Bleeding

Management

Ahmad Thanin

Objectives

• describes the steps or actions taken to control bleeding.

• Explain the effects of blood loss and the body’s mechanisms to control bleeding.

• Describe the different types of external bleeding.

• List the signs and symptoms of internal bleeding and describe the first aid to give.

Types of wounds

Incision: Straight edges to the wound margins, as if sliced with a knife

• Laceration: The wounded tissue is random rather than straight in direction, and may have multiple branches.

• Most often caused by an object with a broken or serrated edge, such as a piece of broken glass or metal,

• Puncture: Sharp object penetrates the tissue, and travels internally.

• Abrasion: A scraping or scratching. Generally quite superficial, and affecting only the surface layers of the epidermis.[7] No internal organs, nerves, or blood vessels other than capillaries, are affected

• Contusion: Simple bruising. In this type of injury, the capillaries in the epidermis and dermis are damaged, without breaking the skin.[8] Blood oozes out of these vessels into the spaces between cells or interstitial space, causing swelling and discoloration. Blood loss is generally limited, and not of serious consequence

• Avulsion: A full thickness laceration-type wound, often semi-circular in shape.

• Avulsions are difficult to repair, and no avulsion should ever be considered a minor injury.

Principles for bleeding

Sources of bleeding

Arteries

Veins

Capillaries

causes

• Trauma • Medical

conditions • Medicines

External Bleeding Management

Direct Pressure Method. a) Apply firm, direct pressure sufficient to stop the bleeding.

b) Apply pressure using hands or pad ensuring that sufficient pressure is maintained and that pressure remains over the wound.

c) To assist in controlling bleeding; where possible:

- elevate the bleeding part.

- restrict movement.

- immobilize the part.

- advise the victim to remain at total rest.

In Direct Pressure Method: a) Don’t remove the embedded object it may plugging the

wound and restricting bleeding.

b) Pace padding around or above and below the object and apply pressure over the pads.

Tourniquet method

• As a LAST resort and only when other methods failed. • It may be applied to a limb to control life – threatening

bleeding like traumatic amputations of limb or injury with massive blood loss.

Important

• Check the tourniquet every 10 to 15 minutes. If the bleeding becomes controllable, (manageable by applying direct pressure), release the tourniquet

Comment !!!

Internal Bleeding • Some times it difficult to recognize.• Signs and symptoms – Universal :

Pale Skin

Pain. Tenderness or swelling over or around the affected area.

Changing of vital signs (Tachycardia + Hypotension), Orthostatic hypotension

Drop of RBC, HgB, Platelets,

The appearance of blood from a body open: a) Bright red and / or frothy blood coughed up from the lungs.

b) Vomited blood which may be bright red or dark brown “ coffee grounds”.

c) Blood - stained urine, Vaginal bleeding.

d) Rectal bleeding which may be bright red or black “tarry”.

Remember • Blood tests may be performed to check for a low red

blood cell count, or anemia. However, if the bleeding occurs rapidly, the initial hemoglobin reading or red blood cell count may be normal.

• The initial treatment plan of any patient with internal bleeding begins with assessing the patient's stability and making certain the ABCs are well maintained.

Management

• Airway.• Breathing.• Circulation.• Blood Transfusion,• Fluids.• Surgery

DON’T 1. apply a tourniquet to control bleeding, except as a last

resort.

2. peek at a wound to see if the bleeding is stopping.

3. probe a wound or pull out any embedded object from a wound. This will usually cause more bleeding and harm

4. remove a dressing if it becomes soaked with blood. Instead, add a new one on top

5. try to clean a large wound. This can cause heavier bleeding

6. try to clean a wound after you get the bleeding under control. Get medical help

Thank You

Q & A