Blood

• The primary function of the blood is to

o supply nutrients and oxygen to body
tissues
o remove waste products such as carbon
dioxide
• Consists of approximately of
o 55 percent plasma (liquid)
o 45 percent cells or solid particles
➢ 44 percent red blood cells
➢ 1 percent white blood cells and platelets
Blood
• Circulating blood volume adult: 5 quarts/liters
• Actual blood volumes will vary depending on
body size
• Acute blood loss may result in hypovolemic
shock
• Hemorrhaging must be stopped to avoid
hypovolemia, which is especially important in
children because they have less circulating
blood volume than most grown adults
 3 TYPES OF EXTERNAL BLEEDING

1. Bleeding from injured

arteries
➢ is generally more serious
and is more likely with
deep injuries
➢ the blood is bright red,
may spurt from the wound,
and blood loss can be very
rapid.
➢ this bleeding needs to be
controlled immediately
 3 TYPES OF EXTERNAL BLEEDING

2. Bleeding from injured

veins
➢ is generally slower and
steady but can still be
serious
➢ the blood is dark red and
flows steadily rather than
spurting
➢ this bleeding is usually
easier to control
 3 TYPES OF EXTERNAL BLEEDING

2. Bleeding from injured

capillaries
➢ occurs with shallow cuts or
scrapes and often stops
soon by itself
➢ the wound still needs
attention to prevent
infection
• Minor bleeding
o little support will stop blood loss
o clean and dress wounds
o Stop by itself or with light pressure on
the dressing
• Severe bleeding
o additional intervention may be
needed
o give first aid immediately to stop
bleeding
First responders can aid
the clotting
process by applying
direct pressure
on the wound, using an
absorbent bandage.
When approaching an injured person,
perform the following:

• Assess the scene, and ensure that the

person is breathing.
• If the injury requires medical attention,
activate EMS.
• Ask permission to provide first aid.
• Don gloves/personal protective
equipment.
Direct Pressure

• is usually sufficient to control most

bleeding
• accomplished by using an absorbent pad
or dressing and gloved hands
• If the bleeding continues and seeps
through the pad, add additional
absorbent material on top of the original
pad.
• Continue to hold direct pressure until the
bleeding stops.
• Secure the pad with a clean or sterile
bandage
- bandage: extending past the edge,
1-2” if possible
• Wrap the bandage from the distal side
(farthest from the heart) of the wound
site toward the heart
• The bandage should help maintain direct
pressure but not prevent circulation.
• To check circulation:
o squeeze the nail beds and look for the
pink color under the nails to return
quickly after pressure is released It
should return to its normal pink color in
2-3 seconds.
o In cold conditions, color refill may take
slightly longer.
o If color does not return in a timely
manner, loosen the bandage and
rewrap
Tourniquets

• are a primary intervention when the

bleeding is a massive arterial (spurting)
bleed and is life-threatening
• a wide band placed tightly enough
around an arm or leg to stop blood flow.
• It must be applied with sufficient force to
stop arterial bleeding, not just venous
bleeding
✓ Double-check the effectiveness:
assessing distal pulses, which should not
be present if the tourniquet is applied
tightly enough
A tourniquet should be:

• utilized only when direct pressure is not

effective
• wide (at least 2" wide if an improvised
tourniquet is used)
• well-padded (6-8 layers of a bandaging
material)
• placed 1-2" proximal to the wound
Note:

A tourniquet shoult not be

• placed directly over knees, elbows or other joints.
If there isn’t room to place a tourniquet between a
wound and a joint, place the tourniquet 1-2"
proximal to the joint.
• made of wire or rope. A narrow, excessively tight
or insufficiently padded band may cause local
damage to tissues in minutes.
Applying a tourniquet
• Before applying a tourniquet, inspect the
wound to ensure direct pressure was
being applied directly to the site of the
bleeding. If not, attempt direct pressure
once more.
• Place a commercial tourniquet and
secure it in place.
• Twist the windlass until bleeding stops
and secure it with the mechanism on the
tourniquet.
• Using a marker, write on the injured
person’s forehead “T” or “TK” (for
“tourniquet”) and the time the tourniquet
was placed.
• The tourniquet should not be removed
until advanced medical care is available.
• Wrap an improvised tourniquet proximal
to the wound several times.
• Secure in place with an overhand knot
• Place a stick or similar object on top of
the knot, and tie a second overhand knot
over it.
• Twist this “handle” just until the bleeding
stops.
• Secure the handle in place by wrapping it
with a second bandage
NOTE:

• Death of tissue below the tourniquet

is possible after two or more hours.
• Tourniquets may cause pain in the
extremity.
Hemostatic Dressings

• Remove any other dressing

materials so the agents can have
direct contact with the bleeding
site.
• Cover the entire bleeding surface
with the hemostatic dressing, and
continue direct pressure.
• Apply additional layers of
hemostatic dressings if necessary.
• Hold dressings in place with a
pressure bandage
Hemostatic Dressings

• Advise medical personnel that a

hemostatic agent was used to assist with
the control of bleeding.
• Retention of the dressing’s packaging
material may be helpful to emergency
personnel.
• Hemostatic dressings should not be left in
place for more than 24 hours.
Open Chest Wounds

• contact EMS immediately.

• Leave the open chest wound exposed
to ambient air.
• Dressings should not be applied except
to address active bleeding.
• Take care to ensure that a saturated
dressing does not cause occlusion,
partial or complete.
So why dressings should not be applied
to open wounds without bleeding?

• Risk of infection: Open wounds are

susceptible to infection. Dressing a
wound that is not actively bleeding can
potentially trap bacteria or dirt against the
wound, increasing the risk of infection.
• Delayed healing: Applying a dressing to
a wound that doesn't require it may
interfere with the body's natural healing
process. Some wounds heal better when
left uncovered and exposed to air.
So why dressings should not be applied
to open wounds without bleeding?

• Moisture retention: Dressings can

create a moist environment that may
promote bacterial growth and hinder the
wound's healing process.
• Potential irritation: Some dressings or
adhesive materials used to secure them
can cause irritation or allergic reactions,
even if the wound isn't actively bleeding.
FIRST AID

When You See

• Bleeding
• Blood on a victim
• Shock: pale, clammy skin
Do This First
1. Put on medical exam gloves or use
another barrier to protect yourself from
contact with the blood ( such as
dressings, a plastic bag, or the victim’s
own hand).
2. Move aside any clothing and place a
sterile dressing (or clean cloth) on the
wound, then apply direct pressure on
the wound with your hand.
Do This First
3. With a bleeding arm or leg, raise the
limb above the heart level while keeping
pressure on the wound. Be careful
moving the victim because of the
possibility of other injuries.
4. If blood soaks through the dressing, do
not remove the old dressing, but put
another dressing or cloth pad on top of
it and keep applying pressure.
Do This First
5. If possible, wrap a roller bandage
around the limb to hold the dressings in
place and apply pressure. Be careful
not to cut off circulation to the limb.
6. If direct pressure does not control the
bleeding, also apply indirect pressure at
a pressure point in the arm or leg to
artery closed
Use indirect pressure to pressure points to
stop bleeding
Additional Care
• Call 911
• Treat the victim for shock
• Do not remove the dressings/bandage.
The wound will be cleaned later by
medical personnel
PERFORM THE SKILL
Controlling Bleeding
PERFORM THE SKILL
Controlling Bleeding
PERFORM THE SKILL
Controlling Bleeding