CPR without enough blood is useless, so a check for deadly bleeding should be included in your primary survey whenever possible.
If your victim is breathing, then you should continue your primary assessment with a check for deadly bleeding.
If your victim isn't breathing, then you'll be doing CPR; a bystander or second trained first aider may be able to perform this check while you continue resuscitation.
With gloved hands check the victim's entire body for bleeding, starting with the head. Stick your hands behind or underneath the victim and remove them, repeating this process every couple of inches until you have reached the victim's heels. If your hands are bloody when you withdraw them, then you've found bleeding. An injury on the head or neck, may indicate a spinal injury, in which case you should keep the victim's head and neck stationary. Be thorough. Blood will seek the lowest level, and a blood soaked sock could be from a knee laceration. Also, hair conceals blood surprisingly well — make sure you check the scalp thoroughly.
|Remember that about 80% of life-threatening bleeding can be controlled adequately using direct pressure alone and the application of a tourniquet may result in the loss of the limb.|
The key element in treating severe bleeding is the application of firm, direct pressure to the wound, using sterile gauze or other dressing. If the wound is in a limb, raising it above the heart can help, though this should not be done if there is a risk of disturbing fractures, or if it causes much pain to the victim.
You may also consider using pressure points to control major bleeding: press down on an artery that is between the heart and the wound to slow blood from flowing to the wound. Two easily found ones are on the underside of the bicep area, and the underside of the thigh area of the leg.
Tourniquets may also be useful in controlling massive bleeding such as an amputation. This is not a standard procedure and should only be used as an ABSOLUTE last resort when the victim will die without it. Also, once a tourniquet is applied, it is only removed by a physician.