1. FIRST AID FOR BLEEDING

2. Haemorrhage  Heamorrhage is the escape of blood from the blood vessels due to wounds or injury  Causes- injury to blood vessels, disease of the vessel wall, disorder of blood  Types-Arterial, Venous, Capillary -External, Internal -Primary, Reactionary, Secondary

3. CAUSES OF BLEEDING  Injuries/Trauma: penetrating injury that breaks through skin with sharp objects  blunt injury that does not break through the skin  Diseases: ulcers, aneurysms, cancers

4. External Bleeding  If an adult looses more than 1 liter of blood or a child looses as little as 1/3 of that amount loss is considered severe.

5. Blood volumes PatientTotal Blood Volume Lethal Blood loss if not replaced (rapid) Adult male5 – 6.6 liters2 liters Adolescent3.3 – 4.5 liters1.3 liters Child1.5 – 2 liters0.5 – 0.7 liters Infant300+ milliliters30–50 milliliters

6. Blood Loss 2-3 pints 6 MODERATE LOSS 2 to 3 pints (20% - 30%) slightly raised cold and sweaty pale dilating, but equal slightly raised light headed, faint constant observation and monitoring of vital signs to determine medical progress cool becoming unstable Pulse Skin Colour Pupils Breathing Consciousness History Peripheral Temp. General Condition

7. Blood Loss over 3 pints 7 SEVERE LOSS over 3 pints (30% and over) fast, light, thready cold and clammy pale - cyanosed dilated and equal, slow to react to light deep sighing - air hunger apathetic, low pain threshold may become thirsty and suffer from blurred vision cold poor, could prove fatal Pulse Skin Colour Pupils Breathing Consciousness History Peripheral Temp. General Condition

8. ARTERIAL BLEED  spurting bright red blood. Most dangerous, must be stopped. Could be life threatening  Can lead to shock, unconsciousness or death

9. VENOUS BLEED  flowing blue/red blood that responds to direct pressure to stop. Pressure may be necessary 6-10 minutes before clotting takes place

10. CAPILLARY BLEED  oozing dark red blood. May clot spontaneously or rapidly with pressure. MOST COMMON type of bleed

11. Control of Bleeding Direct Pressure Elevation Cold Applications Pressure bandage

12. Bleeding Control  Control Methods For External Bleeding:  Direct pressure stops most bleeding.  Wear medical exam gloves (if possible)  Place a sterile gauze pad or a clean cloth over wound  Elevation injured part to help reduce blood flow.  Combine with direct pressure over the wound (this will allow you to attend to other injuries or victims).  If bleeding continues, apply pressure at a pressure point to slow blood flow.  Pressure point locations:  Brachial (Top of elbow)  Femoral (Inside upper thigh) Facilities Planning & Management UW-Eau Claire

13. 1-Treating: Control Blood Loss A- For important but non-complicated external bleeding: Apply direct pressure on the wound. Avoid direct contact with blood (gloves, gauze, handkerchief, etc.)

14. 1 - Treating: Control Blood Loss  B- For important and complicated external bleeding (associated with a fracture or foreign body):  use indirect pressure.  This requires applying pressure  to the appropriate pressure point.  Brachial pressure point = Inner part of the upper arm (Used to stop bleeding in hand, forearm and arm) Femoral pressure point = Groin (Used to stop bleeding in thigh, leg, foot) Brachial Femoral

15. Bleeding Control

16. Dressings and Bandages  The purpose of a dressing is to:  Control bleeding  Prevent infection and contamination  Absorb blood and fluid drainage  Protect the wound from further injury  What to Do:  Always wear gloves (if possible)  Use a dressing large enough to extend beyond the wound’s edges.  Cover the dressing with bandages. Facilities Planning & Management UW-Eau Claire

17. Dressings and Bandages Cont.  Bandage can be used to:  Hold a dressing in place over an open wound  Apply direct pressure over a dressing to control bleeding  Prevent or reduce swelling  Provide support and stability for an extremity or joint  Bandage should be clean but need not be sterile. Facilities Planning & Management UW-Eau Claire

18. Internal Bleeding  Signs of internal bleeding:  Bruises or contusions of the skin  Painful, tender, rigid, bruised abdomen  Vomiting or coughing up blood  Stools that are black or contain bright red blood  What to Do: For severe internal bleeding, follow these steps:  Monitor ABC’s (Airway Breathing Circulation)  Keep the victim lying on his/her left side. (This will help prevent expulsion of vomit from stomach, or allow the vomit to drain and also prevent the victim from inhaling vomit).  Treat for shock by raising the victim’s legs 8” – 12”  Seek immediate medical attention Facilities Planning & Management UW-Eau Claire

19. NOSEBLEEDS  Two Types:  anterior - involving the superficial vessels in front portion of nose  posterior - involving larger vessels in back portion of nose (could be life threatening bleed)

20. CAUSES OF NOSEBLEEDS  trauma  sinus infections/allergies  hypertension (high blood pressure)  dry air conditions Patient applies squeezing pressure

21. TREATMENT NOSE BLEEDS  keep patient quiet  sit upright/lean slightly forward to avoid swallowing of blood  pinch nostrils for minimum of 5 minutes  apply ice to forehead above nose  seek medical attention if bleeding after 6-10 minutes  question patient about anticoagulant drugs (drugs that affect clotting time)  treat for shock

22. SHOCK  Definition:  inadequate tissue/cell perfusion causing body cells and systems to begin death due to a loss of body fluids and oxygen within the blood vessels

23. CAUSES OF SHOCK  trauma - blood loss  illness - body fluid losses of vomit, diarrhea, fever (perspiration)  heart disease - causing blood flow disruptions & rhythm disturbances  gastrointestinal diseases - disrupt electrolyte balance and destroy cells, organs, & systems continued

24. CAUSES OF SHOCK  respiratory disease - causing disruption of the oxygen supply to cells  allergic reactions - causing serious breathing spasms & vasodilatation  head injury - causing central nervous system inability to command properly  spine injury - may result in loss of ability for blood vessels to constrict causing (vasodilatation)

25. Shock Treatment  Treat the cause and prevent the condition getting worse by: Correct positioning of the casualty Reassurance Keeping the casualty fairly warm Monitoring breathing if necessary Do not give anything to eat eat or drink

26. Video Time

28. Question 1 What is the reasion for using dressing and bandages? A) Reduce victims pain B) Reduce internal bleeding C) Help control bleeding and prevent infection D) Make it easier to take the victim to the hospital

29. Answer 1 What is the reasion for using dressing and bandages? A) Reduce victims pain B) Reduce internal bleeding C) Help control bleeding and prevent infection D) Make it easier to take the victim to the hospital

30. Question 2 You have tried to control a victim's bleeding with direct pressure and elevation, but the bleeding doesn’t stop. Where would you apply pressure to slow the flow of blood to a wound on the forearm? A) Outside the arm midway between the shoulder and the elbow B) On the inside of the elbow C) Inside the arm between the shoulder and the elbow D) Any of the above will slow the flow of blood

31. Answer 2 You have tried to control a victim's bleeding with direct pressure and elevation, but the bleeding doesn’t stop. Where would you apply pressure to slow the flow of blood to a wound on the forearm? A ) Outside the arm midway between the shoulder and the elbow B) On the inside of the elbow C) Inside the arm between the shoulder and the elbow D) Any of the above will slow the flow of blood

32. Question 3 How would you manage a nose bleed? A) Tilt the head forward slightly and have the casualty pinch their nostrils B) Tip the head back and pinch the bridge of the nose C) Lie the casualty down and keep them warm D) Alternately apply heat and cold to the neck and forehead

33. Answer 3 How would you manage a nose bleed? A) Tilt the head forward slightly and have the casualty pinch their nostrils B) Tip the head back and pinch the bridge of the nose C) Lie the casualty down and keep them warm D) Alternately apply heat and cold to the neck and forehead

34. THANK YOU