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I am about to participate in a first aid training workshop. Before I do so, I am supposed to pass an online first aid course. While going through the course, I came across this section about applying pressure to wounds in order to stop critical bleeding:

It is always necessary to find an appropriate compromise between safety and promptness.

For instance, you would probably not hesitate to put your fingers into e.g. the wound of your partner without any protection; It would be a more than brave action in the case of a stranger. On the other hand, the casualty may bleed to death before you manage to get a pair of gloves or a bandage.

If the casualty responds, you can ask him/her to press the bleeding wound, and you can enhance the pressure over his/her hand. Or you can use a piece of clothing, etc.

Is it really that dangerous? Why? What should I do if the "casualty" does not respond? How much and why is it risky to apply pressure myself?

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    Additional to Benedikt's answer, in litigious countries (such as the US and some others) you could save someone's life and then be sued for damaging them. Seriously.
    – Rory Alsop ♦
    Nov 13, 2013 at 10:01
  • @RoryAlsop - then my curiosity requires that I ask: Any countries where I can be punished for not helping someone in a life threatening situation, through my inaction?
    – ArjunShankar
    Nov 13, 2013 at 10:36
  • Now that I don't know. Sorry. The US and UK are scary though, in the putting management of lawsuits and health & safety risks before rescuing or helping people. We even have examples of fire/police inactivity (through following policy blindly) allowing individuals to die.
    – Rory Alsop ♦
    Nov 13, 2013 at 11:01
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    @ArjunShankar maybe your question about the countries should be another separate question but might be beyond the scope of outdoors.sx. From Germany I know that you can be punished for not helping, but for everything you did with the intention to help, you cannot be punished even if it made the situation worse.
    – Benedikt Bauer
    Nov 13, 2013 at 11:46
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    Just following up: One Portuguese and one Czech citizen (not lawyers) told me the following: If you don't help a critically injured person in EU, then you can be charged with "negligence leading to death". You should atleast call 155 or 112 and do as told over the phone. -- Neat!
    – ArjunShankar
    Nov 18, 2013 at 14:54

2 Answers 2

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As for the reason why it is risky: You cannot know if the guy you want to help has any disease that can be transferred via blood contact, such as HIV or Hepatitis. Already small wounds in your own skin –you might not recognize it as a wound at all– might be enough to transfer the disease, therefore it would be quite risky to just stick your hand into any random stranger's bleeding wound.

If the person does not respond, you will have to take some decision about your safety vs. the life of someone else. In this case my first thought would be to get me anything that prevents me from putting my hands directly to the wound, e.g. some (hopefully more or less clean) piece of a rain jacket or the like.

On the other hand, if you are somewhere outdoors and someone is bleeding that much that (s)he would bleed out within minutes, chances are high that you would not have been able to save him/her anyway without being at least a trained paramedic. A paramedic once told me that as an untrained person (that includes also persons that have accomplished a standard first aid training) every injury that you cannot fix –i.e. prevent it from getting worse or life-threatening– with bandages, patches, and tape is very likely to be beyond your skills.

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  • Looks like an answer to me. I still like to add regarding how unsafe it is to touch/keep pressure on open wounds. Putting excessive pressure on open wounds with Bone/Muscle/Ligament injury can further damage the wound apart from bleeding.
    – WedaPashi ♦
    Nov 13, 2013 at 6:39
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    Weda - in general though, stemming blood loss is more important than bone/muscle/ligament injuries, so if a tight tourniquet is required to stop someone bleeding out and it may damage a muscle - so be it.
    – Rory Alsop ♦
    Nov 13, 2013 at 10:00
  • @RoryAlsop: True. a valid point.
    – WedaPashi ♦
    Nov 13, 2013 at 13:17
  • @RoryAlsop a tourniquet is really a last resort though. If you apply a tourniquet, they're going to lose that appendage, so it better be your last choice. It's wise to keep gloves within quick reach at all times; even if you waste 1 minute pulling out your gloves you're going to be able to effect much better treatment.
    – nhinkle
    Jan 29, 2015 at 3:57
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    I also disagree that you cannot help any injury unfixable by tape and bandages, although with only a basic first-aid level training that's likely true. A wilderness first aid or better yet wilderness first responder course will give you the skills to manage and control many types of life-threatening situations including severe bleeding. These courses are available to anybody and take much less time and money than a full EMT or Paramedic cert.
    – nhinkle
    Jan 29, 2015 at 3:59
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My wife is a doctor and she always wears gloves when dealing with wounds, even with friends outside of clinic. But when I ask her if I should wear gloves, she says it's not necessary.

The reason is that the probability to catch a disease in, well, developed contries is quite small, so if you do it once in a year you are ok. But if you do it every day you will catch it sooner or later.

If I had an unconscious stranger before me, I would first estimate the risk based on his social status (because there are no other clues) and than decide if I am going to take this risk taking into account that

  • the person will die or be permanently injured before I put on gloves (if I have some), or not
  • the person will die or be permanently injured before medcs arrive, or not
  • my skill is high enough to help the person, or not
  • I am a husband and a father
  • ...

This is where the moral choice comes in and nobody else can do it for you.

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