Wound care far from help
What systematic reviews say about stopping bleeding, cleaning wounds and dressing burns, made practical for a household.
During
- Life-threatening bleeding: call for help, press hard directly on the wound, and use a tourniquet on an arm or leg if you're trained. 1 2
- Minor cuts: wash your hands, clean the cut with mild soap and water, press to stop bleeding, then cover with a clean non-stick bandage. 3
- Clean drinking water is a reasonable choice for washing a wound when saline isn't available. Trials found no clear difference in infection. 4
This guide is not a substitute for training or medical care. When you live far from help, a first aid course is one of the most valuable things you can buy.1
How we built this guide
We started with systematic reviews, which pool every good trial on a question, then used official first aid guidance for the steps. We tell you how strong the evidence is, because for many wound questions it’s weaker than people expect.
Severe bleeding
Follow the Red Cross steps: call for help and press firmly and steadily directly on the wound. For life-threatening bleeding from an arm or leg, apply a tourniquet if you’re trained. 1 Our severe bleeding guide has the full steps.
What the international evidence review (ILCOR) found:
- Tourniquet vs. direct pressure: ILCOR suggests first aid providers use a tourniquet rather than direct pressure alone for bleeding a tourniquet can reach. The recommendation is weak and the evidence very low certainty. 2
- Manufactured vs. improvised: ILCOR suggests a manufactured tourniquet over an improvised one, also a weak recommendation on very low certainty evidence. 2 Buy one; don’t plan to make one.
- Hemostatic dressings: ILCOR suggests a hemostatic dressing with direct pressure over direct pressure alone for severe bleeding, a weak recommendation on very low certainty evidence. 5
Cleaning a wound
For minor cuts: wash your hands, wash the cut with mild soap and water, press to stop the bleeding, then cover it with a clean bandage that won’t stick. 3
Do you need sterile saline? A 2022 Cochrane review of 13 randomized trials and 2,504 people compared water with other solutions. In 8 trials with 2,204 people, tap water versus saline showed no clear difference in infection (risk ratio 0.84, 95% CI 0.59 to 1.19), though the evidence was very low certainty. 4 In practice: if your water is safe to drink, it’s a reasonable choice for cleaning a wound. If it isn’t, treat it first.
Honey on burns
A 2015 Cochrane review of 26 trials and 3,011 people looked at honey dressings. For partial-thickness burns, honey healed wounds about 4.7 days faster than conventional dressings, with high-certainty evidence from 2 trials and 992 people. For most other wound types the evidence was too weak to draw conclusions. 6 The trials tested honey as a wound dressing. Get serious burns treated by a professional.
When to get help
Contact a health care provider if: 3
- The wound is deeper than a quarter inch (0.64 cm), on the face, or reaches bone. It may need stitches.
- You see signs of infection: warmth, redness, throbbing pain, fever, swelling, a red streak from the wound, or pus.
- You haven’t had a tetanus shot in the last 10 years.
Plan your route to the nearest emergency department before you need it.
Sources
- American Red Cross, Life-Threatening External Bleeding
- ILCOR, Control of Severe, Life-Threatening External Bleeding in the Out-of-Hospital Setting: Tourniquets (2019 CoSTR)
- MedlinePlus (U.S. National Library of Medicine), Cuts and puncture wounds
- Fernandez R, Green HL, Griffiths R, Atkinson RA, Ellwood LJ. Water for wound cleansing. Cochrane Database of Systematic Reviews 2022, Issue 9. CD003861
- ILCOR, Control of Severe, Life-Threatening External Bleeding in the Out-of-Hospital Setting: Hemostatic Dressings (CoSTR)
- Jull AB et al. Honey as a topical treatment for wounds. Cochrane Database of Systematic Reviews 2015. CD005083