Bleeding Control in School Settings: Cuts, Scrapes, and Open Wounds

What “Bleeding Control” Means in a School

Bleeding control is the set of simple actions that help slow or stop blood loss while protecting you and the student from exposure. In school settings, most bleeding is minor (small cuts and scrapes), but the same core steps apply: protect yourself, apply firm direct pressure, cover the wound, and escalate when bleeding is not controlled or the injury is serious.

1) PPE and Barrier Methods

What to use

• Disposable gloves (preferred barrier for any contact with blood or body fluids).
• Eye protection if there is spurting blood or risk of splashes (e.g., active nosebleed with coughing, large wound).
• Mask if splashing is possible or per school policy.
• Barrier substitutes if gloves are not immediately available: clean gauze pads, a thick layer of paper towels, a clean cloth, or a plastic bag as a hand barrier. Use the cleanest option available and replace once gloves arrive.

How to put PPE into practice quickly

• Ask a nearby adult to bring the first aid kit and to notify the nurse/office if needed.
• Put on gloves before touching the wound or any blood-soaked materials.
• If you must start pressure immediately, use a barrier (gauze/paper towels) between your hand and the wound, then switch to gloves as soon as possible.

2) Direct Pressure Technique (and How Long to Hold Before Checking)

Step-by-step: direct pressure

1. Expose the area by gently moving clothing aside. If clothing is stuck to the wound, do not pull it off; apply pressure over it and seek help.
2. Place a sterile gauze pad (or clean cloth) directly on the bleeding site.
3. Press firmly with the flat part of your fingers or palm. Pressure should be steady and strong enough to slow/stop bleeding, but not so hard that it causes unnecessary pain.
4. Hold continuous pressure for at least 5 minutes before checking. Use a timer/clock if possible.
5. If bleeding continues, do not remove the first pad. Add more gauze on top and hold another 5–10 minutes of continuous pressure.

Key points that prevent re-bleeding

• Avoid “peek checks” every few seconds. Lifting the pad breaks early clotting.
• If the pad soaks through, add layers; do not rip off the original layer.
• Keep the injured part still. Movement can restart bleeding.

Practical example

A student scrapes a knee on the playground and it is oozing steadily. You glove up, place gauze, and hold firm pressure for 5 full minutes. When you check, it is still oozing. You add more gauze and hold another 5 minutes. Bleeding slows to a light smear; you proceed to dressing and bandaging.

3) Dressing and Bandage Application for Common Locations

Once bleeding is controlled (stopped or minimal oozing), cover the wound to protect it from dirt and reduce re-bleeding. Use sterile dressings when available.

General steps: dressing + bandage

1. Confirm bleeding is controlled with sustained pressure.
2. Place a clean/sterile dressing over the wound.
3. Secure with a bandage snugly enough to hold the dressing in place, but not so tight that it restricts circulation.
4. Check circulation beyond the bandage: warmth, normal color, ability to move fingers/toes, and normal sensation (no numbness/tingling). If any concern, loosen the wrap.

Hands and fingers

• Small cuts: after pressure, use a small adhesive bandage or a gauze pad with tape.
• Knuckle/finger joints: use flexible fabric bandages or wrap gauze and secure with tape so the student can bend slightly without the dressing popping off.
• Wrap direction: start below the wound and wrap toward the hand, overlapping by about half the width of the wrap.
• Do not tape too tightly around a single finger; check fingertip color and warmth.

Knees

• Use a larger non-stick pad if available; knees move and can stick to plain gauze.
• Figure-eight wrap (if trained/comfortable): wrap above the knee, cross over the front, wrap below the knee, and repeat to anchor. Keep it snug, not tight.
• Alternative: a wide elastic wrap around the knee with the knee slightly bent can help keep the dressing in place.

Elbows

• Position: keep the elbow slightly bent for comfort and to prevent the bandage from slipping when the student moves.
• Anchor above and below the elbow joint; consider a figure-eight pattern to reduce sliding.
• Check hand circulation after wrapping (warmth, color, movement, sensation).

When to re-check the dressing

• Re-check within 10–15 minutes for soak-through, slipping, or swelling.
• If blood soaks through, add another dressing on top and reinforce the wrap; do not remove the original dressing.

4) Embedded Objects: What Not to Remove and How to Stabilize

Do not remove embedded objects

If an object is stuck in the wound (e.g., pencil tip, piece of glass, wood splinter that is deeply embedded, metal fragment), do not pull it out. Removing it can worsen bleeding and tissue damage.

How to control bleeding around an embedded object

1. Put on gloves and expose the area carefully.
2. Apply pressure around the object, not directly on top of it.
3. Build a “donut” or bulky ring using rolled gauze or folded cloth around the object to prevent movement.
4. Secure the bulky dressing with a wrap or tape to stabilize the object in place.
5. Keep the area still and get the nurse/office involved immediately.

What not to do

• Do not “wiggle” the object to see how deep it is.
• Do not cut around the object or probe the wound.
• Do not apply a tight wrap that forces the object deeper.

5) Minor vs. Significant Bleeding: When to Call the Nurse or Emergency Services

Minor bleeding (typically manageable with basic first aid)

Examples: small scrapes, shallow cuts, mild oozing that stops with pressure.

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• Bleeding stops with 5–10 minutes of direct pressure.
• Wound edges are not gaping.
• No embedded object, no bite, no heavy contamination.
• Student is alert, stable, and pain is manageable.

Action: Control bleeding, dress/bandage, notify the nurse per school routine, and follow school policy for parent/guardian notification if required.

Significant bleeding (needs urgent escalation)

Use these school-friendly triggers to escalate quickly:

• Bleeding does not stop after 10 minutes of firm, continuous direct pressure (or resumes immediately when pressure is released).
• Blood is spurting or rapidly pooling.
• Large/deep wound, gaping edges, or visible deeper tissue.
• Embedded object or suspected foreign body that cannot be safely removed by non-medical staff.
• Amputation or partial amputation of a fingertip or other body part.
• Signs the student is becoming unwell (pale/clammy, dizziness, fainting, confusion, worsening weakness).
• Bleeding from the mouth with breathing concerns, or any bleeding associated with a serious mechanism (e.g., major fall) where additional injuries may exist.

Who to call and when (typical school workflow)

• Call the nurse/health office immediately for any significant bleeding, embedded objects, deep wounds, or if you are unsure.
• Call emergency services (or direct someone to call) when bleeding is severe/uncontrolled, the student shows concerning symptoms, or the injury appears life-threatening.
• Do not leave the student alone. Delegate: one adult stays, another retrieves supplies and makes calls.

6) Exposure Control and Cleanup Procedures (Per School Policy)

Handling blood-soaked materials

• Keep gloves on while handling used gauze, paper towels, or clothing with blood.
• Place contaminated materials into the designated biohazard bag/container if your school uses one; otherwise follow the school’s written procedure for regulated waste.
• If a student’s clothing is blood-soaked, handle it with gloves and follow policy for bagging and sending items home.

Cleaning surfaces

• Restrict access to the area (keep other students away).
• Use the school-approved disinfectant and follow required contact time (how long the surface must stay wet) per the product label/policy.
• Wear gloves during cleaning; add eye protection if splashing is possible.
• Dispose of cleaning materials per policy and wash hands afterward.

Hand hygiene

• Remove gloves safely (avoid touching the outside) and dispose of them properly.
• Wash hands with soap and water as soon as possible. If not immediately available, use sanitizer and then wash with soap and water when you can.

If you have an exposure

If blood contacts your broken skin, eyes, mouth, or you have a needlestick/sharp injury, follow the school’s exposure protocol immediately (wash/flush, report to administration/nurse, and complete required forms).

7) Documentation Essentials

Accurate documentation supports continuity of care, parent/guardian communication, and school policy compliance. Record facts, not assumptions.

What to document (minimum essentials)

Example documentation entry (template)

10:18 AM – Student sustained 2 cm abrasion to left knee on playground. Gloves worn. Direct pressure with sterile gauze for 5 min; continued oozing, added gauze and held additional 5 min. Bleeding controlled. Non-stick pad applied and secured with elastic wrap; circulation to foot normal (warm, pink, moves toes, normal sensation). Nurse notified at 10:30 AM; student escorted to health office. Parent notification per office procedure.