First Aid Bleeding PDF

Haemorrhage Prepared by Dr/ Salwa Hasan  Learning Objectives: Define the bleeding. Identify types of bleeding. List types of external bleeding. Identify sign of haemorrhage. Discus how to control bleeding.  Definition of hemorrhage Massive loss of blood from the...

Haemorrhage Prepared by Dr/ Salwa Hasan  Learning Objectives: Define the bleeding. Identify types of bleeding. List types of external bleeding. Identify sign of haemorrhage. Discus how to control bleeding.  Definition of hemorrhage Massive loss of blood from the blood vessels due to injuries, both external and internal.  Types of Bleeding according to source Capillary Hemorrhage Venous Hemorrhage Arterial Hemorrhage  Types of Bleeding according to situation 1- Internal Bleeding 2- External bleeding Definition of INTERNAL BLEEDING Is bleeding that flows into a body cavity, an organ, or between tissues (no obvious blood flow).  Signs and symptoms Bruises. Pain. Rapid weak pulse. Tenderness or swelling at site of injury Cold and clammy skin Nausea and vomiting Excessive thirst Drop in blood pressure Decrease level of consciousness Hemoptysis. Hematemsis Hematuria. Melena  S&SAppear in case of internal bleeding Hemoptysis: coughing blood Haematemsis: vomiting blood. Haematuria: blood in urine. Melena: black stool which indicate bleeding in GIT  First Aid Of Internal Bleeding 1- Lay the victim down with his head low and to one side to ensure a good blood supply to his brain& prevent aspiration if vomiting occur.  2-Lossen any constricting clothing around his neck, chest and waist. 3-Reassure him and explain the necessity for him to relax. 4-Check breathing and pulse rate and level of responsiveness at 10-minutes intervals. 5-Examine the victim for other injuries and treat as necessary. 6- If he becomes unconscious, keep his air way open and check breathing and complete the ABC. 7- Keep the victim covered and place a blanket under him. 8- Keep a record of any specimen passed or vomited by the victim. Do not give the victim any thing by mouth  External haemorrhage Definition: Is bleeding that can be seen coming from a wound.  Types of external bleeding: According to the type of blood vessel that has been injured: 1. Arterial bleeding. 2. Venous bleeding. 3. Capillary bleeding.  1. Arterial bleeding: It is the most serious type of external bleeding. It is blood loss from an artery which carries blood away from the heart. Fortunately, it is the least common type of bleeding since arteries are situated deeper in the body. It is bright red in color and spurts from the wound.  2. Venous bleeding: It is blood loss from veins which conduct blood back to the heart. It is dark blood because it is nonoxygenated. It is more controllable than arterial bleeding because blood flow in the veins under less pressure than in the arteries. It should be controlled quickly because of: Potential severe blood loss. Consequents reduction in venous return. Danger of an air embolus (air bubble) may arise from air being sucked into a damaged vein.  3. Capillary bleeding: It is oozing of blood from the wound in minor cuts, abrasions and scratches. It is controlled by first aid procedures and the body’s normal clotting mechanisms.  Signs and symptoms Obvious bleeding ·Thirst. Cold & clammy skin. · Shallow respiration Decrease level of consciousness · Restlessness Weak, rapid pulse Drop in blood pressure  Dangers of Hemorrhage Blood loss Shock Death FIRST AID FOR BLEEDING IS INTENDED TO: * STOP THE BLEEDING *PREVENT INFECTION *PREVENT SHOCK  First Aid Of external Bleeding 1. Direct pressure Apply hard, firm direct pressure to the wound site with clean covering such as large, thick gauze of dressing or a clean material such as sanitary napkin or handkerchief. If the dressing soaked, don’t remove it, apply another dressing over the first and continue to apply pressure.  2. Elevation: Elevation of the injured area over the heart level. It is accompanied by direct pressure. It is immediately indicated unless it causes additional pain. The force of gravity reduces the blood pressure at the wound site so it can slow bleeding.  3. Pressure point Pressure points provide compression of major arteries against an underlying bone or muscle in an effort to close off the artery supplying the injured part and decrease the amount of bleeding. The pressure point is just above the wound. Pressure Points Temporal Facial Carotid Sub-clavian Brachial Radial Ulnar Femoral Popliteal Pedal  Temporal artery Compression of temporal artery which is located about 2.5 cm posterior to the corner of the eye and slightly above the angle, useful in controlling superficial wounds of the frontal part of the scalp or forehead.  Facial artery Can be found by finding the two little notches about 2.5 cm anterior to the angle of the jaw. It supplies blood to the face and lower jaw.  Carotid artery Located on each side of the neck lateral to the Adams apple. The 2 common carotid arteries supply blood to the head and neck so it compression is useful in controlling the serious hemorrhage from the head. Care must be taken not to obstruct the patient’s airway. Subclavian artery It supplies the arm and upper shoulder with blood flow. Pressure applied with fingers downward just behind clavical bone will control bleeding.  Brachial artery Located on the inner side of the upper arm between biceps and triceps muscles. Its compression stops bleeding from arm, hand and fingers.  Femoral artery The femoral artery is located near the groin where the legs join the trunk. Its compression stops bleeding of lower limb.  Radial artery The radial artery at the anterior surface of the wrist on the thumb side a be useful in controlling severe bleeding of the hand or fingers.  Ulnar artery Also on the anterior surface of the wrist but on the small finger side, also supplies the hand with blood. This should be used in conjunction with the radial artery to control bleeding of the hand. N.B. When correct pressure point is done numbness will be felt on injured area  4. Tourniquet: It is used when direct pressure, elevation and pressure point are used but bleeding continue and life could be lost without the use of tourniquet it should be avoided wherever possible because of the danger of nerve and blood, vessel damage. Commonly used when partial or complete accidental amputation has occurred.  Application of tourniquet Place the tourniquet between the heart and the wound but not touching the wound edges, if the wound is in a joint or just below a joint place the tourniquet just over the joint. Place a small pad over the supplying artery so that the pressure focuses on the critical area.  The appropriate material should be wrapped around the limb twice and a secure knot tied (wire or rope should never be used). A suitable strong object as strong stick should be inserted between the 2 loops and turned until bleeding has been controlled.  The tails of the cloth should then be wrapped around the object and tied in place. Indicate in a note the location of the tourniquet and the time it was applied and attach it in the victim’s clothing in an obvious place. Don’t cover the tourniquet with clothes. Don’t loosen the tourniquet unless a physician advises doing so. Transport the patient to a hospital as soon as possible.  Application of Tournique Tourniquets are to be used only as a last resort. Situations under which tourniquet is applied - At night - In mass casualties situation - Doctor’s advice - Amputation  Principles of Applying Tourniquet Apply as close to the wound as possible Do not apply at the joint The limb should be padded before the application of tourniquet The tourniquet should be exposed after application The date and time of application of tourniquet must be record. Thank You