Today we’re continuing to follow the alphabet and looking at the letter “B” for Bleeding as part of our alphabetical approach to First Aid. We know, we’ve skipped slightly out of order on A-Z having taken a deviation via chocking and burns before bleeding but it’s all been relevant given recent celebrations for Halloween and Bonfire Night.
So as you may have guessed in first aid training we deal with many different scenarios involving blood, we’re not generally too squeamish about the red stuff. The scenarios we look at range from the the straightforward nosebleeds to internal bleeds, in addition to the unpleasant task of dealing with complicated fractures, embedded objects and significant blood loss. If you consider the different types of bleed, wound management and how blood loss affects the body, there is a lot to learn! If you’re feeling squeamish, we’d recommend stopping here, we go into quite a lot more detail in this post.
Catastrophic Bleeding: Whilst checking to see if the person is breathing regularly and rhythmically is normally our highest priority, an exception to this is if you are faced with a catastrophic bleed i.e. a major arterial or venous bleed where a person is bleeding so fast, they could die within 3 minutes. In this instance, the bleed would take the highest priority. Once controlled, you would revert back to the ABC (Airway, Breathing, Circulation) protocol.
Internal Bleeding: This is a very difficult condition to recognise but one that can be very serious. Consider internal bleeding if there are no signs of external bleeding but the person is displaying bruising, swelling, pain and/or signs and symptoms of shock i.e. pale, clammy skin and a rise in pulse rate. Possible injuries could be lung, abdominal, brain haemorrhage injuries or bleeding from a stomach ulcer. If you suspect internal bleeding, call 999/112 and treat for shock.
Treatment: With regards to general treatment for external bleeds, with effect from Oct 15, ‘elevation’ was removed from the list of steps when dealing with bleeding. This was because ICLOR (International Liaison Committee on Resuscitation) found that there was not enough evidence to suggest that ‘elevation’ would stop the bleeding on its own. It was subsequently removed to allow first aiders to focus on the steps where there was sufficient evidence that did stop the bleed on its own i.e. direct pressure. The use of indirect pressure points (brachial and femoral artery) as a last resort was also removed. In its place, is the introduction of tourniquets and haemostatic dressings (used effectively by the military for many years) for life-threatening bleeds that cannot be controlled by direct pressure. Haemostatic dressings and tourniquets are easy to use, however, specific training is essential to make sure the application is safe and effective.
Before treating you should always consider the following:
- If the casualty is conscious, remember to ask the person’s consent before treating. If unconscious, assume implied consent.
- Wear gloves/apron.
- Use a dressing that is a low-adherent and an appropriate to the size of the injury.
- Check the dressing packaging has not been tampered with and that it is in date. Use immediately.
- Avoid touching the part of the dressing that covers the wound.
The basics for managing external bleeding is to remember something really simple ‘SEPD’:
- Sit or lay the person down. Consider location of wound and extent of bleeding.
- Examine – Identify type of bleed, exact location and look for foreign objects.
- Pressure – Continuous for 10 mins. Place around embedded object.
- Dress (maximum of 2 bandages)
Check circulation is flowing at the far side of the dressing. Adjust dressing if required.
- Ensure the contaminated dressings, wipes etc are disposed of correctly i.e. yellow/orange ‘clinical waste bag’.
- Wash hands thoroughly.
Effects of Blood Loss:
We know that as a general rule, we can afford to lose approximately 10% (approximately 1 pint) of our blood volume without feeling any real negative effects. However, anything in excess of this, the body will start to show some signs and symptoms of hypovolemic shock (low blood volume) i.e. loss of body fluids which include blood, burns, vomiting/diarrhoea and excessive sweating. Trying to establish how much fluid has been lost can be very difficult as it can be absorbed by clothing or diluted with water/liquid or different surfaces. Recognising the signs and symptoms of hypovolemic shock is therefore essential e.g. increase in pulse, pale clammy skin with possible grey/blue tinges, dizziness, nausea & vomiting etc Critical blood/fluid loss levels are 30%, and if left untreated , it could be fatal. Treatment for bleeding and shock is necessary.
Thanks for tuning in today to take a read of our blog. We like to leave you with an interesting fact. This one, caught our eye recently. Did you know, Mosquitoes prefer blood type O to any other?
Tune in again next week for more A-Z First Aid Top Tips.
If you’d like to learn more about First Aid, please get in touch to discuss training.