First Aid: Bleeding and Hemorrhage

Bleeding

• Bleeding, also known as hemorrhage, is the loss of blood from the body, which can occur internally or externally
• Blood loss can occur in almost any area of the body
• Internal bleeding occurs when blood leaks out through a damaged blood vessel or organ
• External bleeding happens when blood exits through a break in the skin

Stopping the Bleed

• Stop the flow of blood
• Wear gloves
• Cover the wound
• Apply pressure
• If a body part has been amputated, put it on ice

Types of Bleeding

• Arterial bleeding:
  • Blood spurts from the wound
  • Bright, red, oxygen-rich blood
  • Most difficult to control due to high pressure
• Venous bleeding:
  • Blood flows as a steady stream
  • Dark, oxygen-poor blood
  • Easier to control
• Capillary bleeding:
  • Blood oozes from a capillary and is dark red in color
  • Often clots spontaneously

Evaluating a Casualty

• Consider placing a pressure bandage or hemostatic dressing on the wound site or using a tourniquet
• Be aware of the risk of infectious disease from contact with blood or body fluids (HBV and HIV)

Bleeding Control

• Direct Pressure:
  • Apply steady, firm pressure
  • Use a clean cloth or bandage
  • Avoid contact
• Elevate the extremity if no fractures (lie down)
• Apply additional dressings and pressure if bleeding continues
• If bleeding does not stop, apply pressure points and additional dressings

Internal Bleeding

• Signs:
  • Discolored, tender, swollen, or hard tissue
  • Increased respiratory and pulse rates
  • Pale, cool skin
  • Nausea and vomiting
  • Thirst
  • Changes in level of responsiveness
• Can be from severely injured extremities with significant blood loss

Shock

• Causes:
  • Fluid loss (bleeding, burns, diarrhea, or vomiting)
  • Cardiac problems (heart attack, electrocution)
  • Anaphylaxis (severe allergic reaction)
• Signs and symptoms:
  • Pale, cold, clammy skin
  • Weak, dizzy, lightheaded
  • Nausea or vomiting
  • Thirsty
  • Yawning
  • Anxiety or irrational behavior
  • Rapid, weak pulse
  • Rapid, shallow breathing
  • Dropping level of consciousness

First Aid for Shock

• Symptoms:
  • Anxiety, confusion, agitation, restlessness, dizziness, cool, clammy, sweating, pale, rapid and shallow breathing, thirst, nausea, vomiting, not responsive
• Check for normal breathing and severe bleeding, treat for these
• Call 112/153
• Put victim on back, raise legs
• Loosen tight clothing
• Turn victim's head if vomiting occurs
• Keep victim warm with coat or blanket
• Give no food or drink, alcohol or tobacco
• Offer reassurance and comfort
• If unresponsive, put in recovery position

Nosebleed Care

• Sit upright and lean forward to reduce blood pressure in the veins of the nose
• Gently blow your nose to clear blood clots
• Spray both sides of your nose with a nasal decongestant containing oxymetazoline (Afrin)
• Pinch your nose using your thumb and index finger to pinch your nostrils shut
• Breathe through your mouth
• Continue pinching for 10 to 15 minutes
• Avoid peeking at your nose
• If bleeding continues, repeat holding pressure for another 10 to 15 minutes
• Seek emergency care if bleeding continues