First Aid Bleeding and Wounds PDF

Prepared by Dr. Asmaa Ramadan Biochemistry Lecturer First aid in bleeding and wounds (The human Wounds body, assessing the victim).................................................

Prepared by Dr. Asmaa Ramadan Biochemistry Lecturer First aid in bleeding and wounds (The human Wounds body, assessing the victim)............................................................ 1 Types of Wounds………………..…1&2 How wounds heal...................................3 Bleeding..........................................................4 Types of Bleeding………………..…….4 What to do in case of bleeding.……….5 DRATES BIOLOGICAL Dr. Asmaa Ramadan ǀ First Aid 1 IMPORTANCE  Wounds When a blood vessel is damaged, the vessel constricts, and a series of chemical reactions occur to form a blood clot – a “plug” over the damaged area. If large blood vessels are severed, uncontrolled blood loss may occur before clotting can take place, and shock may develop. Wounds can be classified into a number of different types, depending on the object that produces the wound – such as a knife or a bullet – and the manner in which the wound has been caused. Types of Wounds: Incised wound caused Laceration caused by Abrasion (graze) by a clean surface cut blunt forces result in caused by a sliding from a sharped edged tears. fall or a friction burn. object such as a razor. These wounds may This is a superficial Blood vessels are cut bleed less profusely wound. The topmost straight across. than incised wounds, layers of skin are Structures such as but there is likely to scraped off, leaving a tendons or nerves may be more tissue raw, tender area. be damaged. damage. They can contain Lacerations are often foreign particles that contaminated with may cause infection. germs, so the risk of infection is high. Dr. Asmaa Ramadan ǀ First Aid 2 Contusion caused by a Puncture wound Stab wound caused by blunt blow can rupture caused by a nail or a sharp instrument, capillaries beneath the being pricked by a usually a knife, skin, causing blood to needle will result in a penetrating the body. leak into the tissue. puncture wound. -Stab wounds to the -This process results -It has a small entry trunk must always be in bruising and site but a deep track of treated seriously swelling may indicate internal damage. because of the danger deeper damage, such Germs and dirt can be of injury to vital as a fracture or an carried far into the organs and life- internal injury. body, the infection threatening internal risk with this kind of bleeding. wound is high. Gunshot wound caused by entrance of a bullet or missile into the body. -The entry wound may be small, and the exit wound may be large. -Resulting in serious internal injury and sucking in clothing and contaminants from the air. Dr. Asmaa Ramadan ǀ First Aid 3  How wounds heal? When a blood vessel is damaged. 1- It constricts in order to prevent blood from escaping. 2- Injured tissue cells at the site of the wound, together with platelets trigger a series of chemical reactions that result in the formation of a substance that forms a mesh. 3- This mesh traps blood cells to make a blood clot (a jelly like mass). The clot releases a fluid known as serum, which contains antibodies & specialized cells; this serum begins the process of repairing the damaged area. 4- Fibroblast cells form a plug within the clot then dries into a crust that protects the site of the wound until healing process is complete. Dr. Asmaa Ramadan ǀ First Aid 4  Bleeding The average adult blood is 5-6 L. Blood is moved around the body under pressure by the heart & blood vessels. Bleeding may result in a drop in blood volume and blood pressure, which could result in shock or death. Types of bleeding: ✓ According to type of blood vessel: 1- Bleeding from arteries, (which carry oxygenated blood under pressure from the heart) is plentiful, spray out with each heartbeat. If a main artery is ruptured, the volume of circulating blood will fall rapidly. 2- Bleeding from veins, (which carry deoxygenated blood & darker red & is under less pressure than arterial blood). 3- Bleeding from capillaries, blood that flows slowly from a superficial wound. ✓ According to the site of bleeding: 1- Internal bleeding: the bleeding is not apparent. 2- External bleeding: an obvious & apparent bleeding. Internal bleeding Causes Caused by injuries in the body or a disease, as hemophilia, ulcer, pulmonary tuberculosis. Sites of indication of internal bleeding (body openings): Ear, mouth, nose or urethra, vagina, or anus. Recognition: Pale, cold skin & may turn blue-gray. Rapid, weak pulse, Pain. Rapid, shallow breathing, confusion, restlessness. Possible collapse & unconsciousness. External bleeding Causes Caused by injuries outside of the body. Sites of indication of external bleeding - Any place outside of the body. Dr. Asmaa Ramadan ǀ First Aid 5  What happened? - If not controlled, shock may develop & the person may lose consciousness. - Bleeding from the mouth or nose may affect breathing. - When treating severe bleeding, check first whether there is an object embedded in the wound. Aims & caution: - To control bleeding to prevent and minimize the effects of shock. - To minimize infection. - Take care not to press directly on the object. - Do not allow the casuallity to eat or drink as an anesthetic may be needed. What to do in case of bleeding (Procedures)? 1- Remove or cut clothing as necessary to expose the wound. 2- Apply direct pressure over the wound using a sterile dressing at the point of bleeding or ask the casualty to apply direct pressure himself. 3- Raise & support the injured limb above the level of casualty’s heart to reduce blood loss. 4- Help casualty to lie down on a carpet or blanket to protect him from the cold. Since shock may develop, raise & support his legs above the level of his heart. Ask a helper to call 123, give the hospital details of the site & extent of bleeding. 5- Support the injured part in a raised position with bandage that is firm enough to maintain pressure, but not so tight that it impairs circulation. 6- Check the circulation beyond the bandage every 10 min. If the circulation is impaired, loosen the bandage & reapply. 7- Monitor & record vital signs while waiting for help to arrive. Dr. Asmaa Ramadan ǀ First Aid 6  If there is an object in the wound: 1. Control bleeding by pressing firmly on either sides of the embedded object to push the edges wound together. 2. Do not press directly on the object or remove it. Put a piece of gauze over the object to protect the wound. 3. Build up padding on either side, then carefully bandage over the object without pressing on the object. Dr. Asmaa Ramadan ǀ First Aid 7 ✓ Other types of bleeding: Abdominal bleeding: - A stab wound, gunshot, or crush injury can rupture organs & large blood vessels. There may be external and internal bleeding and protruding abdominal contents. Amputation: - A limb that has been partially or completely cut off can be reattached by microsurgery. - Caution: ✓ Do not wash the detached part. ✓ Do not let the detached part touch the crushed ice. ✓ Wrap the detached part in plastic wrap or plastic bag & place it in a container full of crushed ice. ✓ Mark the container with injury time & the casualty’s name. ✓ Do not allow the casualty to eat or drink because an anesthetic may be needed. Bruising: - Can develop rapidly a few days after injury. - Elderly people and those taking anticoagulants, such as aspirin or warfarin, can bruise easily. - Support the injured part in a comfortable position and place a cold compress over the bruise for at least 10 min. Finger wound and wound to the palm: 1- Clean with soap & water if wounded finger or palm has broken skin. 2- Press a sterile dressing on the wound and apply direct pressure to control bleeding. 3- Raise & support the injured hand & maintain pressure on the wound until the bleeding stops. 4- Cover the wound to protect it with adhesive dressing secured with a tubular gauze bandage. Dr. Asmaa Ramadan ǀ First Aid 8  Nosebleed (Epistaxis): Causes: - Tiny blood vessels inside the nose are ruptured, either by a blow to the nose, or as a result of sneezing, high blood pressure & anti-clotting medication. If follows a head injury & the blood may appear thin & watery as this indicates that the skull is fractured & fluid is leaking from around the brain. Caution and aims: - Do not let the casualty move his head back because blood may then run down the throat & induce vomiting. - Maintain an open airway and control bleeding. Procedure: 1- Tell the casualty to sit down & tilt his head forward to allow blood to drain from the nose. Ask him to breathe through his mouth (this will have a calming effect) & to pinch the soft part of his nose for up to 10 min, holding constant pressure. 2- Advise the casualty not to speak, swallow, cough, spit, since this may disturb blood clots that have formed in the nose. Give him a clean cloth or tissue to clean up any dribbling. 3- Release the pressure. If bleeding not stopped, tell him to reapply the pressure for two further periods of 10 min. 4- Clean around his nose with water if bleeding has stopped & the casualty still leaning forward, Advise him to rest for a few hours & avoid effort & not to blow his nose (disturb clots). 5- If the nosebleed is severe, or lasts longer than 30 min, arrange to send the casualty to the hospital. Dr. Asmaa Ramadan ǀ First Aid 9