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External bleeding
 

External bleeding


External bleeding falls into three categories:

1. Arterial bleeding
Arterial bleeding is rapid and profuse. As the blood is under pressure from the heart it will spurt from the wound with each contraction of the heart which makes clotting difficult.

2. Venous bleeding
Blood flows from the wound at a steady rate as the blood is not under as much pressure. This is dark red blood and clots more easily.

3. Capillary bleeding
Blood oozes from the wound. It is very simple to control as the blood pressure in capillaries is very low. Clotting occurs easily with this type of bleeding, as the blood flow is extremely slow.

Most bleeding is not serious, it involves minor blood loss and is easily stopped. Often bleeding can be managed by the body’s own clotting processes and/or simple first aid intervention.
Severe bleeding that cannot be controlled is life-threatening.

Management of minor external bleeding

  • Wear gloves
  • Check for embedded objects (do not apply direct pressure if present, apply pressure around the embedded object)
  • Clean the wound with sterile saline or warm water
  • Apply direct pressure using a sterile pad, clean cloth, hands etc
  • Firmly secure pad/cloth with a bandage
  • Elevate the bleeding part (if on a limb)
  • Monitor and record the casualty’s vital signs
  • Check to ensure that the bandaging is not too tight by checking that the finger or toe nails on the affected limb are pink

Signs and symptoms of life-threatening external bleeding

  • Blood that gushes or spurts from a wound
  • Blood that does not clot after efforts to control it
  • Faintness
  • Pale skin colour
  • Nausea
  • Vomiting
  • Dizzyness

Management of life-threatening external bleeding

  • DRSABCD
  • Seek urgent medical aid - call Triple Zero (000) for an ambulance
  • Wear gloves and other appropriate personal protective equipment (PPE)
  • Check for embedded objects (do not apply direct pressure if present, use indirect pressure)
  • Apply direct pressure using a sterile pad, clean cloth, hands etc
  • Firmly secure pad/cloth with a bandage
  • Elevate the bleeding part (if on a limb)
  • Monitor and record casualty’s vital signs
  • Check to ensure that bandaging is not too tight and has not compromised circulation by checking that the finger or toe nails on the affected limb are pink
  • If the initial pad is soaked through and is not sufficient, leave it in place and apply a second pad and bandage over the top of it. If the second pad soaks through then replace the second pad and bandage only (leaving the initial pad/bandage in place prevents dislodgement of any clots which may have formed)

Constrictive bandaging (tourniquet)

Should only be used when all other bleeding control measures have failed
May be considered in an emergency situation involving the traumatic amputation of a limb or other major injuries incorporating massive blood loss
To apply:

  • Use a wide bandage (at least 5 cm)
  • Apply tightly, directly above the knee or elbow, or as high up as possible where the arm or leg joins the torso
  • The bandage MUST NOT be removed until the casualty receives specialist care
  • Take note of the time of application of the bandage and inform emergency personnel

"A constrictive bandage (tourniquet) is a last resort"