Bleeding

 Human body contains approximately five liters of blood.

 A healthy adult can lose up to half liter of blood without harmful
effects.
 Loss of more than this can be threatening to life. Bleeding must be
controlled immediately to prevent excessive loss of blood. 
 Severe bleeding
• Normal blood volume- 5 litres
• Hemorrhage rapidly & extensively– death in
few mins
• May be externally to outside of the body or
internally into tissue spaces/body cavity
• Sign & symptom depends on the speed &
amount of blood lost
• Once bleeding controlled- place in reclining
position, lie & treat for shock
 Sign & symptom of blood loss
• Weakness, fainting, dizziness
• Pale, moist & clammy skin
• Nausea, thirst
• Fast, weak & irregular pulse
• Shortness of breath
• Dilated pupils
• Ringing in the ears
• Restlessness & apprehension
- DON’T GIVE FLUID BY MOUTH in suspected
internal injury
 Control Of Bleeding

1. Direct Pressure 2. Elevation

3. Pressure points 4. Tourniquet

1) Direct pressure
-place dressing, apply pressure with palm (dressing- sterile/ clean
cloth/bare hand)
-if soaked, apply another over first one
-don’t remove the first one or it’ll disturb the clotting process
-don’t cut off circulation (examine pulse)
-bandage undisturbed for 24 hr
-if not soaked with blood, can leave for several days
2) Elevation

- elevate the affected part (head & extre;)

- lower blood pressure & lessen blood flow
3) Pressure points
-when press & elevation can’t control bleeding
- press the artery supplying the area
- use only when necessary ( reduce the blood flow below the pressure point)
Pressure points
4) Tourniquet
-only when all other means have failed
-shut off all normal circulation beyond application point–-- destruction of
tissue & possible amputation of limb
-periodically release– loss of blood---shock
-too tight/loose---^ blood loss
-if applied, immediate radio medical Advice;
-wide band of cloth; folded bandage, cloth
-NEVER COVER/ HIDE TOURNIQUET
-NEVER LOOSEN unless physician advises, - record the time
 Internal bleeding
 May be concealed or revealed
 If in broken limb, amt can be detected by
swelling size
 Bleeding in chest or abdominal cavities may
be revealed if coughed up or vomited
 In this case, casualty will be in shock
 Look out for sign & symptom of shock
(rapid pulse, rapid respiration, cold
extremities, thirst, nausea, restlessness, ..)
 Most important indication of continuing
bleeding---rising pulse & falling BP
 If suspect internal bleeding, record pulse &
BP every 5-10 mins.
 After 1 hr , if pulse & BP remains normal---
then, no bleeding
 If bleeding (+), may need blood transfusion.
 Get RADIO MEDICAL ADVICE
 Lay down the casualty , slight head-down
tilt, raise legs
 Bleeding from nose
-pinch for 10 mins
-slowly release, look for drips
-not to blow nose for next 4
hrs
-refrain from violent nose-
blowing over next 2 days
-if continue bleeding, press on
soft part for 10 min again
-if still bleed, need to pack the
affected side with strip gauze
 Bleeding
• LIP, CHEEK & TONGUE: press on both sides
with gauze/swab
• TOOTH SOCKET: see dental emergencies
• EAR PASSAGE: d/t head injury or blast
pad over ear
bandage in position
keep affected ear downward
Never plug with cotton wool
get radio medical advice
 Shock
 Shock is the result of a decrease in vital functions of the various
organs because of inadequate circulation of blood or oxygen
deficiency.
Some causes of shock are;

 Severe painful injuries

 Severe bleeding
 Extensive burns
 Extensive loss of body fluids
 Eg. Diarrhea
 All allergic reactions
 Poisoning from drugs, gases and chemicals
 Alcohol intoxication
 Rupture of stomach ulcer
 Septicemia
 Strokes
 Heart attack
Sign and Symptoms of shock
 The skin is pale, cold and moist
 Rapid and shallow respiration
 Thirst ,nausea and vomiting
 Weak and rapid pulse
 Restlessness
 Decreased blood pressure

Treatment
 
 Eliminate the causes of shock.
 This includes controlling bleeding, restoring breathing and relieving
severe pain.
 Have the injured person lie down.
 The patient should be placed in a horizontal position. The legs may be
slightly elevated to assist blood flow to heart and head.
 Keep the patient warm, but not hot.
 Relieve pain as quickly as possible.
 Administer fluids.
 Liquids should not be given by mouth if the patient is unconscious,
convulsing or about to have surgery. If none of the above conditions
is present, can given a solution of oral rehydration salts or any
liquid except alcohol. Alcohol should NEVER be given.
 Intravenous administration of fluids is preferable if a trained
person is available.
 In a case of suspected shock, get Radio Medical Advice.

30 cm