Wound Packing

When to pack a wound

• Deep wound that is bleeding heavily
• The wound is in a location where a tourniquet can't be used (neck, shoulder, groin, armpit)
• Direct pressure with a bandage is not controlling the bleeding
• You can see into the wound cavity

What you need

• Gauze: hemostatic gauze (like QuikClot or Celox) is ideal, but regular clean gauze works
• Gloves if available
• A clean cloth, dupatta, or torn shirt if no gauze is available

Steps

1. Expose the wound: remove or cut away clothing to see the full wound
2. Identify the source: find where the blood is coming from inside the wound
3. Start packing: push gauze firmly and directly into the wound cavity, starting at the deepest point where the bleeding is heaviest
4. Pack tightly: feed gauze into the wound continuously, packing it in firmly with your fingers. Do not be gentle; you need to create pressure inside the wound.
5. Fill the entire cavity: keep packing until the wound is completely filled with gauze, slightly above skin level
6. Apply pressure: place your palm over the packed wound and press down hard for 3–5 minutes
7. Bandage over it: wrap a pressure bandage tightly over the packed wound to hold everything in place
8. Do not remove packing: even if blood soaks through, add more material on top. Never pull out packing to "check."

Using improvised materials

If you have no gauze:

• Clean cotton cloth torn into strips (dupatta, t-shirt)
• Sanitary pads (surprisingly effective: they're designed to absorb)
• Clean cotton: any clean, absorbent fabric

Avoid: tissue paper (falls apart), dirty cloth, leaves or soil

After packing

• Get to medical help as quickly as possible
• Keep the person warm and lying down
• Monitor their breathing and consciousness
• Note the time you packed the wound and tell medical teams