BLEEDING Flashcards
What are the 8 main types of wounds?
GUNSHOT ABRASION AMPUTATION DE-GLOVED CONTUSION LACERATION INCISION PUNCTURE
What is the treatment recommended for external bleeding?
Sit or lay down Expose the wound Pad the wound with a sterile dressing Elevate the wound Pressure apply Shock check for signs of Infection control
Eye Injury
Small particles of dust or contaminants can be washed out the eye with clean water or eye wash making sure the water runs away from the unaffected eye.
Chemicals in the eyes should be washed out with copious amounts of clean water.
For a serious eye injury hold a sterile dressing over the eye which can be bandaged in place. Tell the casualty to close the good eye or bandage that as well to avoid them blinking and moving the damaged eye as well.
Nosebleeds cause and treatment
A bang to the nose, picking or blowing it. Weakened or dried out blood vessels, high blood pressure or a fractured skull.
- Sit the casualty down with their head leaning FORWARD.
- Nip the soft part of the nose with fingers and maintain pressure for 10 minutes. Collect any drips of blood in a pad or dressing.
- Tell the casualty to breath through their mouth and not to cough or sneeze.
- Check the medication that person may be on for anti-coagulants. If they are on these send them to hospital.
- If blood does not stop then repeat again until a total of 30 minutes has past then send to hospital.
- Advise a person who’s bleed stops to try and not cough, sneeze and try and breathe through their mouth for a while. Avoid hot drinks and picking at the nose.
What level of blood loss is critical?
30%
At what level of blood loss should you check for shock?
Around 10% upwards.
What basic signs and symptoms may someone experience as they lose more and more blood from 20% upwards?
- Blood vessels constrict to prevent blood loss, this may be seen in the skin which will go from normal to pale to cyanosis.
- Conciousness and levels of response will deteriorate as blood supply to vital organs especially the brain is reduced,
- Pulse rate will rise but will weaken before maxing out and then becoming undetectable.
- Breathing will become more rapid then deep gasping as air hunger sets in.
Amputation treatment ?
- Stop bleeding by direct or indirect pressure and elevation.
- Dress the wound with a low adherent dressing
- Oxygen or entonox therapy.
- Monitor vital signs
- Monitor the casualty for shock.
- Place amputated part in a plastic bag wrap and place on ice avoiding direct contact with the ice. Make sure the part goes with the casualty.
- don’t allow the part to get wet.
Internal bleeding?
- Can be difficult to recognise so check mechanism of injury or recent health issues.
- Check for swelling, firmness, bruising, pain or discolouration in area.
- Monitor vital signs
- Check and monitor for shock
5 Other unexplained symptoms such as difficulty breathing.
What is the risk associated from crush injuries and when should you move someone?
Where blood flow is impaired due to crushing then toxins can build up in the muscle tissue. If the crush weight is released the toxins can cause kidney failure which is caused crush syndrome.
If blood is impaired for 15 minutes or more then do not remove the weight until professional medical care is on site.
Stabilise the casualty and establish a time scale of the incident.
How would you treat a gunshot wound?
GUNSHOT caused by a bullet or missile which is travelling at speed. A small entry wound can be accompanied by a large exit wound or severe internal damage. Pack with dressings and treat for bleeding, check for shock and monitor vitals, urgent removal to hospital.
A ABRASION such as a graze where the top layers of skin are scraped off. Usually as a result of friction or a sliding fall. Dirt that is not embedded should be removed using clean water or sterile fluid with swabs. Wound should be covered to stop infection but not with a dressing that will stick to it. Otherwise advise wet removal of dressing.
A AMPUTATION of a body part this will be covered separately. Treat for severe bleeding , monitor for shock and check for vitals, urgent removal to hospital.
D DE- GLOVED where the skin is severed from the body resulting in creasing or a flap of skin leaving a bare area of tissue. Place skin in place if possible, treat bleeding and arrange transport to hospital
C CONTUSION is a bruise where ruptured capillaries are bleeding under the skin. Can be caused by a blunt blow or impact or from underlying damage to a joint or bone. Cool the area with Ice protecting contact with the skin.
L LACERATION is a rough rip or tear to the skin more likely to have dirt in it than a clean incised cut. Clean cut and treat for bleeding.
I INCISION is a clean cut usually caused by a sharp object. The wound may be deep with complications. Treat as per bleeding.
P PUNCTURE wound is a stabbing wound from a knife or other object. The wound could appear small but may have internal injuries. Pack with dressings and treat for bleeding, check for shock and monitor vitals, urgent removal to hospital.
What is direct pressure?
Direct pressure: Stem bleeding by applying direct pressure over the wound using your hands(wearing gloves) and a sterile pad. A sterile dressing may be used for this purpose and extra pressure may be applied directly over the wound with your hand if required. Pressure should be continuous but not so tight as to stop circulation altogether. Leave any embedded object in place and pad around them not placing pressure on the object. Check capillary refill once applied and regularly thereafter. Colour should return in around 2 seconds unless the wound is elevated or limb is cold.
What is indirect pressure?
If direct pressure is not possible or is ineffective then apply indirect pressure to either brachial or femoral points. Squashing the artery against the bone will reduce the blood flow. Apply this for a maximum of 10 minutes.
Brachial runs on the inside of the upper arm on the inside of the bicep.
Femoral artery runs approx at the top corners of the bikini line to the front upper thigh. You may have to use the heel of your foot to apply pressure and make sure you explain what you are doing.
How would you treat a splinter?
Splinters may be removed carefully with tweezers. If in doubt leave it alone.
- Clean the area with soap and water or sterile solution.
- Use clean tweezers and grip the splinter as close to the skin as possible and pull out the splinter from the same angle as it entered.
- Gently squeeze the area to encourage a little bleeding.
- Wash it again and then dry and cover with dressing or plaster.
- Check tetanus is up to date.
Embedded objects
Do not try and remove objects from nose. ears or other orifices.
An embedded object in a wound should not be removed. These should be removed in hospital where pain relief and professional cleaning and removal should take place. Build up around the object stemming blood loss and have the person removed to hospital.
