Chapter 8Bleeding

Bleeding

• Average-size adult has 5 to 6 quarts(5 to 6 L) of blood.− Rapid blood loss can lead to shock and death.

• Loss of 1 quart (1 L) in adult• Loss of a half quart (0.5 L) in child

• Hemorrhaging− Loss of a large quantity of blood in a short

amount of time

Types of External Bleeding

• Arterial (spurting)• Venous (flowing)• Capillary (oozing)

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Body’s Response to Bleeding

• Body responds naturally to bleeding− Blood vessel spasm

• Severed blood vessels draw back and constrict.− Clotting

• Platelets form clot.• Serves as a protective covering for wound

Care for External Bleeding

• Wear gloves.• If no gloves, improvise with other materials.• Expose wound to find source of bleeding.

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Care for External Bleeding

• Place sterile gauze pad or clean cloth over wound.

• Apply pressure.• Hold direct

pressure for at least 5 minutes.

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© Jones & Bartlett Learning.

Care for External Bleeding

• If the bleeding does not stop within 10 minutes:– Add dressings and

press harder over a wider area.

• Apply a pressure bandage over the dressing.

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© Jones & Bartlett Learning.

Care for External Bleeding

• If the bleeding continues, call 9-1-1.− Consider using a

tourniquet if severe bleeding from an arm or leg cannot be stopped.

• Dispose of gloves and wash your hands.

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© Jones & Bartlett Learning.

Bleeding is Controlled: What to Do

• Care for the wound.• If needed, seek medical care for:

– Cleaning– Stitches– Tetanus immunization

Bleeding Continues: What to Do

• Apply a manufactured tourniquet.– If a manufactured tourniquet is not available,

apply an improvised tourniquet.– DO NOT cover, release, or remove.– Write “TQ” and the time it was applied on a

piece of tape, and apply it to the forehead.• Call 9-1-1, or drive the person to a medical

facility.

Bleeding Still Continues: What to Do

• Apply a hemostatic dressing if:– Direct pressure is not

effective– A tourniquet is not available,

is ineffective, or cannot be applied

Courtesy of Z-Medica.

Applying a Manufactured Tourniquet

• Apply the tourniquet about 2 inches above the wound.

• Twist the rod until the bleeding stops.

• Secure the rod in place.

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© Jones & Bartlett Learning.

Applying a Manufactured Tourniquet

• Write “TQ” (for tourniquet) and the time it was applied on a piece of tape, and stick it on the person’s forehead.

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Applying an Improvised Tourniquet

• Use a triangle bandage, wide roller bandage, or similar cloth folded into a long band about 2 inches wide and several layers thick.

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Applying an Improvised Tourniquet

• Wrap the band twice around the arm or leg about 2 inches above the wound and tie a knot.

• Place padding underneath the band.

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Applying an Improvised Tourniquet

• Place a short rigid object onto the knot and then tie a square knot over it.

• Twist the object until the bleeding stops.

• Secure the object.

© Jones & Bartlett Learning.

© Jones & Bartlett Learning.

Applying an Improvised Tourniquet

• Write “TQ” (for tourniquet) and the time it was applied on a piece of tape, and stick it on the person’s forehead.

© Jones & Bartlett Learning.

Internal Bleeding: What to Look For

• Bright red blood from mouth or rectum, or blood in urine

• Vaginal bleeding (nonmenstrual)• Vomited blood• Black, foul-smelling, tarry stools • Pain, tenderness, bruising, or swelling• Broken ribs, bruises over chest, or rigid

abdomen

Internal Bleeding: What to Do

• Monitor breathing.• Expect vomiting.• Treat the person for shock.• Treat internal bleeding in an extremity by

applying a splint.• Seek immediate medical care.

Bruises: What to Do

• Apply an ice pack over the injury for 20 minutes.

• If arm or leg is bruised:– Apply an elastic compression bandage.– Place several layers of gauze pads or other

cloth between the bandage and injury.