4. External Bleeding
AIMS
Reduce blood loss by applying
direct pressure and elevating the
injured part
To prevent shock
Cover any open wound with a dressing, to
protect it from infection and promote natural
healing
Minimise the risk of infection, between the
casualty and yourself, pay scrupulous attention
to hygiene.
Page 28-33
5. Major External Bleeding
Raise and support injured limb.
It may help to lay casualty down. Apply a sterile
Apply direct pressure
over the wound dressing
Dial 999 for an ambulance.
Treat the casualty for shock.
Check the dressing for seepage, and check the circulation beyond the
bandage.
Page 31
6. Embedded Object Wounds
Apply Place padding Bandage over
Do not
pressure to around object. padding or on
remove
surrounding Build padding either side of
object.
area. up as high as it if object still
embedded protrudes.
object.
7. Nose Bleeds
Aim:
• To control blood loss, and maintain an open airway
Treatment
• Sit the casualty down with head well forward
• Casualty should breath through the mouth and pinch the
nose just below the bridge.
• After 10 minutes release the pressure.
• If nosebleed persists, reapply pressure for further
periods of 10 minutes
• If nosebleed persists beyond 30 minutes, casualty
should go to hospital in the treatment position.
Page 32
8. Bleeding from the Mouth
Aims
• To control bleeding
• Safeguard airway by preventing inhalation
of blood
Page 33
9. Bleeding from the Mouth
Possible causes
• Cuts to tongue, lips or lining of the mouth
• Tooth socket bleeding may be the result of
loss of tooth
Page 33
10. Bleeding from the Mouth
Treatment
• Lean casualty forward
• Place a gauze dressing pad over the wound and
ask casualty to apply pressure
• If bleeding has not stopped after 30 minutes, the
casualty should go to hospital
Page 33
11. Knocked Out Tooth
An “Adult” tooth may be replanted. Do not clean it. Put the tooth in milk.
Place a pad over the tooth socket, making sure
that it is higher than the adjacent teeth so that the
casualty can bite on it.
Ask the casualty to sit down with their hand
supporting their jaw. Tell them to bite hard on the
pad.
A younger child may need you to hold the pad in
place.
Page 33
12. Crush Injuries
• Ensure it is safe to approach the scene.
• Monitor and maintain airway and breathing.
• Treat major bleeding and cover smaller wounds.
• Keep casualty still and reassure them while waiting
for help.
• Treat for shock.. Keep them warm.
IF THE INJURED PERSON IS STILL TRAPPED ?
13. Crush Injuries
Casualty Still Trapped
• Additional risks to casualty if still trapped, releasing the
body may bring on severe shock.
• Even greater concern is “crush syndrome”
IF THE CASUALTY HAS BEEN TRAPPED FOR LESS THAN 15 MINUTES
Crush syndrome takes some time to develop. If you can do so,
safely remove the object. Treat as for crush injuries.
IF THE CASUALTY HAS BEEN TRAPPED FOR LONGER THAN 15 MINUTES
DO NOT RELEASE THE CASUALTY
Make an early call for help. Treat as for crush injuries.
14. Recognising Internal Bleeding
• Casualty show signs of shock (cold, clammy, pale skin, loss of
consciousness , thirst, general weakness, a fast weak pulse)
• Casualty coughs up blood
• Passing blood from rectum
• Casualty has been in an accident where they fell from height,
stopped suddenly etc
• Casualty has bruising and/or swelling – may be “pattern bruising” at
site of injury
• Blood coming from nose or mouth after head injury
16. Internal Bleeding
Treatment
• If injury is cause by penetrating object do not try
to take it out
• Lie casualty flat and raise their legs
• Do not let casualty eat or drink
• Keep casualty warm, loosen tight clothing
• Watch their ABC
• It they become unconscious, place them in
recovery position (but still keep legs elevated)
17. Palm Wounds
AIMS
• Control blood loss
• Arrange transport to hospital
The palm is richly supplied with blood and a wound may
bleed profusely.
A deep wound may sever tendons and nerves.
18. Palm Wounds
Treatment – Fist Bandage
• Press a sterile dressing firmly into the palm and ask
casualty to clench fist over it
• Bandage the fingers so that they are clenched over the
pad
• Support the arm in an elevation sling
• Ensure casualty receives treatment in hospital
Bandage fingers
over pad, leaving
thumb exposed
19. Amputation
Aims
• To minimise blood loss and shock
• To preserve the amputated part
Treatment
• Control blood loss by applying direct pressure and
raising the injured part. (Do NOT use tourniquet).
• Apply a sterile dressing or non-fluffy clean pad
secured with a bandage.
• Treat the casualty for shock. Dial 999 for an
ambulance.
20. Care of the Amputated Part
• Wrap the severed part in kitchen film or a plastic
bag.
• Wrap the bag in soft fabric.
• Put a bag filled with ice cubes around the fabric.
• Put the whole package in another container. Mark
with the time of injury and the casualty’s name. Give
it to the ambulance attendant.
21. Chest Wound
• A chest wound may cause sever internal
damage.
• The lungs are particularly vulnerable, and
breathing problems, shock, and collapsed
lung may follow an injury.
• It is important to make an airtight seal over
the wound to prevent air entering the cavity.
22. Chest Wound
TREATMENT
Cover the wound with the palm
of your hand and support the
casualty in a semi-upright
position.
With the casualty supported
over the wound with a
sterile dressing or clean pad
and tape it in place.
23. Chest Wound
TREATMENT cont’d
Create a seal over the wound with a kitchen
film. Secure on 3 sides with tape.
Incline the casualty towards
the injured side, supported
on cushions.
Continue to monitor ABC and be prepared to resuscitate if necessary