classifications open-break in skin closed-no break in skin or mucous membrane…injury occurs to...

Bleeding and WoundsProviding First Aide

Wounds involve injury to soft tissues. classifications Open-break in skin

Closed-no break in skin or mucous membrane…injury occurs to underlying tissue

Open………… ………...closed

Complications

Bleeding Infection Tetanus (lockjaw)

› Serious infection caused by bacteria

Classification of wounds

Abrasion Skin is scraped off Bleeding limited Dirt and

contaminants often enter this type of wound….prevent infection

Incision Injury caused by sharp object (knife, scissors, razor)

Edges of wound smooth

If deep bleeding –heavy

Damage to muscles, nerves, tissues possible

Laceration Tearing of tissues by excessive force

Jagged, irregular edges

Bleeding-heavy Contamination may

lead to infection

Puncture Cause by sharp object (pin, nail, pointed instrument)

Bleeding-limited….but internal bleeding can occur

Chance of infection is increased

Tetanus may develop if tetanus bacteria present

Avulsion Tissues are torn or separated form the victim’s body

Can result in a piece of tissue hanging from the ear, nose, hand, etc.

Bleeding-heavy Care should be taken

to preserve the body part while caring for the wound

Amputation Body part is cut off and separated from body

Loss of finger, toe, hand or other body part

Care must be taken to preserve the body part…surgeon may be able to reattach

https://www.youtube.com/watch?v=9up5Hy5lMrE&oref=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3D9up5Hy5lMrE&has_verified=1

First aid-amputation Wrap part in cold

moist dressing Use sterile water or

normal saline if available

Place wrapped part in plastic bag to keep moist

Keep bag cool or put in ice water

NEVER place body part directly on ice

Transport body part with the victim

Controlling bleeding

First priority Possible to bleed to

death in short period of time

Types of bleeding

Arterial Blood spurts Heavy blood

loss Bright red LIFE

THREATENING

https://www.youtube.com/watch?v=-fFHikNgkuE

Venous Blood loss is slower, steady

Dark red, maroon

Easier to control

https://www.youtube.com/watch?v=0tpiWsGWwaw

Capillary Blood oozes

https://www.youtube.com/watch?v=Z-_JB6sErNI

Always use…..

Standard Precautions

Gloves Thick layers of

dressings Avoid contact of

blood with your skin

Wash hands ASAP after giving first aid to victim

Four main methods to control bleeding1. Direct pressure Apply pressure

directly to wound with dressing

If no dressing available-› Use clean cloth› In major

emergency may have to use bare hand….but this should be avoided if possible

Direct pressure cont.

Apply pressure 5-10 minutes

If blood soaks through…cont to add dressings

Do not disturb dressing….clotting

Pressure will usually stop bleeding.

2. Elevation Raise injured part above level of heart.

Gravity will decrease blood flow

Continue to apply direct pressure while elevating

Do not elevate if fractures suspected

3. Pressure bandage

Applied to hold dressing in place

Maintain direct pressure & elevation while applying pressure bandage

Check pulse site below bandage to make sure bandage is not too tight› Pulse present› No discoloration of

skin› Loosen or replace

bandage if circulation is impaired.

4. Pressure on pressure points

Used when other steps do not relieve bleeding.

Apply pressure to main artery and press it against underlying bone

Should not be used any longer than absolutely necessary

https://www.youtube.com/watch?v=a2zwU2c-HZo

2 main pressure points

Brachial artery-located half way between elbow and axilla (armpit)

Femoral artery in leg-located in groin

cont When bleeding stops…› Slowly release

pressure on pressure point

› Continue direct pressure & elevation

› If bleeding starts again, reapply pressure to pressure point

First aid for minor wounds without severe bleeding

Wash hands Gloves Wash wound with

soap and water› Wipe in outward

direction away from the wound

› Sterile gauze if available

› Discard gauze after each use….and use a new gauze each time

Signs of Infection

Swelling Heat Redness Pain Fever Pus Red streaks

Tetanus

Caused by clostridium tetani

Enters most commonly through puncture wounds

Causes painful muscular spasms that can lead to respiratory failure and in 40% death.

Embedded objects

Splinters Small pieces of glass Etc… Remove gently with

sterile tweezers or clean with alcohol or disinfectant

Objects embedded in tissues should be left in place and removed by physician

Closed wounds

bruise Cold applications to reduce swelling

Serious closed wounds

Internal bleeding may lead to death

s/s:› Pain› Tenderness› Swelling› Deformity› Cold and clammy› Rapid & weak pulse› Drop in B/P

Serious closed wounds cont…

Uncontrolled restlessness

Excessive thirst Vomited blood Blood in urine or

feces

Cont…

Get help ASAP Check breathing

and check for shock Avoid unnecessary

movement Avoid giving food or

fluid

Shock Shock is defined as a clinical set

of signs and symptoms that are associated with an inadequate supply of blood to body organs especially brain and heat.

Shock can lead to death even though victim’s injuries or illness may not be fatal

Can occur with any injury or illness requiring first aid.

Causes of Shock Hemorrhage or excessive loss of

blood

Excessive pain or infection

Heart attack or stroke

Poisoning by chemicals, drugs, or

gases

Lack of oxygen

Psychological trauma

Dehydration from burns, vomiting,

or diarrhea

8 Main Types of Shock Anaphylactic

Cardiogenic

Causes: allergic reaction to food, medications, insect stings, bites, or snake bites.

Blood pressure drops, Urticaria (hives) and respiratory distress may occur

Causes: damage to heart muscle from heart attack or cardiac arrest

Types of Shock cont.. Hemorrhagic

Metabolic

Causes: severe bleeding or loss of blood plasma

Decrease in blood volume causes blood pressure to drop

Decreased blood flow to body cells

Causes: loss of body fluid from severe vomiting, diarrhea, or a heat illness

Also caused by disruption in acid-base balance as occurs in diabetes. Blood Pressure drops

Types of Shock cont… Neurogenic

Psychogenic

Causes: Injury and trauma to brain and\or spinal cord

Blood vessels dilate and blood pressure drops

Causes: emotional distress such as anger, fear, or grief

Emotional response causes sudden dilation of blood vessels

Some individuals faint

Types of Shock cont.. Respiratory

Septic

Causes: Trauma to respiratory tract; respiratory distress or arrest (chronic disease, choking)

Causes: acute infection such as toxic shock syndrome

Blood pressure drops When shock occurs, the body

attempts to increase blood flow to the brain, heart, and vital organs by reducing blood flow to other body parts.

Signs and Symptoms of Shock Skin is pale or bluish-gray in

color; Check nail beds and mucous membrane around the mouth

Skin is cool or cold to the touch Diaphoresis or excessive

perspiration, clammy Rapid and weak pulse At times radial pulse is too weak

to be felt Check pulse at carotid artery of

this occurs Respirations are rapid, shallow,

and may be irregular

Signs and Symptoms cont.. Blood pressure is very low and may

not be obtainable General weakness Victim becomes listless and

confused Eventually victim looses

consciousness Anxiety and extreme restlessness Excessive thirst Nausea and\or vomiting Blurred vision Eyes appear sunken with vacant or

confused expression

Signs and Symptoms cont..

Pupils may become larger, or dilate

Tx. Obtain medical help for victim as soon as possible because shock is life threatning

Goals of Treatment for shock

Control Bleeding Provide oxygen if available Ease pain through position change Provide emotional support Improve circulation Maintain body temperature DO NOT move the victim unless it is

necessary to keep out of danger Keep victim lying flat on back to

improve circulation Raise feet 12 inches to provide

additional blood supply to heart and brain

Cont… Victim vomiting or has bleeding injuries of jaw or mouth

Position victim on side Prevents choking on blood, vomitus,

ect. Maintain body temperature Cover victim with blankets or

additional clothing Avoid overheating Avoid giving victim anything to eat

or drink If victim complains of excessive

thirst, use wet cloth to moisten lips and mouth and provide comfort