A stab wound is a severe penetrating trauma that causes rapid blood loss and internal damage. Immediate first aid is necessary to manage life-threatening effects, but it is not a substitute for professional medical care. Contact emergency services immediately. The priority is to control blood loss and support the victim until trained personnel arrive.
Prioritizing Immediate Safety and Emergency Contact
Before approaching an injured person, confirm the scene is safe and that the threat has passed. Do not enter a hazardous environment, as effective care depends on your own safety. Once the area is secure, immediately call 911 or your local emergency number.
The call handler will guide you, but you must provide accurate information about the incident. State the victim’s exact location and the nature of the emergency, specifically mentioning the stab wound. Describe the victim’s current condition, including consciousness, breathing, and the presence of severe bleeding.
If possible, designate someone else to remain on the phone with emergency dispatchers while you begin first aid. Continuous communication ensures medical professionals are prepared for the victim’s condition and can offer real-time instructions.
Controlling Hemorrhage (Stopping the Bleeding)
Controlling external bleeding (hemorrhage) is the immediate priority for a stab wound where the object is absent. Rapid blood loss can lead to hypovolemic shock quickly. The standard for initial control is the application of direct, firm pressure to the wound site.
Use a clean cloth, sterile gauze, or absorbent material to cover the wound. Apply continuous, heavy pressure directly over the injury and maintain this pressure without interruption. If the material becomes saturated, do not remove it, as this disrupts the forming clot; instead, place additional layers on top and continue pressing.
If the wound is on a limb, elevating the injured extremity above the heart can help decrease blood flow. Direct pressure must remain the primary focus, sustained for a minimum of 10 minutes to activate the body’s natural clotting cascade. Once bleeding is controlled, secure the dressing firmly with a bandage or cloth to maintain pressure, creating an improvised pressure dressing.
If life-threatening arterial bleeding on a limb fails to stop with direct pressure, a tourniquet may be necessary as a last resort. Place the tourniquet two to three inches above the wound, ensuring it is on bare skin or thin clothing, and avoid placing it directly over a joint. Tighten the device until the bleeding stops completely, which will likely cause significant pain. Note the exact time the tourniquet was applied, as this information is needed by the medical team.
Managing an Impaled Object
The presence of an impaled object, such as a knife or shard of glass, requires a specific first aid protocol. The object must never be removed by a lay person, even if it appears superficial. The impaled item may be acting as a physical plug, preventing a severed artery or vein from bleeding internally or externally.
Removing the object eliminates this temporary plug, potentially leading to immediate, massive hemorrhage. Furthermore, extraction could sever surrounding blood vessels or nerves. The aim is to minimize the object’s movement to prevent further internal tissue damage.
To stabilize the impaled object, surround it with bulky dressings, clean cloth, or padding, such as a rolled-up shirt or towels. Build up the material high enough to cradle the object and prevent movement. Secure the material firmly with bandages or tape without applying downward pressure directly onto the object. Stabilization ensures the object remains fixed until a surgeon can safely remove it.
Apply gentle pressure to the edges of the wound around the stabilizing material to help control any residual bleeding. Continuously monitor the wound site to ensure the stabilization materials remain effective.
Treating for Shock While Awaiting Medical Help
Hemorrhagic shock is a systemic response to severe blood loss, occurring when body tissues do not receive enough oxygen. Symptoms include pale, cool, and clammy skin, a rapid and weak pulse, and fast, shallow breathing.
The victim may also exhibit confusion, anxiety, or restlessness as the brain is deprived of blood flow. To manage this condition, lay the victim flat on their back (supine recovery position). If possible and no head, chest, or suspected spine injuries are present, slightly elevate the victim’s legs approximately 8 to 12 inches.
This elevation promotes venous return, encouraging blood flow toward the core organs like the heart and brain. Maintaining body temperature is also important, as hypothermia can worsen the effects of shock. Cover the injured person with a blanket, coat, or anything available to prevent heat loss.
Throughout this waiting period, reassure the victim to help manage their psychological state and keep them calm. Continuously monitor their responsiveness, breathing rate, and pulse until emergency medical personnel arrive. Do not give the victim anything to eat or drink, as this is necessary in case they require immediate surgery.