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