First Aid for Cuts and Bleeding: A Workshop Guide

First aid for bleeding: the scene first, then the wound

The edge of a piece of sheet metal slides over the glove onto the wrist, a utility knife comes down on a finger instead of cardboard, or a breaking glass sheet cuts a forearm. First aid for bleeding at such moments is a few minutes of correct intervention; but the first step is to look at the scene, not the wound:

Stop the machine. If the injury happened on a machine, the machine is stopped and, if necessary, isolated. If there is amputation or crushing on a press or similar machine, follow the sequence in our article on first aid for amputation and crush injuries.
Protect yourself. Put on disposable gloves. Contact with blood is a risk for blood-borne infections.
Sit or lay the casualty down. A person who sees blood or is in pain may faint; do not treat them standing up.
Have 112 called if needed. If there is spurting bleeding, amputation, confusion or cold sweating, help is called immediately; the first aider continues treatment.

The number of first aiders in a workplace is determined by the hazard class: one first aider for every 20 workers in less hazardous, every 15 in hazardous and every 10 in very hazardous workplaces (Regulation on First Aid). For the limits of a first aider's authority, see our article on first aiders' duties and powers.

Recognising how serious the bleeding is

It is not always possible to tell the type of vessel by the colour of the blood. These signs are more reliable for making a decision:

Appearance	Likely situation	First response	Healthcare facility?
Oozing bleeding that slows within a few minutes	Superficial cut	Washing, direct pressure, clean dressing	Often not needed unless the wound is deep or dirty
Continuous bleeding that slows with pressure	Deeper cut	Continuous pressure, pressure dressing	Often needed; the need for stitches is assessed
Spurting or rapidly spreading bleeding	Major vessel injury	Immediate firm direct pressure, tourniquet if necessary	112
Little bleeding, but numbness or loss of movement in a finger	Nerve or tendon injury	Dressing, keeping still	Always

First aid for cuts: direct pressure and pressure dressing

The basis of first aid for cuts is direct pressure. The steps:

Place a clean gauze pad or cloth over the wound. If no materials are available, do not wait; press immediately with your gloved hand.
Press with the palm, firmly and continuously. Do not keep lifting it to check "has it stopped?"; apply uninterrupted pressure for at least 10 minutes.
If the cloth becomes soaked with blood, do not remove it; add a new one on top and keep pressing. Lifting the cloth underneath disturbs the clot that is starting to form.
Once the bleeding is under control, apply a pressure dressing: wrap a roller bandage over the cloth tightly enough to cover the wound and maintain the pressure.
Check that the bandage is not cutting off circulation: fingertips should not go pale, turn blue or become numb. If swelling increases after bandaging, the bandage is loosened and reapplied.
Keep the casualty warm, give nothing by mouth and monitor their condition.

Supporting measures such as raising the limb do not replace direct pressure. If there is a piece of glass or metal embedded in the wound, do not remove it; apply pressure around it while supporting the object in place, and send the person to a healthcare facility.

When is a tourniquet used, and what are its limits?

The answer to when to use a tourniquet is narrow: when there is life-threatening bleeding in an arm or leg that cannot be stopped with direct pressure, or when a limb has been severed. Current international first aid guidelines accept the tourniquet in these situations as a continuation of direct pressure; there is no place for a tourniquet in minor and moderate bleeding.

Position: A few centimetres above the wound, not over a joint. A tourniquet is not applied to the trunk or neck.
Tightness: It is tightened until the bleeding stops. An insufficiently tightened tourniquet can block venous return and increase bleeding.
Time: The time of application is written down and told to the medical team.
Loosening: The first aider does not loosen or remove the tourniquet; that decision belongs to the medical team.
Material: A commercial tourniquet is more reliable than an improvised one made with a belt or thin cord. Thin string, wire or cable is not used.

Workshop accident first aid examples: knives, sheet metal, glass

Each cutting source produces a different wound; a workshop accident first aid plan should know these differences:

Knives and utility knives: The cut has clean edges but can be deep. Tendon injuries are common in palm and finger cuts; if the finger cannot bend fully or sensation at the fingertip is reduced, the casualty is referred even if the wound looks small. For areas where knives are used continuously, such as slaughterhouses and meat processing, see our article on slaughterhouse and band knife safety.
Sheet metal edges and burrs: The wound may be long, irregular and dirty; metal dust and oil get into it. The wound is washed with plenty of clean water and not rubbed. For wounds caused by dirty and rusty objects, the workplace physician assesses tetanus vaccination status; for the vaccination plan, see workplace vaccination programme. For sheet metal work, see press brake and guillotine safety.
Glass: Small fragments may remain in the wound and may not be visible. With glass cuts, no attempt is made to clean inside the wound; it is assessed at a healthcare facility. For prevention, see our article on glass cutting and handling work.

Most cuts can be prevented with gloves of suitable cut resistance; for selection, use the TS EN 388 explanations in our article on choosing work gloves.

The hospital referral decision

If any of the following apply, the casualty is sent to a healthcare facility:

Bleeding does not stop despite at least 10 minutes of continuous pressure.
The edges of the wound gape, or fatty tissue or muscle is visible in the wound.
The wound is on the hand, a finger or over a joint and there is loss of movement or sensation.
A foreign body has remained, or may have remained, in the wound (glass, metal fragment).
The wound was caused by a dirty, rusty object and tetanus vaccination status is unknown.
The wound is on the face or the person takes blood-thinning medication.
The casualty is pale, sweating coldly, dizzy or has a change in consciousness.

When in doubt, refer. The first aider should not have to make the referral decision alone; there should be a consultation route agreed in advance with the workplace physician.

After the accident: recording, notification and prevention

Even a small cut is an occupational accident. Under Art. 14 of Law No. 6331 on Occupational Health and Safety, occupational accidents are recorded and notified to the Social Security Institution (SGK) within 3 working days after the accident; for details, see our article on notifying minor occupational accidents. After treatment, blood-contaminated surfaces are cleaned wearing gloves, supplies used from the cabinet are replaced the same day and the cause of the injury is investigated.

The first aider must also be protected. If the casualty's blood came into contact with an open wound, the eyes or the mouth of the first aider during treatment, the area is immediately washed with plenty of water and the incident is reported to the workplace physician the same day. The physician assesses whether follow-up is needed depending on the type of exposure. For the details of this approach, see our article on sharps injuries. The incident record includes the location of the injury, the tool or material involved, the treatment given, the referral status and the first aider's name; this record is an input both to the occupational accident investigation and to the review of the cabinet contents.

As Bursa Sistemer, in our workplace physician service we determine first aid supplies according to risk areas at workshops in Bursa and the surrounding provinces, write referral criteria together with first aiders, and add a bleeding scenario to emergency plan drills. For how to obtain a first aider certificate, see our article on the first aid certificate.

Frequently Asked Questions

How long should pressure be applied to a bleeding wound?

At least 10 minutes, without interruption. Lifting the cloth during this time to check the bleeding disturbs clot formation. If the cloth becomes soaked, a new one is added on top.

When is a tourniquet applied?

If there is life-threatening bleeding in an arm or leg that cannot be stopped with direct pressure, or if a limb has been severed. The time of application is noted and the tourniquet is not loosened until the medical team arrives.

Should iodine tincture or powder be put on a wound?

The Regulation on First Aid defines first aid as interventions without medication; the first aider does not apply medicines, powders, creams or traditional mixtures to the wound. Small cuts are washed with clean water and covered with a clean dressing; for deep wounds, pressure is applied and the casualty is referred.

How can you tell whether a wound needs stitches?

That decision is made by the healthcare facility. Wounds whose edges do not close by themselves, deep wounds and wounds over a joint may need stitches and should be assessed without delay.

Is a small cut also notified as an occupational accident?

Every incident falling within the definition of an occupational accident is recorded and notified to SGK within 3 working days after the accident. For details of the notification, see our article on notifying minor occupational accidents.