First Aid for Bleeding: Essential Steps for Treatment
Author:
CPR Select
Last updated:
7/27/2024
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 assistance, ensure the safety of both yourself and the injured person. If the situation is hazardous, wait for professional help to arrive.
2. Assess the Severity
Determine the severity of the bleeding:
Minor Bleeding: For minor cuts and scrapes, use clean, disposable gloves if available, and proceed to clean and cover the wound.
Moderate Bleeding: For moderate bleeding, apply direct pressure to the wound with a clean cloth, sterile gauze, or your hand.
Severe Bleeding: In cases of severe bleeding, prioritize stopping the bleed immediately. This often involves more direct pressure, elevation, and possibly the use of a tourniquet (as a last resort).
3. Call for Help
In cases of severe bleeding or if the bleeding doesn't stop with initial measures, call 911 or the emergency services number in your area. Time is critical in severe bleeding situations.
4. Elevate the Wound (if applicable)
If the bleeding is coming from an extremity (arm or leg), raise it above heart level. This help reduce the flow of blood to the injured area and slow down bleeding.
5. Apply Direct Pressure
Use a clean cloth, sterile gauze, or your hand to apply firm and steady pressure directly over the wound. Maintain this pressure for at least 10-15 minutes, even if the bleeding slows down or appears to stop.
6. Use a Tourniquet (as a Last Resort)
A tourniquet should only be used in extreme cases where direct pressure and elevation have failed, and there is a risk of exsanguination (life-threatening blood loss). To use a tourniquet:
Place it 2-3 inches above the bleeding site.
Tighten it until the bleeding stops.
Mark the time it was applied.
Do not remove it; this should be done by medical professionals.
7. Dress and Bandage the Wound
Once the bleeding is under control, clean the wound gently with mild soap and water. Apply an appropriate dressing, such as sterile gauze or a clean cloth, and secure it with a sterile bandage or tape. Be careful not to disturb any blood clots that have formed.
8. Monitor for Shock
Bleeding leads to shock. Keep the injured person lying down, elevate their legs (unless there are suspected spinal injuries), and cover them with a blanket to maintain body temperature. Monitor their breathing and pulse while waiting for professional help.
9. Prevent Infection
To reduce the risk of infection, advise the injured person to keep the wound clean and dry. They should seek medical attention for wound evaluation and possible antibiotics if the wound is deep or dirty.
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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: This is usually minor and involves small blood vessels near the skin's surface. It often results in oozing of blood from small cuts or scrapes.
Venous Bleeding: Venous bleeding occurs when blood flows from a vein. It is characterized by a steady flow of dark red blood.
Arterial Bleeding: This is the most severe type of bleeding and results from an injury to an artery. Arterial bleeding is characterized by spurts of bright red blood that coincide with the heartbeat.
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
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 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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