WOUNDS&

BLEEDING

Wounds• is damage to the soft tissue of the body,

including the blood vessels.• Open wound is when the top layer of skin has

broken; there is risk of infection, and of losing blood.

D – Direct pressureE – Elevate the affected partP – Pressure on the supplying arteryP – Pressure bandage

• Closed wound is when the skin does not break, but the soft tissue, including the blood vessels, is damaged;

• blood leaks into the tissue from the blood vessels

I – ice applicationC – CompressionE – Elevate the injured partS – Splinting (if necessary)

Kinds of open wounds:• Incision – clean cut

caused by a sharp-edged object

• Abrasions and lacerations – caused by an accident and can be a small graze (abrasion) or a deep, jagged opening in the tissue (laceration)

• Puncture or stab wound - caused by an object with a sharp point, such as a knife or nail

• Sucking chest wound – wound in the chest that has gone deep enough to make a hole in the lungs

• Gun-shot wound – this wound may have both an entry and an exit wound

• Amputations – a wound where an arm or leg or finger or toe has been completely or partly cut off

Abdominal wound

• If the abdominal contents do protrude through the wound, do not attempt to put them back, instead cover with a large dressing until further treatment given

• if the abdominal contents do not protrude, cover the wound with a large standard dressing and place the casualty in the half-sitting-up position

Bleeding

• Bleeding from small blood vessels occurs when there is a minor cut of the skin.

• Blood oozes from the wound; it usually stops by itself or when a dressing is applied.

• volume of blood loss depends on the number of blood vessels damaged

Bleeding

• The human body contains 5–6 Liters of blood.

• healthy adult can lose up to 500 ml of blood without a harmful effects,

• It should be controlled immediately to prevent excessive loss of blood.

Kinds of Bleeding:1. Arterial Bleeding–Bright red in color–Blood spurts from the blood

vessels2. Venous Bleeding–Dark red–Blood oozes from the

wound3. Capillary Bleeding–Dark red–Little blood can be lost–Clotting is spontaneous

The signs and symptoms of excessive loss of blood are:

• Weakness or fainting• Dizziness• Pale, moist and clammy skin• Fast, weak & irregular pulse• Shortness of breath• Restless

• The number of symptoms and their severity are generally related to how fast the blood is lost and in what amount.

• Once the bleeding has been controlled, the patient should be placed in a reclining position, encourage to lie quietly, and treated for shock.

In all cases of external bleeding, follow the three cardinal rules:

1. Lay the patient down;2. Examine the wound3. Elevate the affected part if possible;4. Provide pressure where the blood comes from.

Use a dressing or a clean cloth or handkerchief.5. tie a dressing firmly round the wound to

maintain the pressure;

• If possible disposable gloves should be worn to protect yourself.

• Do not disturb the dressings until you are prepared to undertake definitive treatment.

• The bleeding stops because of the formation of a clot.

• if blood continues to come through the dressing, apply another bandage on the top of the first one. Bandage more firmly.

• If you remove the dressing, the clot will break and bleeding will start again.

• keep the injured part as still as possible and the casualty at rest because movement disturbs (and destroys) the blood clot;

• after bleeding has been controlled, rest the limb

You can remember the treatment for severe bleeding as:

E – Expose the wound if under clothingX – Examine the woundP – Apply pressureE – Elevate (raise) the injured partC – Cover to prevent infectionT – Treat for shock

Tourniquets• device used to control severe bleeding• It is only required when large arteries are

severed• only used as an absolute last resort after

all other methods have failed• used only for life threatening

hemorrhage that cannot be controlled by other means

• Improper use of a tourniquet may cause tissue injury

Apply Tourniquet• If you do not have a specially designed

tourniquet, find a length of strong, pliable cloth like gauze or clothing such as a shirt or a skirt• Place the tourniquet around the arm or leg

between the wound • Tie a half-knot• Place a stick above the knot• Tie a full knot over the stick.• Twist the stick until the material is tight around

the limb

Your aims for bleeding:• Control blood loss.• Prevent infection.• Treat for shock, if necessary.• Try to arrange removal to the nearest health

facility, if necessary

As always, assess D R A B, respond as needed, and treat any more urgent conditions. Whatever kind of open wound you are dealing with, you should first control the bleeding; and then clean and dress the wound to stop infection.