First Aid in Bleeding and Wounds PDF

First aid in Bleeding and Wounds Dr. Sija Binoy Lecturer College of Nursing September 4, 2024 www.gmu.ac.ae Good Samaritan Law Offer legal protection to people who give reasonable assistance to those who are, or whom they believe...

First aid in Bleeding and Wounds Dr. Sija Binoy Lecturer College of Nursing September 4, 2024 www.gmu.ac.ae Good Samaritan Law Offer legal protection to people who give reasonable assistance to those who are, or whom they believe to be injured, ill, or otherwise incapacitated. With the introduction of the ‘Good Samaritan’ law in the United Arab Emirates, approximately 78% of the public is willing to help a person in need. In November 2020, the UAE became the first Arab country to pass this law, permitting bystanders to provide medical aid during emergencies without the fear of any legal consequences.  Background Generally, bleeding of a minor nature includes small cuts, abrasions, etc. However, bleeding may be severe and life threatening if a large vein or artery has been injured – eg. Jugular vein in the neck, brachial artery in arms. Some wounds are associated with other injuries which can be situated beneath the skin – eg. an organ injured by stabbing; broken bones which have pierced the skin. Symptoms and signs- Not all may be present A wound with or without - an embedded foreign object Pain on skin surface of wounds Bruising or discoloration of the skin Loss of normal function in the injured area Pale, and cold skin  Bleeding Bleeding (also known as hemorrhaging) often occurs after an injury. Additionally, it can be the result of a disease. Bleeding occurs when blood vessels becomes damaged. Bleeding injuries can happen outside of the body (external bleeding) or inside the body (internal bleeding). Bleeding- Types A. External bleeding – refers to blood coming from an open wound. B. Internal bleeding – refers to blood not seen outside and skin is not broken (skin is intact). It can be difficult to detect. Appears bluish or greyish or maroon in color.  External Bleeding- Three types for identification - Capillary (oozing) - Blood oozes from capillaries. It is not serious and can be controlled easily. In this type of bleeding, it will clot and stop by itself. Venous (flowing) – Blood flows steadily. It is easier to control than arterial bleeding. Arterial (spurting) – Typically bleeding from an open artery. Serious type because a large amount of blood can be lost in a very short period of time. Arterial bleeding is less likely to clot because blood can clot only when it is flowing slowly. https://youtu.be/_4hjD_Ykgn8 ARTERIAL BLEEDING- Bright red in color due to high oxygen content VENOUS BLEEDING – Dark red in color due to low oxygen content CAPILLARY BLEEDING - Dark red in color – from damaged capillaries CAUTION DO NOT come in direct contact with blood or body fluids with bare hands. Protect yourself with gloves, extra gauze pads, or clean cloths or have the victim apply the direct pressure. If you have to use bare hands, do so only as a last resort. After the bleeding has stopped and the wound has been cared for, vigorously wash hands with soap and water. DO NOT use direct pressure on an eye injury, especially a wound with an embedded object or a skull fracture. DO NOT remove a blood-soaked dressing. Doing so can pull off clots that have already formed. Apply another dressing on top and continue putting pressure over the wound. Care for External Bleeding- 1. Apply firm pressure over the wound. Use a sterile or clean bulky pad and apply it firmly with hand pressure. Apply a bandage to keep the dressing in place. If bleeding is severe, DO NOT waste time looking for suitable padding, but be prepared to use the patient’s hand or your hand to hold the wound together if the patient is unable to do this unaided.  Care for external bleeding contd……… 2. Raise the injured area If the wound is on a limb, raise it in a supported position to reduce blood flow to the injured area. If an arm is injured, you can apply an arm sling or elevation sling. Use disposable gloves if possible. If gloves are not available, place your hands inside a plastic bag. If there has been any contact (splash on skin) with blood or any other body fluids, wash your hands and skin thoroughly with soap and water as soon as possible after the incident. Care for external bleeding contd……… 3. If a foreign body is embedded in the wound DO NOT remove it but apply padding on either side of the object and to avoid pressure on the foreign body. Hold the padding firmly in place with a roller bandage or folded triangular bandage applied in a criss-cross method to avoid pressure on the object. Care for external bleeding contd……… 4. Keep the patient at total rest Even if the injury involves the arm or upper part of the body, the patient should rest in a position of greatest comfort for at least 10 minutes to help control the bleeding. 5. Seek medical assistance If the wound appears to be minor and the patient is able to travel, arrange an urgent appointment with a local doctor to assess and treat the injury. If the injury is severe or the patient is very unwell – call 998 for an ambulance as soon as possible. While waiting for an ambulance to arrive, observe the patient closely for any change in condition. Internal Bleeding Causes: Damage to blood vessel Certain medications Gastrointestinal causes – peptic ulcer, gastritis Broken bones Accidents Recognizing internal bleeding- The signs of internal bleeding are: Bright red blood vomitus from mouth or bleeding per rectum or blood in the urine. Vomited blood which can be bright red, dark red or look like coffee ground. Black, foul-smelling, tarry stools Pain, tenderness or swelling Mostly -Bruises over the lower chest or a rigid abdomen. Wounds- An injury to living tissue caused by a cut, blow, or other impact, typically one in which the skin is cut or broken. An open wound is a break in the skin’s surface resulting in external bleeding. It may allow bacteria to enter the body, causing an infection. There are different types of open wounds. Types of open wounds 1.) Abrasion - Top layer of skin is removed, with little or no blood loss. Abrasions tend to be painful because the nerve endings 2.) Laceration –skin cut with jagged, irregular edges. This type of wound is usually caused by a forceful tearing away of skin tissue. 3.) Incision – Tend to have smooth edges and resemble a surgical or paper cut. The amount of bleeding depends on the depth, the location and the size of wound. Types of open wounds contd………… 4.) Puncture – Usually deep, narrow wounds in the skin and underlying organs such as stab wound from a nail or a knife. 5.) Avulsion – A piece of skin and/or underlying tissue is torn loose and is hanging from the body or completely removed. This type of wound can bleed heavily. Often involves ears, fingers and hands. 6.)Amputation – Involves cutting or tearing off of a body part such as finger, toe, hand, foot, arm or leg. Wounds That Require Medical Attention Arterial bleeding Uncontrolled bleeding Deep wounds Large or deeply embedded objects Human or animal bite Cut eyelid Internal bleeding Wound Infection - Signs of infection Swelling around the wound Redness A sensation of warmth Throbbing pain Pus discharge Fever Seek medical care for infected wounds. Get tetanus booster shot every 10 years.  Covering a wound If the wound is small and does not require sutures, cover it with a thin layer of antibiotic ointment. These ointments can kill many bacteria and rarely cause allergic reactions. Cover a small or large wound with a sterile dressing. Do not close gaping or dirty wounds with tape or butterfly bandages. Bacteria may remain, leading to a greater chance of infection. Large, deep or contaminated wounds should be managed by a medical professional. If a wound bleeds after dressing has been applied and dressing becomes stuck, leave it on as long as the wound is healing.