How to Care for a Stab Wound

A stab wound is often extremely painful, bleeds heavily, and can be fatal. Immediate intervention is crucial to stop the bleeding and stabilize the victim until medical professionals can assess the injury. Stab wound care requires quick action and calmness to effectively perform first aid, control bleeding, and save the victim's life.

Survey the Scene. The victim is often stabbed in areas with unstable conditions, and the attacker may still be nearby, posing a threat to you and the victim. Avoid putting yourself at risk by approaching the scene or the attacker. Only approach the victim once you are sure the environment is safe for you.

• Although waiting for the attacker to leave the scene might cost valuable time in saving the victim, you won’t be able to help anyone if you become the next victim.

Call emergency services immediately. If the victim has been stabbed, it is crucial to contact emergency services as soon as possible.

• If you are the only one present at the scene, calling emergency services should be your top priority. If there is no phone available, seek help from passersby or a nearby shop. Everyone wants to assist the victim quickly, but the most effective action is to help them get medical attention as soon as possible.
• If the attacker is still nearby and you cannot safely approach the victim, use this time to call emergency services.

Lay the victim down. Before taking any action to treat the wound, you should lay the victim flat on the ground. This helps stabilize the victim, especially if they start feeling dizzy or are about to lose consciousness. You certainly don't want their injury to worsen due to falling after fainting.

• Place the victim's head on a coat or backpack to make them more comfortable, or if there are others around, ask them to sit down and place the victim's head in their lap. This not only makes the victim feel more comfortable but also helps them remain calm.

Assess the victim to determine the severity of the injury. Are there one or multiple stab wounds? Are there any slashes? Where is the bleeding coming from? Is the stab wound at the front or back of the body?

• You may need to remove some of the victim's clothing to properly identify the wound. Try to locate all injuries before starting treatment.
• However, if you discover a serious injury requiring immediate treatment, you must address it right away. A wound is considered severe when blood is flowing continuously and heavily, or spurting in a stream. Spurted blood indicates an artery has been severed.

Wear disposable gloves if available. Alternatively, you can wrap your hands in plastic bags. Although this step is not mandatory before tending to the wound, it will protect both you and the victim from infection risks.

• If available, use nitrile gloves or any gloves not made from natural rubber. These types of gloves minimize the risk of latex allergies, which can complicate treatment. Nitrile or other non-latex gloves are usually blue or purple, and they are quickly replacing the traditional white latex gloves.
• If gloves are not available, try to wash your hands or use hand sanitizer. If nothing is available, use some cloth layers to separate yourself from the victim’s blood.
• Remember, you do not have to touch the victim if you suspect a risk of infection or if you feel uncomfortable. Wait for medical personnel if in doubt. If you choose to handle the wound yourself, you must minimize direct contact with the victim’s blood.

Check the victim's airway, breathing, and circulation.

• Ensure their airway is clear and unobstructed.
• Listen for breathing sounds and observe chest movements.
• Check the pulse to confirm that the heart is still beating.
• If the victim stops breathing, proceed with artificial respiration.
• If they are conscious, start treating the wound while talking to them to help keep them calm and slow their heart rate. If possible, redirect their gaze away from the injury to avoid adding distress.

Remove the victim's clothing around the stab wound area. This will help you locate the exact position of the injury for proper treatment. Clothing may sometimes obstruct the wound with blood, other fluids, or dirt, depending on the environment in which the victim was found.

• Be careful when removing clothing as the victim may be in considerable pain.

Do not remove the penetrating object if it is deeply embedded. Leave the object in the wound and avoid moving it, as pulling it out could cause more damage. The object is actually helping to control bleeding, so removing it could lead to further blood loss. If pushed deeper into the body, the object could damage internal organs.

• It is essential to wrap the wound tightly around the object, as close to it as possible. Medical professionals can remove the object carefully without causing harm to internal organs, while also controlling the bleeding during the process.

Control the bleeding. Wrap the wound with clean, absorbent material (such as a piece of clothing or a towel), or, ideally, with sterile gauze. If the object remains in the wound, wrap tightly around it. Apply pressure to the wound to help slow the bleeding.

• Some first-aid techniques recommend using the edge of a credit card to 'seal' the wound, as it is a readily available item. This method not only helps control bleeding but also prevents lung collapse if the wound is in the chest by allowing air to escape through the wound.
• If the bleeding is profuse, apply pressure to the main artery leading to the injury while continuing to press down on the wound. These points are known as 'pressure points'. For instance, to control bleeding in the arm, apply pressure just above the elbow, or just below the armpit. For leg wounds, apply pressure behind the knee or in the groin area.

Position the victim with the wound higher than the heart to limit blood loss. If the victim is able to sit, position them with their back straight. If they cannot sit on their own, assist them in sitting if possible.

Secure the gauze with bandages. If you have access to first aid supplies, secure the gauze tightly with adhesive tape. Avoid lifting or removing the gauze to prevent disrupting the clotting process and causing renewed bleeding. If the gauze becomes soaked with blood, apply additional cloth on top.

• If no materials are available to secure the gauze, continue applying gentle pressure with your hands to assist with clotting.
• Be cautious with chest wounds. For such injuries, use materials like aluminum foil, plastic bags, or cling film to cover the wound, but only tape three sides and leave the other side open. This ensures air can escape, preventing the wound from drawing air into the pleural cavity, which could lead to a collapsed lung.
• Never use a tourniquet unless it is the last resort to save a life. Understand how to use it properly and when it's appropriate. Improper use of a tourniquet can cause serious injuries or necessitate amputation of the affected limb.

Maintain pressure on the wound until medical help arrives. While awaiting emergency responders, you must continuously monitor the victim’s airway, breathing, and circulation.

• Look for signs of shock and treat them. Symptoms of shock include cold, clammy skin, pale complexion, rapid pulse or breathing, nausea, dizziness or fainting, and excessive restlessness or agitation. If shock is suspected, loosen tight clothing and cover the victim with a blanket to keep them warm. Encourage the victim to stay still. See How to Handle Shock for more information.

Assess the victim's consciousness level. If the victim is unconscious, quick action is necessary. Place them in the recovery position, meaning lying on one side with the head tilted backward, the hand under the head, and the arm bent or extended along the ground. The top leg should be bent to help stabilize the position and prevent the body from rolling forward. Do not place the victim in the recovery position if you suspect a spinal or neck injury, and keep monitoring their breathing.

• If the victim is unconscious and not breathing, lay them flat on their back and begin artificial respiration.

Keep the victim warm and comfortable. Shock or blood loss can cause the victim’s body temperature to drop. You should cover them with a blanket, coat, or anything that can help retain heat.

• Keep the victim still. Whether they are lying down or sitting, ensure that they remain calm and still, and it is essential to have someone stay with the victim to provide reassurance and monitor their health condition.

Begin cleaning the wound. If you're in a remote location and cannot contact emergency services (e.g., camping in the wilderness), you should clean the wound once you've managed to stop the bleeding. In typical circumstances, this task is done by emergency personnel, but there are times when you must act on your own.

• Remove any debris from the wound. However, remember that even if the wound appears clean, it was likely punctured by an object, so it's impossible to know if that object was sterile. In other words, all wounds need to be properly cleaned.
• Saline solution is the best option for cleaning the wound, but if that's unavailable, clean water is your next best choice.
• You can make your own saline solution by dissolving one tablespoon of salt in one cup of warm water.
• When cleaning the wound, the victim will likely feel pain, so be sure to warn them if they are still conscious.

Bandage the wound. Do not bandage the wound while it's still dirty, as all stab wounds are considered contaminated. Proper bandaging protects the wound from external contaminants like dust, preventing infection. The wound should be covered with a gauze soaked in saline solution, then loosely wrapped with adhesive tape. In this case, wrap it lightly without tightening, as you only need to wait for the blood to clot.

• If you have received medical training or are certain the wound is clean, you may securely bandage the wound. First, ensure the wound is dry. If you have adhesive, apply it around the edges of the wound (not directly on it). Place one end of the tape on the wound, and gently close the skin gap before securing the rest of the tape. Cover the wound with clean cloth, adhesive cloth, or whatever is available to prevent dirt from reaching the wound and causing infection. Be sure to change the bandage daily.
• If the wound is still bleeding heavily, DO NOT cover it with a bandage.

Apply antibiotic ointment if available. If you have antibiotic ointment, apply it to the wound at regular intervals to prevent infection from setting in.

Ensure the bandage isn't too tight. Check the area furthest from the heart on the bandaged limb. For example, if the wound is on the arm, check the fingers. If it's on the leg, check the toes. Tight bandages can restrict blood flow to the area beyond the bandage, which is dangerous as it can lead to permanent tissue damage. You can easily identify this issue, as the affected area will change color (becoming blue or dark). If you notice these signs, loosen the bandage and seek help as soon as possible.

• If you don't have enough supplies, try to use sterile gauze to cover the wound, and then secure it with makeshift items such as a towel, shirt, etc., over the gauze.
• Although cleaning the wound will cause pain (unless you use purified water), this pain is a clear indication that the wound is being properly disinfected.