FIRST AID IN THE X-RAY DEPARTMENT 193

The first aid treatment for haemorrhage is directed towards its arrest.
If the haemorrhage is external, the first action should be to apply pressure
to the wound, if possible with a clean, firm pad. It may, however, be more
important to apply the pressure as quickly as possible (for example if the
bleeding is arterial and profuse), and in that case the radiographer's thumbs
should be pressed on the wound. Firm pressure should be maintained.
In order to aid lowering of the blood pressure, the patient should be
put lying flat. His head should be lowered if possible, unless the bleeding
is from head or neck. If the site of haemorrhage is a limb, the limb should

be elevated unless there is suspicion of a fracture. Medical assistance should

be sought, and the patient should be reassured. It is generally recommended
that the patient should be kept warm, but overheating is to be avoided.
It may be presumed that in
X-ray department medical assistance
the
will it is unlikely that the
be available before much time has passed, and
radiographer will have to maintain for long unaided first aid measures for
haemorrhage. The direct pressure on the wound and the general proce
dures described are probably all that will be required.
However, as arterial bleeding is difficult to arrest because of the force
direct pressure on the wound may be insufficient in some cases.
it,

behind
In this circumstance pressure with the thumbs should be applied to the
artery itself at superficial and lies over bone,
point where the vessel
is
a

against which can be firmly compressed. These points are known as

it

pressure points, and they are found in various situations in the body. The
artery should be compressed at point between the wound and the heart.
a

The following examples give particular arteries and the points of pres
sure against underlying bone
:

of the zygomatic arch

The temporal artery against the posterior part
just above the temporomandibular joint.
The facial artery against the ramus of the mandible where the vessel
becomes superficial at point about inches anterior to the angle of
i|
a

the mandible.
The carotid artery against the transverse process of the 6th cervical
pressure placed at the anterior border of the sternomastoid
by

vertebra
muscle at the level of the cricoid cartilage, and directed backwards.
The subclavian artery against the first rib deep in the floor of the
of the clavicle,
by

supraclavicular fossa lateral to the medial end pressure

directed downwards.
The brachial artery against the inner side of the humerus about half
by

way between the medial epicondyle and the axilla, pressure directed