Wounds & bleeding Flashcards
contusion (bruise)
- treatment
cool area with icepack / cold running water ASAP
abrasion (graze)
- treatment
- dirt that is not embedded should be removed with clean water + sterile swabs
- clean from centre of wound outwards (to avoid introducing new dirt to wound)
laceration (rip/tear to skin)
- treatment
- treat for bleeding
- prevent infection
incision (clean cut, e.g. with knife)
- treatment
- treat for bleeding
- prevent infection
puncture (stabbing wound)
- treatment
- call emergency services if wound near internal organs
- NEVER remove embedded object (may be stemming bleeding)
gun shot
- treatment
- call emergency services if wound near internal organs
- pack wound with dressing to prevent bleeding (entry + exit wound)
de-gloving (severing of skin from body)
- treatment
- replace skin flap if possible
- arrange urgent transportation to hospital
3 types of bleeding (+ identifying signs)
- arterial, spurting
- venous, oozing
- capillary, trickling (fast at first, usually slight + easily controlled)
what is the critical amount of blood loss?
one third of blood volume (most adults have 8-12 pints)
signs of 30% blood loss
x5 signs
- lowered consciousness
- restless + anxious
- cyanosis
- rapid pulse, hard to detect
- rapid breathing
hygiene when treating bleeding
5 things to remember
- cover own cuts with waterproof dressing
- wear disposable gloves / apron
- use specialised cleaning agents for body fluid spillages
- dispose of soiled dressing in clinical waste bag
- wash hands thoroughly before + after
EXTERNAL BLEEDING
- treatment
(4 things, acronym)
SEEP
Sit or lay
Examine (be able to describe bandaged wounds to medics later)
Elevate (above heart level)
Pressure (either direct or indirect)
how long should you apply direct pressure?
10 mins (should work for most minor wounds)
how do you apply direct pressure if object is embedded?
apply pressure either side
2 types of indirect pressure (+ tips for applying)
femoral
- femoral artery located where thighbone crosses ‘bikini line’
- can apply pressure using heel of foot
- careful to explain your actions
brachial
- brachial artery on inside of upper arm
- get casualty to ball fist, place under armpit, squeeze arm down on fist
how long (max.) should you apply indirect pressure?
10 mins
how can you check a dressing isn’t so tight as to cut off circulation?
‘capillary refill’ test - squeeze finger or toe and watch colour return within 2 second
what can you do if initial dressing isn’t stemming flow of blood?
(4 things)
- extra ‘hand’ pressure
- elevation
- if dressing saturated with blood, leave on and put new dressing on top
- if second dressing still isn’t working, remove and start again ensuring it is tight enough
when should you NOT remove a splinter?
3 examples
- if embedded deeply
- if difficult to remove
- if on a joint
removing a splinter
5 things
- carefully clean the area with warm, soapy water
- using clean tweezers, remove splinter at the same angle it entered
- squeeze around wound to encourage a little bleeding
- wash again, then dry and cover with dressing
- seek medical advice about patient’s tetanus immunisation being up to date
what should you do if a casualty has something stuck in their nose, ear or another orifice?
- DO NOT remove it
- go to hospital
NOSEBLEED
- initial treatment
(4 things)
- sit casualty down with head tipped forward
- nip soft part of the nose, maintain constant pressure for 10 mins
- breathe through mouth
- give casualty a disposable cloth to mop up excess blood
NOSEBLEED
- 3 things to avoid for few hours
- breathing through nose
- blowing or picking nose
- hot drinks
when do you send a nosebleed casualty to the hospital?
2 things
- if it persists for 30 mins or more
- if they are on anti-coagulants (e.g. warfarin)
what if someone suffers frequent nosebleeds?
advise them to see a doctor
EYE INJURY
- small particles or dirt
- wash out of eye with cold tap water
- DON’T wash into good eye
EYE INJURY
- treating more serious injury
(3 things)
- keep casualty still and place dressing over damaged eye (bandage if necessary)
- tell casualty to close good eye (if it moves, so will the other). bandage if necessary
- take patient to hospital or call ambulance
AMPUTATION
- 3 priorities
- stop the bleeding
- preserve the body part
- reassure the patient
what type of dressing should you use on an amputation?
low-adherent, non-fluffy dressing
how should you store the amputated body part?
2 things + 1 warning
- wrap in plastic bag
- put on ice
- DO NOT allow part to touch ice or get wet
INTERNAL BLEEDING
- 4 signs + symptoms
- signs of SHOCK
- pain at site of bleeding
- bruising and/or swelling
- other signs specific to part of body (e.g. difficulty breathing if bleeding near lungs)
INTERNAL BLEEDING
- treatment
(2 things)
- call emergency services
- treat for shock as necessary
what is CRUSH SYNDROME? when does it occur and why?
- when crush injury blocks bloodflow and toxins build up
- dangerous after 15 mins of blockage
- toxin levels can be so high as to cause kidney failure if released
CRUSH INJURY
- treatment less than 15 mins
(5 things)
- release casualty as quickly as possible
- call emergency services
- control bleeding / cover open wounds
- treat for shock as necessary
- monitor airway + breathing until help arrives
CRUSH INJURY
- treatment after 15 mins
(3 things)
- DO NOT release casualty
- call emergency services
- monitor airway + breathing
