Bleeding and Wounds 4

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Information about Bleeding and Wounds 4

Published on February 7, 2008

Author: Rina


:  Bleeding And Wounds Sources of External Bleeding: Sources of External Bleeding Arteries Veins Capillaries Arterial Bleeding: Arterial Bleeding Most serious / arteries are usually deep in the body Rapid and profuse blood loss Bright red / spurts Less likely to clot Must use external means to stop blood flow Venous Bleeding: Venous Bleeding Steady flow / bluish-red May be profuse More easily controlled Veins are closer to the body surface Can be serious Capillary Bleeding: Capillary Bleeding Easily controlled Blood oozes Road rash Blood Vessel Spasm: Blood Vessel Spasm Severed arteries Artery draws back into the tissue Artery constricts and slows bleeding Partially severed arteries Associated with greater blood loss Example: amputations Definitions: Definitions Hemorrhage: Rapid blood loss Adult: 1 quart may lead to shock Child: 1 pint loss of blood Dressing A protective covering for a wound – Bandage A material used to hold a dressing in place Dressings: Dressings Used to control bleeding Prevents contamination Dressings should be: Sterile Larger than the wound Thick, soft, compressible Lint free (no cotton balls) Types of Dressings: Types of Dressings Gauze pads Adhesive strips Trauma dressings Improvise Donut shaped Dressings: Dressings Application Wash hands Dressing should extend over edges of wound Do not touch dressing surface that is to be next to the wound Place medications directly onto pad Cover with a bandage Removal of Dressings Soak “stuck” dressing in warm water Bandages Are Used For:: Bandages Are Used For: Holding dressings in place Applying pressure Prevent or reduce swelling Provide support or stability Application of Bandages: Application of Bandages Leave toes and fingers exposed if possible Bandage too tight? Check for color, circulation, temperature Wrap towards the heart Small end of bone to large end Types of Bandages: Types of Bandages Roller gauze Improvised Triangular Cravat Adhesive / paper tape Adhesive strips Tourniquets are rarely recommended Damage to nerves and vessels Someone Has A Cut Leg: What Should You Do? (external bleeding / depends on severity): Someone Has A Cut Leg: What Should You Do? (external bleeding / depends on severity) Call for help when necessary Protect yourself from bodily fluids Expose the wound Apply sterile gauze pad (dressing) Apply constant, direct pressure for 10 minutes (don’t peak) Cut Leg: Cut Leg If dressing becomes blood soaked do not remove dressing, add others over it After 10 minutes, if bleeding persists apply pressure harder and over a wider area for 10 more minutes (seek help) Additional Options: Additional Options Elevate limb above heart level Apply pressure at a pressure point When bleeding stops: Apply pressure bandage (roller gauze) Wrap towards the heart Problem Bleeders: Problem Bleeders Hemophiliacs Aspirin When Not To Apply Direct Pressure: When Not To Apply Direct Pressure Protruding bone Skull fracture Embedded object May use a donut shaped pad Types of Open Wounds : Types of Open Wounds Abrasion – scrape Incision – smooth edged cut (not in text) Laceration – jagged irregular edges Puncture – deep, narrow stab wound High rate of infection (animal bites) Should heal from inside out Gently press on wound edges to promote bleeding – rinse wound -dress Avulsion – flap of skin torn loose Amputation – cutting off a body part Minor Open Wounds: What To Do: Minor Open Wounds: What To Do Wear gloves and expose wound Control bleeding Clean wound To prevent infection Wash shallow wound gently with soap and water (betadine) Wash from the center out / Irrigate with water for 5 minutes Severe wound? Control bleeding and get help Wound Care: Wound Care Do not close wound with steri-strips Use roller bandages (or tape dressing to the body) Keep dressings dry and clean Change at least daily More frequently if wet or dirty Use antibiotic ointments for shallow wounds only Wound Care #2: Wound Care #2 Do not apply: Mercurochrome, merthiolate, iodine, alcohol, or hydrogen peroxide Do not make dressing air tight If dressing sticks? soften with warm water prior to removal Signs of Wound Infection: Signs of Wound Infection Swelling, redness, pain, warmth Fever / chills Swollen lymph nodes Red streaks Tetanus (lock jaw) Receive injection in first 72 hours Throbbing Pus When To Seek Medical Attention ** Indicates High Chance of Infection: When To Seek Medical Attention** Indicates High Chance of Infection Arterial or other uncontrolled bleeding Deep incisions, lacerations, avulsions Severe injury in “bend” Wound gapes open (stitches) Large or deeply imbedded objects **Significant debris (bike wreck, chainsaw, tattoo **Animal bites, ragged wounds **Large or deep puncture wounds When To Seek Medical Attention #2: When To Seek Medical Attention #2 If scarring would be significant Eyelids (prevent drooping) Slit lips Extremely dirty Injury to bone, joint, tendon Any situation in doubt (ear ring) If no tetanus shot in past 10 years 5 years for dirty wound Significant infection Amputations: Amputations Crushing Poor chance of reattachment Guillotine Clean cut Good chance of reattachment (fingertips of kitchen counter) De-gloving Skin peeled off Amputation: What To Do: Amputation: What To Do Control bleeding Treat for shock Recover body part Transport Care For Amputated Part: Care For Amputated Part Wrap in dry clean cloth Do not wrap in wet dressing Place in waterproof container Place bag on bed of ice Transport immediately Blisters: Blisters Prevention (hike up mountain) Duct tape Donut shaped moleskin Spenco second skin Do not remove “roof” Open or Painful Blister: Open or Painful Blister Clean blister site – treat as a minor wound To drain a blister: Sterilize needle Make several holes at blister base Apply antibiotic ointment and dressing Change daily Check for infection Impaled Object: Impaled Object Do not remove Control bleeding Stabilize object Shorten object only if necessary One exception: If impaled in cheek and > l hour from help Control bleeding Dressings inside and outside of cheek (frog gig) Houston, TX, Dec. 2000 Child with pencil Impaled Eye: Impaled Eye Do not apply pressure to eye Place padding around object Stabilize object Paper cup Cover both eyes Explain to victim Seek medical attention Blow to the Eye: Blow to the Eye Call 911 or transport if: Eye is bleeding Eye is leaking fluid Cold Pack Do not remove contacts Particles in the Eye: Particles in the Eye Do not rub Flush with water Potentially, brush out particle with a sterile dressing Chemical Burn to the Eye: Chemical Burn to the Eye Flush 20 minutes with low pressure water Milk or other non-irritating liquid Remove contacts Flush outward Roll eyeball Loosely bandage both eyes with cold, wet dressings Seek medical attention Dry Chemical Burns: Dry Chemical Burns Dust off chemical Protect yourself Then rinse 20 minutes Eye Avulsion: Eye Avulsion Do not replace in socket Cover loosely with moistened sterile dressing Pad around area Cover with paper cup etc. Cover uninjured eye Medical attention Unconscious Victim’s Eyes: Unconscious Victim’s Eyes Keep eyes closed by: Taping Cover with moist dressings Ear Injuries: Ear Injuries Insect in ear: (cricket) Irrigate – pour lukewarm water into ear and try to float it out Do not try to float out a bean or popcorn (Wooden bead in ear) Bleeding from within the Ear: Bleeding from within the Ear Watery blood could mean a skull fracture Allow victim to sit up and tilt the affected ear lower to let blood drain out Cover ear with loose dressing but DO NOT apply pressure Nosebleeds: Nosebleeds Prevention: Humidifier, vaporizer, vaseline Types: Anterior Posterior Nosebleeds: First Aid: Nosebleeds: First Aid Sitting position Tilt head slightly forward Pinch nose 10 minutes Bleeding persists? Repeat pressure for 10 more minutes Ice bridge of nose If available, spray with Afrin or Neo-Synephrin When to Seek Medical Attention for Nosebleeds: When to Seek Medical Attention for Nosebleeds Second attempt to control bleeding fails Bleeding keeps reappearing Posterior bleeding Weakness or faintness Taking anticoagulants / aspirin Other health problems (son) Foreign Objects in Nose: Foreign Objects in Nose Peanuts, beans, french fries… (little sister smelled) Do not have a child try to “blow” an object outGently blow Tweezers? Possibly for adults – not children Broken Nose: Broken Nose Ice pack Treat as nose bleed (nephew) Dental Injuries: Dental Injuries Knocked out tooth Broken tooth Knocked Out Tooth: Knocked Out Tooth Rinse mouth / rinse tooth if dirty Place roll of gauze in the socket Do not scrub or use alcohol or mouthwash on the tooth Never touch root Transport in cold, whole milk Broken Tooth / Fractured Jaw: Broken Tooth / Fractured Jaw Broken tooth? Clean area Cold compress Remote area? Candle wax, gum See dentist Fractured jaw? Immobilize Medical attention (mom w undiagnosed broken jaw) Scalp Wounds: Scalp Wounds Suspect spine injury Profuse bleeding Skull or brain exposure? Indentation in skull? Control bleeding Scalp Wounds #2: Scalp Wounds #2 Depressed skull fracture? Use donut shaped dressing Apply pressure around edges of wound Elevate head and shoulders if appropriate Lessens bleeding Do not remove impaled objects Immobilize with bulky dressings Skull Fractures: Skull Fractures Signs and symptoms Penetrating wound Point tenderness Deformity Skull Fractures #2: Skull Fractures #2 Bleeding from ears or nose Leakage of clear or pink watery fluid from ears or nose (CSF fluid) Halo effect Discoloration under eyes or behind ears Unequal pupils Profuse bleeding Skull Fracture: What To Do: Skull Fracture: What To Do Monitor ABC’s Apply dressing Control bleeding as best as possible Stabilize neck (elevate head if appropriate) Do not clean open skull fracture Do not stop CSF flow Medical attention Fish-hook Removal: Fish-hook Removal Do not remove if near eye or other problem areas Tape in place, transport Otherwise: Ice area Push hook through Cut off barb and back hook out Internal Bleeding: Internal Bleeding Look for abdominal: Pain Tenderness Rigidity Bruises Internal Bleeding: Internal Bleeding Look for: Black stools Bright red stools Cough or vomit with blood Fractured ribs or bruises Internal Bleeding: What To Do: Internal Bleeding: What To Do Monitor ABC’s Lay on side if appropriate (expect vomiting) Treat for shock Raise legs 8-12 inches (if conscious) Cover victim Bruises: Ice, ace wrap, elevate

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