Major trauma: assessment and initial management

Preventing and treating blood loss

If the person is bleeding heavily the ambulance team should put pressure on the wound to help stop the bleeding and put a dressing on it. If there is a large wound to a leg or arm, and pressure does not stop the bleeding, a bandage (called a tourniquet) should be wrapped tightly around the leg or arm to control the bleeding.

An injection of tranexamic acid should be given as soon as possible to help reduce the bleeding. Tranexamic acid works by preventing the body from breaking down blood clots too soon, which allows the clots to help stop the bleeding.

Replacement fluids and blood should also be given to bring the person's blood circulation back to normal. These are usually given by a drip directly into a vein (intravenously) in their hand or arm.

If the ambulance team think there might be bleeding inside the body from a broken pelvis, they should use a pelvic binder to reduce the bleeding and ease the pain. A pelvic binder is a wide fabric belt that is wrapped around the body to protect the pelvic area (between the stomach and the thighs). It is adjusted to fit snugly so that it stops the broken bones in the pelvis from moving around.

At the hospital, people may have X‑rays or a CT scan to check for bleeding inside the body. CT scans in children under 16 should usually be limited to the parts of the body that are injured, to lessen the amount of radiation they receive.