First Aid for Bleeding: Essential Steps for Treatment
Author:
CPR Select
Last updated:
10/18/2024
Bleeding is a common medical emergency that ranges from minor cuts and scrapes to severe injuries that require immediate attention. Knowing how to provide first aid for bleeding is essential for anyone, as it helps control bleeding, prevent infection, and potentially save lives. This comprehensive guide will walk you through the steps to manage bleeding effectively.
Ensure safety for yourself and the injured person.
Assess the severity of the bleeding (minor, moderate, severe).
Call for professional help (911 or emergency services) if needed.
Elevate the wound (if applicable) above heart level.
Apply direct pressure with a clean cloth or gauze for 10-15 minutes.
Use a tourniquet as a last resort for severe bleeding only.
Dress and bandage the wound with sterile materials.
Monitor for signs of shock (keep the person lying down, elevate legs, cover with a blanket).
Encourage keeping the wound clean and dry to prevent infection.
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Before offering help, always assess the situation. Look for hazards like broken glass, fire, or sharp objects that could endanger you or the injured person. If the environment is unsafe, do not intervene until it is secure or until professional help arrives. Use personal protective equipment (PPE), like gloves, if available, to protect yourself from bloodborne pathogens or infections.
2. Assess the Severity
Determine the severity of the bleeding:
Minor Bleeding: For minor cuts and scrapes, clean the wound with water and cover it with a sterile dressing or adhesive bandage. Disposable gloves should be used if available to avoid contamination.
Moderate Bleeding: For deeper cuts, apply direct pressure with a clean cloth or gauze until the bleeding stops. Ensure the wound is covered and watch for signs of infection later.
Severe Bleeding: If blood is flowing profusely, take immediate action to stop it. Severe bleeding can lead to life-threatening complications quickly. You may need to apply firm pressure and consider additional methods like using a tourniquet.
3. Call for Help
Call 911 or your local emergency services immediately if the bleeding is severe, uncontrollable, or the person shows signs of shock. Time is critical when dealing with heavy blood loss. Provide clear details about the injury, the person’s condition, and your location. This will ensure that paramedics arrive prepared for the situation.
4. Elevate the Wound (if applicable)
For bleeding from an arm or leg, raise the injured limb above heart level. Elevating the wound reduces blood flow to the injured area, helping to slow the bleeding. However, do not attempt this if you suspect a fracture or spinal injury, as it may cause further harm.
5. Apply Direct Pressure
Direct pressure is the most effective method of controlling bleeding. Place a clean cloth, sterile gauze, or your hand directly over the wound, applying firm and steady pressure. Hold the pressure for 10-15 minutes, even if the bleeding seems to slow or stop. Do not lift the dressing to check the wound too early, as this can dislodge any clots that are forming. If blood soaks through the cloth, add more layers without removing the ones already in place.
6. Use a Tourniquet (as a Last Resort)
A tourniquet should only be used for life-threatening bleeding when other methods have failed. This is particularly effective for limb injuries:
Place the tourniquet 2-3 inches above the bleeding site (not over a joint).
Tighten it until the bleeding completely stops.
Mark the time of application so that medical professionals know how long it has been in place. Tourniquets can cause tissue damage if left on for too long.
Do not remove the tourniquet yourself; this should be done by trained medical personnel.
7. Dress and Bandage the Wound
Once the bleeding is under control, gently clean the wound using mild soap and water to reduce the risk of infection. Apply a sterile dressing or clean cloth to the wound, securing it with adhesive tape or bandages. Be careful not to disturb any blood clots that have formed. The dressing should be changed regularly, but avoid disturbing the wound unnecessarily during the first few hours after the injury.
8. Monitor to Prevent Infection
After first aid, it's important to prevent infection and watch for any worsening symptoms. Advise the injured person to keep the wound clean and dry, and seek medical attention if the wound is deep, dirty, or does not heal properly. Signs of infection include redness, swelling, increasing pain, or fever. In addition, continuously monitor the person for any deterioration in their condition, such as difficulty breathing, changes in consciousness, or persistent pain.
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Bleeding refers to the process of blood escaping from blood vessels due to an injury or other medical conditions. It is a natural response of the body to stop excessive blood loss and initiate the healing process. Bleeding occurs both externally, where blood flows out of the body through a wound or opening in the skin, and internally, where blood escapes into body cavities or tissues. There are different types of bleeding, including:
Capillary Bleeding: Typically minor, it's characterized by slow oozing of blood from small cuts. It is generally easy to control and usually does not pose a significant health risk.
Venous Bleeding: This involves a steady flow of dark red blood from a vein. While it can be more serious than capillary bleeding, it is usually easier to control than arterial bleeding.
Arterial Bleeding: The most critical type of bleeding, identified by bright red blood that spurts in rhythm with the heartbeat. This type requires immediate medical intervention due to the rapid loss of blood and the risk of shock.
Internal Bleeding: Internal bleeding is not visible as it occurs inside the body. It is caused by trauma, medical conditions, or diseases and is typically detected through symptoms like pain, swelling, or changes in vital signs.
Bleeding ranges from minor and easily managed to severe and life-threatening. Proper first aid and medical attention are essential in managing bleeding, particularly when it is severe or does not stop on its own.
What is External Bleeding?
External bleeding is usually associated with open injury. There are many different types of wounds and open injuries that breaks the continuity of the skin, such as abrasions, hematoma, lacerations, excoriation, incision, puncture wounds, and gunshot wounds. Although puncture wound doesn't bleed much, they carry a high risk of infection.
Once the bleeding occurs, our body begins a complex chain of events immediately. The brain, lungs, and heart will try to compensate for the blood loss to maintain the supply of oxygen-rich blood in the body. These represent the body attempting to maintain perfusion to the vital organs by constricting peripheral blood vessels . Therefore, first aid responders should be competent in dealing with major blood loss.
What are the Signs and Symptoms of External Bleeding?
Even a small injury results in severe external bleeding, depending on where it is on the body. The presence of blood is an easy way to spot external bleeding. Common signs of external bleeding include:
Visible wound
Pain from the skin surface
Loss of normal function at the site of injury
Pale, cold, and clammy skin
Fast heart rate
Chest pain
Dizziness or lightheadedness
Loss of consciousness
Signs of Life-Threatening Bleeding
Recognizing the signs of life-threatening bleeding is crucial for immediate action. While minor bleeding can often be managed with basic first aid, life-threatening bleeding requires urgent medical attention. Here are the key signs that distinguish life-threatening bleeding from minor cases:
Uncontrolled Bleeding: Blood that continues to flow despite applying direct pressure is a serious indicator. This often happens with arterial or severe venous bleeding.
Blood Spurting from the Wound: If blood spurts in rhythm with the heartbeat, it is likely arterial bleeding, which can cause rapid blood loss.
Pooling of Blood: Large amounts of blood pooling around the wound, or soaking through bandages quickly, signals severe bleeding.
Pale, Cold, or Clammy Skin: These are signs of shock caused by excessive blood loss. The body diverts blood from the skin to vital organs, leading to these symptoms.
Loss of Consciousness: A person losing consciousness, especially after significant blood loss, is a sign the body is not receiving enough oxygen due to hemorrhage.
Weak or Rapid Pulse: A weak, fast pulse may indicate that the heart is struggling to pump enough blood to the body.
Shortness of Breath: Difficulty breathing can occur due to reduced blood flow and oxygen reaching the organs.
These signs require immediate intervention and medical help, as they indicate the body is in danger of going into shock or organ failure due to blood loss. Proper and swift action is critical in managing life-threatening bleeding.
How can a rescuer recognize a victim experiencing a traumatic arterial bleed?
Recognizing a traumatic arterial bleed is crucial, as it is life-threatening due to the rapid loss of blood. Here are some key signs that helps a rescuer identify a victim experiencing a traumatic arterial bleed:
Profuse and Rapid Bleeding: Arterial bleeding typically results in a copious amount of bright red blood spurting out of the wound in sync with the victim's heartbeat. The bleeding is often more severe and faster than venous or capillary bleeding.
Pulsatile Bleeding: Arterial bleeding have a pulsatile or rhythmic flow, coinciding with the victim's heart rate. This pulsing is a distinctive indicator of arterial bleeding.
Blood Color: Arterial blood is oxygen-rich and appears bright red. The color is noticeably different from venous bleeding, which tends to be darker in hue.
Difficulty Controlling Bleeding: Arterial bleeding is challenging to control with simple direct pressure alone. Even firm pressure is not sufficient to stop the bleeding.
Weakness and Confusion: Due to rapid blood loss, the victim shows signs of shock, such as weakness, confusion, dizziness, or fainting. They appear pale and have a rapid pulse.
Cool and Clammy Skin: As blood loss progresses, the skin becomes cool, clammy, and pale. This is a sign of inadequate blood circulation.
Decreased Blood Pressure: In severe cases, arterial bleeding leads to a significant drop in blood pressure, which is life-threatening. The victim exhibits signs of hypotension, including altered mental status.
What will you use to protect yourself from the blood if someone is bleeding?
Protect yourself by wearing protective gloves, such as latex gloves and covering any wounds on your hands. Then, use a pad such as a clean cloth, t-shirt, or clean bandage to apply continuous pressure to the wound. If you don't have anything absorbent, use your fingers.
When should a tourniquet be applied?
Tourniquets should be used when direct pressure alone cannot stop the bleeding or if direct pressure cannot be effectively applied for any reason. Heavy and uncontrolled bleeding causes death within minutes, so it's necessary to act fast when dealing with a traumatic wound.
What are the pressure points to stop bleeding?
There are two major pressure points in the body. Suppose the bleeding is from the leg, press with the heel of one hand on the femoral artery in the groin, where the leg bends at the hip. If the bleeding is from the arm, squeeze the brachial artery located on the inside of the upper arm.
Can certain health conditions affect bleeding severity?
Yes, certain health conditions affects bleeding severity. Conditions like hemophilia, von Willebrand disease, liver disease, and low platelet counts (thrombocytopenia) impairs the blood's ability to clot, leading to more severe or prolonged bleeding. Additionally, medications like blood thinners (e.g., warfarin, aspirin) increase bleeding risk.
Are there natural remedies to stop bleeding?
Yes, there are natural remedies that help stop bleeding. These include:
Applying pressure: Direct pressure on the wound with a clean cloth or bandage help control bleeding.
Ice packs: Applying ice constricts blood vessels and reduce bleeding.
Herbal remedies: Some herbs like yarrow, witch hazel, and cayenne pepper are known for their hemostatic properties and help in clotting.
Aloe vera: Known for its soothing and healing properties, aloe vera help manage minor cuts.
Do different types of wounds require specific first aid techniques?
Yes, different types of wounds require specific first aid techniques:
Cuts and lacerations: Clean the wound, apply pressure, and use a sterile bandage.
Puncture wounds: Clean around the wound, but avoid scrubbing, and seek medical attention if the object is embedded.
Abrasions: Clean the area thoroughly to prevent infection and apply an antibiotic ointment.
Avulsions: If a piece of skin or tissue is torn away, keep the area clean, control bleeding, and seek medical help immediately.
Can applying pressure too long cause complications?
Yes, applying pressure for too long causes complications. Prolonged pressure restricts blood flow, potentially leading to tissue damage or necrosis. It is important to maintain a balance between controlling bleeding and ensuring adequate blood circulation.
Is there a difference in treating bleeding in children versus adults?
Yes, there are differences in treating bleeding in children versus adults:
Fragility and sensitivity: Children's skin is more delicate, requiring gentler handling.
Emotional response: Children are more frightened and require reassurance and calm communication.
Smaller blood volume: Children have a smaller blood volume, so they go into shock more quickly from blood loss compared to adults.
Wound size: Because children are smaller, even minor wounds appears more significant relative to their body size, necessitating prompt and careful treatment.
What Legal Considerations Should Be Taken Into Account When Providing First Aid for External Bleeding?
When giving first aid for external bleeding, several legal points are important. Good Samaritan laws protect those who help in emergencies, as long as they act reasonably and without serious mistakes. These laws differ by location but generally encourage bystanders to help without fear of being sued. Always get the injured person's consent before giving aid, unless they are unconscious, in which case consent is assumed. Stay within your training and certification limits to avoid legal trouble. Finally, keep a record of what happened and what actions you took for legal and medical follow-up.
What Advancements Have Been Made in the Medical Field for Treating Severe External Bleeding?
There have been many new developments in treating severe external bleeding. Hemostatic agents like QuickClot and Celox help blood clot faster and are useful in emergencies. Better tourniquets, such as the Combat Application Tourniquet (CAT), control bleeding more effectively. Advanced wound dressings with antimicrobial features prevent infections and manage wounds better. Point-of-care coagulation testing allows quick assessment and treatment of blood clotting in trauma cases. In surgery, minimally invasive techniques and robot-assisted surgeries reduce bleeding risks. These advancements improve survival rates and patient outcomes.
How to control arterial bleeding?
To control arterial bleeding, which is life-threatening, follow these steps:
Apply direct pressure: Use a clean cloth or dressing to press down firmly on the wound. If the blood soaks through, add more layers—don't remove the soaked ones.
Elevate the injured area: If possible, raise the injured limb above heart level to reduce blood flow.
Use a tourniquet: For severe arterial bleeding that doesn’t stop with pressure, apply a tourniquet above the injury, but only if you’re trained to do so. It should be tight enough to stop blood flow but not cause additional injury.
Bleeding control measures for specific injuries
Head wounds: Avoid pressing directly on open fractures or embedded objects. Control bleeding by applying pressure around the wound.
Abdominal injuries: Do not press on the wound if organs are visible. Cover the wound with a sterile dressing and wait for emergency services.
Limb injuries: Use a pressure bandage or tourniquet if bleeding is not controlled with direct pressure.
How long can you apply pressure to a wound?
You can apply pressure to a wound for as long as necessary until help arrives or bleeding stops. Constant pressure should be maintained, and if using a tourniquet, it should be left on until professional help is available.
How Can First Aid Training Help in Controlling Bleeding?
First aid training helps in controlling bleeding by teaching critical skills such as applying direct pressure, elevating the injured area, and using tourniquets. The American Red Cross states that applying firm pressure with a clean cloth stop most external bleeding. Elevation of the injured area above the heart reduce blood flow, aiding in bleeding control. First aid courses instruct participants on the proper use of tourniquets, which is life-saving in severe limb injuries; a study in the Journal of Trauma and Acute Care Surgery found that tourniquet application significantly reduces mortality in traumatic limb injuries. Additionally, first aid training emphasizes recognizing the severity of bleeding, ensuring timely and appropriate responses.
How Effective Is First Aid Training in Managing Bleeding Emergencies?
First aid training is highly effective in managing bleeding emergencies. According to a study published in the Journal of Emergency Medical Services, individuals with first aid training are more capable of providing immediate and appropriate care in bleeding emergencies compared to those without training. The American Heart Association notes that effective first aid reduces mortality rates by 20% in trauma cases involving severe bleeding. Moreover, research by the National Safety Council shows that first aid training increases the likelihood of bystanders taking action during bleeding emergencies, with trained individuals intervening in 80% of such cases, compared to only 30% intervention by untrained bystanders. These statistics underscore the critical role of first aid training in improving outcomes during bleeding emergencies.
Sources:
American Red Cross First Aid/CPR/AED Participant’s Manual, Chapter 3: “Control of Bleeding”
King, D. R., Filips, D., Blitz, S., & Logsetty, S. (2013). "Tourniquet use in the civilian prehospital setting." Journal of Trauma and Acute Care Surgery, 75(3), 573-579.
Chapman, R. D., & De Lorenzo, R. A. (2009). "First Aid Training and the Control of Bleeding." Journal of Emergency Medical Services (JEMS), 34(12), 24-30.
National Safety Council, "The Effectiveness of First Aid Training Programs"
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