Haemorrhage Control Flashcards
management of a haemorrhage casualty
SAFE approach
Reassure
CAT HAEM
Quick Look – alertness, respiratory effort, skin colour
AIRWAY
BREATHING
CIRCULATION
Blood on the floor
Four more (chest, abdomen, pelvis, long bones)
Pulse
Consider treating for shock
Define a wound
A wound is a break in
the continuity of tissues
Can be open or closed
Types of wounds
6
Laceration
Puncture
Contusion
Gunshot
Incision
Abrasion
Types of external bleeds + Definition
Capillary bleeding – Dark red and oozes from wound slowly and steadily
Venous bleeding – Darker than arterial and flows steadily
Arterial bleeding – Characteristically brighter red and spurts.
Describe a closed wound
Causes
In a closed wound, soft tissue beneath the skin is damaged but no break in epidermis
Characteristic closed wound is a contusion
Trauma to the nerve endings causes pain, and leakage of fluid into spaces between the damaged cells produces oedema
If small blood vessels are disrupted a discoloured mark (bruising) will cover the area
If large blood vessels are torn beneath the contused area this results in haematoma (collection of blood beneath the skin – evidenced as a lump with a bluish discolouration).
Internal bleeding signs and symptoms
+ Lungs, Stomach, kidneys, large intestine
njury
Colour – pale
Contusion, swelling and tenderness
Haematoma (swelling filled with
blood)
The above can be unreliable!
Pulse rate increased
Respiratory rate increased
PR and especially RR are more reliable indicators – pay attention to these observations and take them properly, otherwise you may miss internal bleeding!
Lungs:
Haemoptysis = Coughing blood: appears as red/pink froth or spots of blood
Stomach:
Haematemesis = Vomiting blood (‘coffee grounds’ appearance of partially digested blood, or ‘frank’ blood from upper GI bleeds)
Kidneys:
Haematuria = Urinating blood (from dark urine to bright red in appearance)
Large Intestine:
Melena = Very dark red or black, sticky tar-like substance.
4 more
Actively look for possible internal bleeding
Chest (feel, assess resonance, listen, look including back/sides) Abdomen (soft, non-tender?) Pelvis (look for deformity, think about mechanism) - Pelvic Binder Long bones (Femoral Fracture? KTD?)
If suspected, evacuate urgently – the definitive treatment is surgery.
Describe an open wound
An open wound is characterised by an interruption in continuity of the skin
Open wounds are potentially more serious than closed wounds for two reasons:
Vulnerability to infection
Greater potential for serious blood loss
Injuries involving compromise of nerves, vessels, muscles, tendons or ligaments whilst either being contaminated or involve a foreign body -require skilled intervention and urgent evacuation.
Principles of treating an open wound
Control bleeding by whatever method is most effective
Keep wound as clean as possible, cut away clothing, wash loose dirt DO NOT pick out embedded foreign matter
Cover with appropriate dressing, avoid dry dressings unless controlling significant haemorrhage
Never definitively close a wound unless you have seen its base (extent of depth).
Rules for severed limbs
Rules for severed limbs:
Clean it with normal saline
Place inside a plastic bag or pack it in some form of padding
Keep as cool as possible
The limb should be sent to the receiving facility as soon as possible with the patient.
Open abdominal wounds
Considerations/treatment
Do not push protruding bowel/organs back in
Cover wound (keep moist)
Keep the casualty warm
Raise legs if horizontal wound with no protrusions
Do give pain relief.
3 types of external bleeds
Arterial spurts
Venous flow
Capillary ooze
