Cuts, scrapes and grazes are common, especially in children. But anyone can injure themselves, so it’s a good idea to know what to do if you’re nearby, and when you should worry. Let’s talk you through it. We've assumed in this article that you know the person you're treating, but if you're a bystander and helping a stranger, contact with blood carries risk of disease. We would advise caution in this case, wearing single-use gloves if available or helping them to a medical facility instead.
Firstly, try to stop the blood flow, through a combination of putting pressure on blood vessels and blocking the open wound. This allows time for their body to kick in with the necessary response – we have natural clotting factors in our blood, and these will get to work at any site of injury. Any clean, absorbent material will do the job – gauze is ideal if you have that in your medical box, but otherwise a clean towel or bandage will work. Keep the pressure on the wound for several minutes, perhaps 10 to 20 minutes. It can help to work against gravity and hold an arm or leg up – get them to lie back if necessary.
Once bleeding has stopped, clean the wound under cold running water and pat it dry with gauze or a clean towel, or you can clean it with sterile wipes. You can use antiseptic around the wound if you have it handy. Apply a new dressing over the wound and either stick or bandage it in place - this will prevent infection and re-bleeding. Change it as often as needed and keep it dry (or apply a waterproof dressing) for baths and showers. For a dressing that is stuck down, soak it in sterile salted water or bottled saline to remove the dressing, but try to avoid disturbing any scab that's forming.
Bleeding is serious if you see blood pulsating out, or gauze or towels are quickly soaking through. Large or deep wounds are more serious, especially if they have been caused by a sharp object such as a knife or shard of glass. You should call an ambulance in these circumstances and apply pressure until it arrives. If the person bleeding looks pale or blue around the lips, feels faint or nauseous, or they feel very cold, this is reason to call an ambulance, as they may be losing a lot of blood. Less urgently, you should seek medical attention if your wound is “dirty”, such as lots of dust, grit or glass in it, or it was caused by an animal or human bite, this needs to be looked at and properly cleaned. Antibiotics and a tetanus vaccine booster may be offered for additional protection from infection. Any sign of infection a few days later, such as becoming more painful, red, oozing or pus, is worth getting checked out urgently and, again, antibiotics may be offered. Cuts to the face are treated with more caution, due to the risk of psychological trauma from any scarring, so you may choose to get this checked out at the emergency department, and they may offer stitches.
Some medications aim to keep blood flowing by preventing clots, which can be helpful if you are at risk of heart disease. But it prevents proper clotting of your blood. Warfarin is one of these, and apixaban or rivaroxaban are others. For a small cut, if bleeding has not stopped within 1 hour with pressure applied, or the wound is large or deep, you should seek urgent medical attention. Regular aspirin and clopidogrel are also taken to keep blood flowing, and may prove a barrier to effective clotting of a wound. If bleeding continues, they may need to be seen at a medical facility.