Wounds & Bleeding

What is the first step in treating severe bleeding?

• AWash the wound with water
• BGive the casualty an aspirin
• CApply direct pressure with clean material✓
• DApply a tourniquet immediately

Answer: The first step is to apply firm, direct pressure with clean material (sterile dressing or clean cloth) to control bleeding.

What should you do if blood soaks through a dressing?

• AApply another dressing on top without removing the first✓
• BApply ice immediately
• CRemove the soaked dressing to check the wound, then apply a fresh one in its place
• DLeave it as it is

Answer: Do not remove the first dressing as this may disturb clots. Apply another dressing on top and maintain pressure. If bleeding is severe, this is a sign to call 999.

When should a tourniquet be applied to control bleeding?

• AFor minor cuts and grazes only, where a dressing alone would not stay in place on the limb
• BFor all bleeding wounds, because a tourniquet controls blood loss faster than direct pressure ever can
• COnly for life-threatening limb bleeding that cannot be controlled by direct pressure✓
• DAt no point in a first aid setting, because only a paramedic or a doctor may apply one

Answer: Apply a tourniquet as soon as possible for life-threatening bleeding from a limb that direct pressure does not control. RCUK 2025 first aid guidance places it 5-7 cm above the wound but not over a joint, and only a healthcare professional should release it.

Where should a tourniquet be placed on a limb?

• ADirectly over the wound itself, so that the pressure is applied where the bleeding is
• BDirectly around the nearest joint, such as the elbow or the knee, and tightened there
• CBelow the wound, between the wound and the hand or foot, so that blood cannot escape past it
• DAround the limb, 5-7cm above the wound, avoiding placement over a joint.✓

Answer: Current Resuscitation Council UK guidance specifies placing a tourniquet 5-7cm above the injury, never over a joint — this achieves effective compression without unnecessarily sacrificing limb tissue or risking incorrect placement over a joint.

What should be done with an embedded object in a wound?

• ATry to wiggle it out slowly
• BDo not remove it; apply pressure around it and secure it with dressings✓
• CPour water over it to flush it out
• DRemove it immediately and then dress the wound over

Answer: Never remove an embedded object. It may be plugging the wound and controlling bleeding. Secure it in place with bulky dressings and get medical help.

What is the appropriate action for a partially severed limb or amputation?

• AKeep the severed part, wrap it in clean material, seal it in a plastic bag, and place the bag on ice (not the tissue directly). Transport it with the casualty.✓
• BAttempt to reattach the severed part yourself, using a clean dressing, before the ambulance arrives on scene
• CDiscard it and focus on the casualty's bleeding
• DWash the severed part, pack it in ice and hand it to the paramedics

Answer: Keep the severed part, wrap it in clean cloth (not directly in ice), place it in a plastic bag, and put the bag in ice. Transport it with the casualty for possible reattachment.

How should you treat a casualty with a nosebleed?

• ATilt the head well back and pinch the bony bridge of the nose so the blood drains down the back of the throat
• BLie the casualty flat on their back with a rolled-up coat under the shoulders and wait for the bleeding to stop
• CTilt the head back, pinch the bridge of the nose and hold for two minutes
• DSit upright, lean slightly forward, pinch the nose for 10-15 minutes, and breathe through the mouth✓

Answer: Sit upright and lean slightly forward to prevent blood from running down the back of the throat. Pinch the soft part of the nose firmly for 10-15 minutes.

What are the signs of internal bleeding?

• AFlushed hot skin, a slow strong pulse and a high temperature that keeps rising
• BThirst, fruity-smelling breath and deep, rapid breathing that builds over hours
• CPale skin, rapid pulse, dizziness, abdominal pain, and weakness✓
• DWheezing, a raised itchy rash and swelling of the face, lips and tongue

Answer: Signs include pale, clammy skin, rapid pulse, dizziness, weakness, abdominal pain, and possible dark vomit or stools. Internal bleeding is life-threatening.

What should you do if you suspect internal bleeding?

• ALay them completely flat and raise the head
• BMassage the abdomen
• CCall 999 immediately and keep the casualty lying down and warm✓
• DGive the casualty lots of fluids

Answer: Call 999 immediately for suspected internal bleeding. Keep the casualty lying down, warm, and reassured. Do not give food or drink.

How should you position a casualty with a head wound that is bleeding?

• ASit them upright with slight elevation of the head✓
• BLie them completely flat
• CTilt the head back
• DPlace them in the recovery position immediately, even if they are fully conscious and alert

Answer: Sit the casualty upright with the head slightly elevated to reduce bleeding pressure. Support the head and neck in case of spinal injury.

What is the correct procedure for cleaning a minor wound?

• AApply a dressing without cleaning the wound, so that the scab is not disturbed
• BCool it under running water for 20 minutes, then cover it loosely with cling film
• CRinse gently with clean water, pat dry, and apply an antiseptic if needed✓
• DRest it, apply ice, then compress and elevate it, as you would for a sprained ankle

Answer: Rinse the wound gently with clean running water to remove debris, pat dry with clean material, and apply an appropriate dressing.

What is the purpose of elevation in treating a bleeding wound?

• ATo prevent movement of the limb, which is the only reason elevation is used
• BTo reduce swelling around the injury
• CTo use gravity to reduce bleeding and pressure at the wound✓
• DTo make the wound easier to see so that the dressing can be positioned accurately

Answer: Elevation uses gravity to reduce blood pressure in the wound area, helping to control bleeding when combined with direct pressure.

How long should direct pressure be maintained on a wound?

• A1-2 minutes
• B10-15 minutes or longer until bleeding is controlled✓
• C30 seconds
• DFor 5 minutes at the very most

Answer: Maintain direct pressure for at least 10-15 minutes or until bleeding is controlled. Check progress, but do not repeatedly lift the dressing.

What should you do if a casualty has an open fracture with bleeding?

• AGive the casualty painkillers straight away and then splint the limb before the ambulance arrives
• BPush the bone back, cover the wound and then immobilise the limb
• CApply direct pressure around the wound without moving the limb, then immobilise it✓
• DStraighten the limb to stop bleeding

Answer: Apply direct pressure around the wound to control bleeding without moving the limb. Immobilise the fracture carefully to prevent further injury.

How should you treat a casualty with crush injuries that are actively bleeding?

• APack the wound with ice cubes to slow the bleeding, then wrap the limb tightly
• BApply direct pressure, maintain the pressure, and call 999✓
• CElevate the limb above the level of the heart and keep it raised there
• DRemove the crushing object immediately, whatever its weight and however long it has been there

Answer: Apply firm direct pressure to control bleeding and call 999 immediately. Do not remove the crushing object unless there is immediate danger.

What is the correct way to apply a pressure bandage?

• AApply firm but not tight; allow some finger space under the bandage✓
• BMake it very loose to allow circulation
• CWrap it tightly around the whole limb so that the bandage cannot slip out of position
• DWrap in a spiral pattern without overlap

Answer: A pressure bandage should be firm to maintain pressure on the wound but not so tight that it cuts off circulation. You should be able to fit a finger underneath.

What signs indicate that a bandage is too tight?

• APale skin, numbness, tingling, or coldness below the bandage✓
• BThe bandage is not fully covering the wound
• CThe wound is still bleeding slightly
• DRedness, warmth and swelling above the bandage

Answer: Signs of a too-tight bandage include pale or blue skin, numbness, tingling, coldness, or loss of pulse below the bandage. Loosen it immediately.

How should you treat a casualty with profuse bleeding from the groin area?

• ACool with running water for 20 minutes, as for a burn
• BLoosen tight clothing and fan them to keep them cool, as for heat exhaustion
• CApply direct firm pressure with a dressing and maintain pressure for at least 10-15 minutes✓
• DSupport the leg in a sling and splint it, as for a suspected fracture

Answer: Apply firm direct pressure with a large dressing and maintain it. Call 999 for severe groin bleeding as it can be life-threatening.

What should be avoided when treating severe bleeding?

• AProbing the wound, removing blood clots, or frequently checking under dressings✓
• BApplying direct pressure to the wound with a dressing
• CCalling the emergency services, since a first aider should manage severe bleeding alone
• DKeeping the casualty warm and reassuring them calmly while you wait for the ambulance to arrive

Answer: Avoid probing the wound or removing dressings repeatedly as this can disturb blood clots and restart bleeding. Maintain steady pressure.

What is the correct procedure for applying a triangular bandage to an arm wound?

• AWrap the triangular bandage around the arm several times without securing the end or covering the wound first
• BApply a base dressing first, then secure with a triangular bandage, ensuring it is not too tight✓
• CApply the triangular bandage directly over the open wound and tie the ends at the back of the neck
• DUse it alone, without a dressing, tied directly over the wound

Answer: Apply a sterile dressing to the wound first, then use a triangular bandage to secure it. Tie it so it is firm but allows some finger space underneath.