First Aid International

Bleeding

Bleeding is the loss of blood from the vessels that make up the circulatory system. These vessels are known as arteries, veins and capillaries. There is two forms of bleeding, external or internal. External bleeding is obvious, whereas internal bleeding is more difficult to detect.

Blood Vessels

Arteries

  1. bright red blood

  2. usually spurting

Capillaries

  1. red in colour

  2. oozing from the wound at a steady rate

Veins

  1. darker in colour

  2. flows from the wound

Components of blood

Plasma makes up about half of the total blood volume. The other components are the red blood cells, white blood cells and the platelets. White blood cells are responsible for fighting disease. The red blood cells carry oxygen. The platelets are responsible for clotting the blood.

Blood functions

The blood has three major functions:

  1. transport of oxygen, nutrients and wastes

  2. protection against disease by transport of antibodies to defend against germs, and assistance with clotting and healing in response to injury

  3. maintenance of constant body temperature by circulating throughout the body.

External bleeding

Severe external bleeding occurs after a deep incision or laceration. The most serious bleeding is from an artery. This can be life-threatening if the cut is large and under too much pressure to control. Minor bleeding usually stops by itself within 10 minutes when the blood clots.

Signs of external bleeding

The signs of life-threatening external bleeding include:

  1. blood spurting from a wound

  2. blood that fails to clot after all measures have been taken to control bleeding

  3. the casualty will also display signs of shock.

Management of bleeding

Inspect the wound to ensure there are no objects embedded.

  1. Apply direct pressure to the wound

  2. Lie the casualty down and elevate the affected area, if injuries permit

  3. Ensure once applied that the bandage is not too tight and there is good circulation beyond the bandage

  4. If bleeding continues through the padding, remove padding then reassess and relocate pad and bandage

  5. Monitor the casualty’s pulse and breathing

  6. Treat for shock

  7. Call ambulance if necessary.

Preventing the transmission of diseases

  1. Ensure that you do not come in contact with your casualty’s blood. There needs to be an effective barrier between you and the casualty. Examples of these are: casualty’s own hand, gloves or clean folded material.

  2. Wash your hands with warm water and soap and dry them off effectively, both before and after care if possible and even if you wore gloves.

  3. Avoid talking, coughing, sneezing and laughing over the casualty’s open wound.

Steps to control bleeding

  1. Direct pressure

  2. Pad and bandage

  3. Elevation

Internal bleeding

Internal bleeding occurs when there is a rupture of either arteries, veins or capillaries. Capillary bleeding is seen in the form of bruising beneath the skin and is usually not considered serious. Deeper bleeding involving arteries or veins and may result in severe blood loss.

Internal bleeding often results from a traumatic incident. It is possible for the casualty to not show any signs of internal bleeding but there may be significant damage to perhaps the liver and spleen as there is no bone coverage of the abdominal cavity. There may also be severe damage to the vessels if injured by penetrating or embedded objects.

Signs and Symptoms

  1. Pain at the sight

  2. Tenderness

  3. Rigid abdominal muscles

  4. Bleeding from other signs eg coughing or vomiting blood

  5. Signs of shock.

  6. Rapid, weak pulse

  7. Bleeding from other body orifices

Management of internal bleeding

  1. DRABC

  2. Lie casualty down and rest comfortably

  3. Raise legs if injuries permit

  4. Keep casualty warm

  5. Reassure

  6. Continue to check pulse and breathing

  7. Call 000

  8. Do not give anything to eat or drink.

© First Aid International 2002

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