Serious bleeding accidents: Serious bleeding accidents

Bleeding can occur from various parts of the body in the case of injury. This can not only be life-threatening but also very distressing for the patient and even for the first aider. When you have to deal with a bleed, keep calm and trust your training. It often looks worse than it actually is. With all types of bleeding as with other first aid care, we must first make sure we have got our gloves on. The first part of controlling serious bleeding is the use of direct pressure. This could be by the patient applying pressure over the wound or using your gloved hand. This stops some of the blood from leaving the body and it also assists in the clotting process, which is where the body produces fibrous threads to block the hole. With cuts, we can also apply a pressure bandage which is sterile and wrapped in plastic. You need to check the expiry date of the dressing to make sure it is in date. Ideally, you would not use an expired dressing, but if it is all you have, then you have to use it. To open the packet, simply tear the end and remove the dressing. The dressing is a bandage with a gauze pad fixed to it. As you unwrap the bandage, you will come to the pad. If there is an embedded object in the body, do not remove it.

The first thing we do is apply direct pressure with your gloved hand and ideally a sterile gauze pad over the wound. You can ask the patient to do this as soon as you arrive which will give you more time to put your gloves on. Sit them down or lay them down, whichever is more comfortable for them just in case they faint, as there is less distance for them to fall and hurt themselves. If serious, you can ask a bystander to call for an ambulance, or if alone, you can do this after the dressings are in place. The dressing is applied distally, which means furthest away from the heart and then towards the body. The reason for this is to avoid forcing blood past the injury site. Apply the dressing with enough pressure to stop the bleeding, but not too much pressure to cut off circulation. If blood comes through the first dressing, remove the dressing, check the wound and apply a fresh dressing over the wound. Dressings can hold a lot of blood, so if you are at this stage, it is a serious bleed and you need to get medical help as soon as possible. Once the bleed is stable, you can put the arm into a sling.

Once the dressing is on, check the circulation by squeezing a fingertip to check for a capillary refill. We have talked about putting a dressing on an arm, but the same applies to any other cut. If it is a cut to the body, you can apply direct pressure just using a dressing pad until the bleeding is controlled, or you may be able to bandage it in place. Finally, in all cases of serious bleeding, shock is a concern. So if they are going into shock, lay them down and elevate their legs, if possible.