Without delay, press a thick pad of any cloth that’s handy directly on a severe wound. Use towels, socks, handkerchiefs. Never mind if you can’t get to sterile gauze pads; infection is less worrisome than bleeding. Don’t lift the pad to see what’s happening; that will renew the bleeding. If the pad gets saturated, top it with another and keep pressing.
When bleeding stops or slows, apply a pressure bandage: place the center of a strip of cloth, a necktie, or the like over the pad and wrap it tightly around arm, leg, head, or torso. Tie the bandage over the wound. For a very severe wound, someone should apply pressure manually all the way to the hospital.
If an arm or a leg is wounded, keep the limb elevated while you press, unless you suspect a fracture. An arm can be held upright by another person, a leg can be propped straight against anything suitable, even a bystander.
Elevating the limb and applying direct pressure may not stop the bleeding. Find the place where the main artery above the wound comes close enough to a bone to be squeezed against it, and press that place. At the same time, continue direct pressure on the wound itself. For a leg wound, press the heel of your hand into the groin; for an arm wound, press the flat of your fingers into the upper arm.
In the case of very severe injury or an accident where there might be internal bleeding, keep the injured person warm and lying down until medical care arrives. Keep the head lower than the body unless the victim is unconscious or you suspect a head, neck, or back injury .