Bleeding: Causes, Recognition, and First Aid Guide

Bleeding epidemiology and condition

Bleeding is the escape of blood from the blood vessels. In external bleeding, blood escapes the body through a surface wound. In internal bleeding, blood escapes from tissues inside the body.

In arterial bleeding-the blood is bright red and spurts with each heartbeat.

In venous bleeding-the blood is dark red and flows more steadily.

Recognition

Severe blood loss will result in the following signs and symptoms of shock:

• Pale, cold and clammy skin

• Rapid pulse, gradually becoming weaker

• Faintness, dizziness, thirst and nausea

• Restlessness and apprehension

• Shallow breathing, yawning, sighing and gasping for air

What to do

• Protect -protect yourself in order to avoid any direct contact with the blood (see below).

• Precaution-contact with a casualty’s blood Diseases can be transmitted via blood. In order to prevent any contact with the blood of the casualty, first responder must, if possible :

  -protect himself/herself by wearing gloves;

  -wrap his/her hand in a clean, impermeable plastic bag.

• Find and assess the bleeding-If there is no foreign body, apply firm and direct pressure over the wound with your fingers or the palm of your hand, using a sterile dressing or clean non-fluffy pad . If possible, ask the casualty to apply direct pressure himself.

• Help the casualty to lie down-this action allows you to get help from a bystander who can alert the emergency services. If nobody comes, call the emergency services.

• If there is a bystander, ask him/her to call the emergency services

• If there is no bystander, call the emergency services after transferring the compression using: a compression bandage; or the casualty's hand, if possible.

• Maintain direct pressure on the wound until the arrival of the emergency services

• Reassure the casualty and explain what is happening

• Wash your hands after providing first aid, if possible

• Protect the casualty against cold or heat

• Monitor if there is worsening of casualty’s condition

Checking circulation below an injury

Injuries and first aid procedures may reduce or cut off circulation to the tissue below the injury (called distal circulation):

• Dislocations and fractures can impinge on an artery.

• Swelling or bandaging can compress an artery.

• Blood vessel damage may reduce blood flow through an artery.

If oxygenated blood does not reach the tissues below the injury, after several hours there may be tissue damage that could lead to loss of the limb.

Check circulation below an injury before tying any bandages, then once again after tying the bandages. You may have applied the bandages too tightly or swelling may have made them too tight.

Check circulation below the injury by comparing the injured limb to the uninjured limb:

• Check skin colour—if the skin does not have same colour as the uninjured side, circulation may be impaired.

• Check skin temperature—if the skin temperature feels colder than the uninjured side, circulation may be impaired.

• Check for a pulse—at the wrist or ankle, and compare to the other limb.

• Check the nail beds—press on a fingernail or toenail until the nail bed turns white, and then release it. Note how long it takes for normal colour to return, and compare to the uninjured side.