pressure point may help to reduce the bleeding)
  • Continue applying very firm direct pressure to the wound until emergency responders take over

Fire control personnel will need to encourage callers to be very firm and push as hard on the wound as they can, even though it may be painful for the casualty.

Fire control personnel should encourage zero responders not to give up, reassuring them that their actions will be helping to stabilise the casualty’s condition until medical help arrives.

Contamination from blood

Zero responders should use gloves from first aid supplies if they are available or wrap their hands in plastic bags as a simple barrier. However, waiting for hand protection should not delay treatment. If reassurance is necessary, fire control personnel may tell zero responders helping others that the risk of infection is very low if infected blood comes into contact with their unbroken skin.

A zero responder who has come into contact with blood should be advised to wash thoroughly afterwards, with soap and warm water, once safe to do so. In the meantime, alcohol-based hand gels or wipes can be used.

If a zero responder has an open wound themself that has been contaminated with blood, then they should wash their hands thoroughly as described and then attend the nearest Urgent Care Centre, Minor Injuries Unit or A&E for advice and reassurance. Locations of these can be found at:

Strategic Actions

Tactical Actions