Stop the Bleed Basics: How to Control Severe Bleeding With Pressure, Wound Packing and a Tourniquet

Quick answer: the Stop the Bleed program, run by the American College of Surgeons, teaches three actions anyone can take while waiting for help. Make sure the scene is safe and call 911. Find the source of the bleeding. Then compress it: press hard with both hands directly on the wound, pack deep wounds with gauze or clean cloth and keep pressing, or place a tourniquet two to three inches above a bleeding arm or leg wound (not on a joint) and tighten it until the bleeding stops. Leave a tourniquet in place for emergency responders. A short hands-on class makes these steps far easier to perform under stress.

Most first aid in an emergency kit is for small problems: scrapes, blisters, minor burns. Severe bleeding is different. A person with a major wound can lose a life-threatening amount of blood in minutes, which may be faster than an ambulance can reach a high-rise apartment, a crowded transit station or a street blocked by a storm.

That gap is why the Stop the Bleed campaign exists. Launched by the White House in 2015 and now led by the American College of Surgeons (ACS), it teaches bystanders the same basic bleeding-control steps used by emergency responders. This guide summarizes those steps and explains how to prepare. It is part of our guide to building an apartment emergency kit, which covers supplies for every kind of urban emergency.

Sources: American College of Surgeons, Stop the Bleed program materials and “Stop the Bleed” booklet; U.S. Department of Homeland Security, Stop the Bleed campaign information; American Red Cross, first aid guidance for severe bleeding; National Highway Traffic Safety Administration Office of EMS public information. This article is general information and not a substitute for hands-on training. Always call 911 in an emergency. Checked October 2026.

Why Bystanders Matter

Emergency medical services do remarkable work, but they cannot be everywhere at once. Response times depend on traffic, distance, building access and how many calls are coming in. In a large incident or a disaster, many patients may need help at the same time.

The people closest to an injured person are usually other bystanders. The DHS describes the idea behind Stop the Bleed simply: a bleeding injury can be survivable if someone nearby acts quickly. Pressure, packing and tourniquets require no medical license, and they can be learned in a short class.

Legal worries stop some people from helping. Every state has some form of Good Samaritan law that protects people who give reasonable emergency help in good faith, although details vary by state. Training helps you stay within what a reasonable bystander would do.

Step One: Ensure Safety and Call 911

Your own safety comes first. If the injury came from traffic, violence, a collapse or a fire, an unsafe scene can create a second patient: you.

Before you approach:

• Look for ongoing danger such as vehicles, falling objects, electrical hazards or an active threat.
• Call 911, or tell a specific person to call. “You in the blue jacket, call 911” works better than a general shout.
• Ask someone to find a bleeding control kit if one is nearby. Many public buildings, schools and transit hubs now keep them near AEDs.
• Put on gloves if they are available. They protect you from bloodborne disease.

If you are alone, the ACS booklet suggests putting your phone on speaker so you can keep your hands free while the dispatcher guides you.

Step Two: Find the Bleeding and Judge How Serious It Is

Open or cut away clothing so you can see the wound. Blood can pool under heavy coats or soak into clothes in a way that hides how much is being lost.

The ACS describes life-threatening bleeding with these signs:

• Blood spurting out of the wound
• Blood that won’t stop flowing or that keeps coming
• Blood pooling on the ground
• Clothing or bandages soaked with blood
• Loss of all or part of an arm or leg
• Bleeding in someone who is confused or unconscious

Any of these calls for immediate action. Smaller wounds that ooze can usually wait for a simple dressing.

Step Three: Compress the Wound

There are three ways to compress, and the right one depends on where the wound is and what you have.

Direct pressure

For most wounds, start here. Place a clean cloth, gauze or even your gloved hand directly on the wound and push down hard with both hands. Use your body weight by locking your arms and leaning over the wound. Keep pressing without lifting to check, since lifting lets bleeding restart.

Wound packing

For deep wounds, especially in places where a tourniquet will not work, such as the neck, shoulder or groin, the ACS teaches wound packing:

1. Find the source of the bleeding inside the wound.
2. Pack gauze or clean cloth tightly into the wound, pushing it in with your fingers and feeding more until the wound is filled. Hemostatic gauze, which contains an agent that helps blood clot, is preferred if you have it, but plain gauze or clean fabric also works.
3. Press firmly with both hands on top of the packed wound and keep holding pressure until help arrives.

Packing feels uncomfortable to do, and it will hurt the injured person. Both are expected.

Tourniquet

For severe bleeding from an arm or leg, a tourniquet can stop blood flow to the wound. The ACS guidance for a commercial tourniquet:

1. Place it high and tight, two to three inches above the wound, between the wound and the heart. Do not place it over a joint, such as the knee or elbow. If you cannot see the wound clearly, place it as high on the limb as possible.
2. Pull the strap tight and secure it.
3. Twist the windlass rod until the bleeding stops.
4. Lock the windlass in place with the clip or strap.
5. Note the time the tourniquet was applied. Write it on the strap or tell responders.

Tourniquets are painful when applied correctly. That pain does not mean you did something wrong. If bleeding continues after the first tourniquet is tight, a second one can be placed above it. Do not loosen or remove a tourniquet once it is on; that is a decision for medical professionals.

Commercial vs Improvised Tourniquets

Training programs generally recommend purpose-made tourniquets with a windlass. Improvised versions made from belts or shirts are hard to tighten enough to stop arterial bleeding and can fail. If you have no tourniquet, direct pressure and packing remain your best options.

A few buying notes:

• Buy from a reputable medical supplier. Counterfeit tourniquets that look like well-known models are sold online, and some break under tension.
• Choose a model used in recognized training, so what you learned in class matches what you carry.
• Use a separate trainer for practice. Repeated tightening can wear down the tourniquet you rely on.

What to Keep in an Apartment Bleeding Control Kit

A bleeding control kit is small and fits beside a regular first aid kit. Common contents in public-access kits include:

Item	Purpose
Commercial tourniquet	Stops severe bleeding from an arm or leg
Hemostatic or compressed gauze	Packs deep wounds and helps blood clot
Pressure bandage	Holds pressure on a wound after packing
Nitrile gloves	Protects the helper
Trauma shears	Cuts clothing to expose the wound
Permanent marker	Records the time a tourniquet was applied
Instruction card	Reminds you of the steps under stress

Store it where you can reach it quickly, ideally with your main first aid kit. Our guide to a first aid kit for a small apartment covers placement in tight spaces. A second small kit can live in a go bag or car. Our urban go bag checklist has room for one.

Check the kit at least once a year. Replace anything that has been opened, and check the expiration date printed on hemostatic gauze.

While You Wait for Help

Once bleeding is under control, keep doing what is working. Do not lift the dressing to check, and do not let go of pressure on a packed wound until responders take over.

A few other things help while you wait:

• Keep the person warm. The American Red Cross advises covering an injured person with a blanket or coat, since blood loss makes it harder for the body to stay warm, and cold makes bleeding harder to control.
• Keep them still and lying down if possible, unless the scene is unsafe.
• Talk to them. Reassurance helps, and a change in how they respond is useful information for EMS.
• Leave objects in place. If something is stuck in the wound, the Red Cross advises against pulling it out. Pack or pad around it and press on the sides instead.
• Brief responders when they arrive: what happened, what you did, and the time any tourniquet went on.

After You Have Helped

Helping in a bleeding emergency is physically and emotionally demanding. Take a few minutes to look after yourself afterward.

Wash your hands and any skin that touched blood with soap and water as soon as you can, even if you wore gloves. If blood got into your eyes, mouth or an open cut, tell the responders and contact a health care provider promptly, since they can assess whether follow-up is needed.

Strong reactions afterward are common. Trouble sleeping, replaying the scene or feeling shaky are normal responses to a frightening event. Talking with someone you trust helps, and the national 988 Suicide and Crisis Lifeline also accepts calls and texts from people dealing with emotional distress after a traumatic experience.

Finally, restock. Replace the tourniquet, gauze and gloves you used so the kit is ready the next time someone needs it.

Taking a Stop the Bleed Class

Reading about bleeding control helps, but practice matters more. The ACS runs a course finder on its Stop the Bleed website, and classes are taught by hospitals, fire departments, EMS agencies and community groups. Many are free or low cost, and the basic course is short enough to finish in an evening.

A typical class includes:

• A short presentation on recognizing life-threatening bleeding
• Hands-on practice applying pressure, packing a wound model and placing a tourniquet on yourself and a partner
• Questions about kits and real-world situations

The American Red Cross also covers severe bleeding in its first aid courses, which pair well with CPR and AED training.

Building Bleeding Control Into Your Building Plan

Apartment buildings concentrate many people in one place, and responders may take longer to reach upper floors. A few neighbors with training and a kit can make a meaningful difference.

• Ask management whether the building has a bleeding control kit near the AED, and where.
• Suggest a group class for residents through your local fire department or hospital.
• Add kit locations to your building’s emergency contact sheet.

Our guide to creating an apartment building emergency plan with neighbors covers how to organize this.

Frequently Asked Questions

What are the three steps of Stop the Bleed?

Call 911 and make sure the scene is safe, find the bleeding, and compress it using direct pressure, wound packing or a tourniquet.

Where should a tourniquet go?

Two to three inches above the wound on an arm or leg, between the wound and the heart, and not over a joint. If you cannot see the wound clearly, place it as high on the limb as possible.

How tight should a tourniquet be?

Tight enough that the bleeding stops. It will be painful, and that is expected.

Can I remove a tourniquet once bleeding stops?

No. Leave it in place and let emergency medical professionals decide when to remove it. Note the time it was applied.

Where can I take a Stop the Bleed class?

Use the course finder on the American College of Surgeons Stop the Bleed website, or ask your local fire department, hospital or EMS agency.

The Bottom Line

Severe bleeding is one of the few emergencies where a trained bystander can change the outcome in the first few minutes. Learn the three steps, keep a small bleeding control kit with a genuine commercial tourniquet beside your first aid supplies, and take a hands-on class so your hands know what to do. Then share what you learned with the people you live near.