Bleeding:

Description:

Bleeding, technically known as haemorrhaging, is the loss of blood from the circulatory system. Bleeding can occur internally where the blood leaks inside the body or externally (possibly via a opening such as ear, nose, mouth, anus (back passage), vagina or through the skin.

 

Typically a healthy person can endure a loss of up to 10-15% without having a serious medical problem. If you were to be a blood donor a typical donation would take about 8%.

 

Types of bleeding can be either:

  • Arterial (bright red and spurting as it is under pressure).
  • Venous (dark red) and under less pressure, it gushes rather than spurts.
  • Capillary (bluish bruising under the skin). The most common form that occurs in all minor wounds and oozes out.

 

Types of wounds:

  • Incisions or Incised wounds (clean cut caused by a sharp edge such as a knife or piece of glass).
  • Laceration (irregular, tear-like wound, possibly caused by a blunt object).
  • Abrasion (superficial, such as a graze in which the topmost layer of the skin is scraped off).
  • Contusion More commonly known as a bruise (blunt blow rupturing the capillaries).
  • Puncture (an object has penetrated into the skin).
  • Gunshot (bullet or missile under force penetrates the skin).

 

Treatment:

SEEP. will assist you in remembering the treatment procedure (see below).

 

External bleeding:

  • S - Sit or lay: Sit or lay the patient down.
  • E - Examine: Examine wound for any foreign objects.
  • E - Elevate: Elevate the wound if possible above the level of the heart.
  • P - Pressure: Apply direct or indirect pressure.

 

Direct Pressure:

Placing pressure on the wound will constrict the blood vessels manually, helping to stem any blood flow. Keeping the wound above the level of the heart will decrease the pressure at the site of the wound and therefore reduce bleeding (this applies mainly to limbs and head, however if a fracture (break) was suspected in a limb it should not be moved. 

 

  • Wear gloves.
  • Apply direct pressure over the wound using patient's own hands, preferably with a layer of gauze between to minimize infection.
  • Apply a dressing large enough to cover the wound.
  • Apply firm pressure, but not tight enough to stop the flow of blood to the rest of the limb.
  • If an inbreeded object is still in the wound apply pressure to both sides of the wound. Objects should NEVER be removed.

 

Indirect Pressure:

In situations where direct pressure and/or elevation are not possible or proving ineffective then using pressure to constrict the artery which supplies the bleeding point is an option, but is the last resort.

  • Apply pressure to the artery supply the limb (for a maximum of 10 minutes).
  • Use two main pressure points.
  • Brachial, by using two fingers in the upper inside part of the arm just below the arm pit and Femoral using three fingers on the upper inside of the thigh bone (femur).

 

Dressings:

  • Should be large enough to cover the wound.
  • Apply the dressing firmly to control the bleeding.
  • Check dressing is not tight as to restrict the flow of blood.
  • If blood seeps through this dressing apply a further dressing.
  • If this does not work remove dressing and start again.

 

Internal Bleeding:

The treatment of internal bleeding is usually beyond the scope of simple first aid so should be considered as LIFE THREATENING. Medical advice should be sought immediately as inevitably surgical intervention will be required.

  • Internal bleeding takes place within our body.
  • Can be the result of inquires - trauma to the chest or abdomen, spontaneously such as bleeding from an artery (aneurism) or stomach.
  • Bleeding can also take place within the skull i.e. from the brain.
  • Shock may develop rapidly in your patient.

 

Signs & Symptoms:

  • Pain, or history of a (recent blow or fall).
  • Bruising – swelling.
  • Blood may be discharged from various orifices of the body.
  • Rapid weak pulse.
  • Pale clammy skin.
  • Fast, shallow breathing.
  • Deep, sighing breathing (Air hunger).
  • Blue colour to lips.
  • Nausea or vomiting.
  • Decreasing level of consciousness (AVPU) Alert – Voice – Pain – Unresponsive.
  • Confusion.

 

Treatment:

  • Lay patient down flat with their legs raised.
  • Dial 999.
  • Keep patient warm, but do not overheat.
  • Do not allow patient to have food or drinks or smoke.
  • Be prepared for patient to go unconscious (place in recovery position).

 

CAUTION:

  • Embedded objects should not be removed.

 

 

We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.

 

You might also be interested in our blog. One of our more popular articles is about quality or quantity when it comes to first aid training.

 

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