Bleeding is a loss of blood from the blood vessels.Severe or continued bleeding may lead to collapse and death. Thus, the first aider must aim to control severe bleeding. The total quantity of blood in the human body varies according to size. An adult can lose 500 ml of blood without any harm, but the loss of 300 ml might cause death in an infant.

Remember :severe bleeding is serious. The extent of bleeding may be hidden . Act quickly !

CONTENTS

External Bleeding

Uncontrolled Bleeding

Internal Bleeding

External Bleeding

Symptoms and signs

• obvious bleeding.

Management

- DRABC

- lay casualty down

- apply direct pressure to the site of bleeding

- raise and rest the injured part when possible

- loosen tight clothing

- give nothing by mouth

- seek medical aid urgently.

Direct pressure

1. Apply direct pressure to the wound with your fingers or hand.

2. As soon as possible , place a clean dressing over the wound. Apply a bulky pad extending beyond the edges of the wound, and firmly bandage. If bleeding continues , leave the dressing in place and relocate the pad.

3. Do not disturb pads or bandages once bleeding is controlled.

Uncontrolled Bleeding

If severe bleeding cannot be controlled by direct pressure , it may be necessary to apply pressure to the pressure points. These are found on the main artery above the wound. When bleeding has been controlled, remove pressure to the point and reapply direct pressure to the wound. Occasionally, in major limb injuries such as partial amputations and shark attack , severe bleeding cannot be controlled by direct pressure. Only then, it may be necessary to resort to the application of a constrictive bandage above the elbow or knee.

Using a constrictive bandage

1. Select a strip of firm cloth, at least 7.5 centimetres (3 inches) wide and about 75 centimetres (30 inches)long. This may be improvized from clothing or a narrow folded triangular bandage.

2. Bind the cloth strip firmly around the injured limb above the bleeding point until a pulse can no longer be felt beyond the constrictive bandage and bleeding is controlled. Tie firmly.

3. Note the time application. After 30 minutes, release tje bandage and check for bleeding . If there is no bleeding, remove it .If bleeding recommences, apply direct pressure. If this is unsuccessfully, reapply the constrictive bandage, and recheck every 30 minutes.

4. Ensure that the bandage is clearly visible and inform medical aid of the location and time of its application.

Internal Bleeding

Symptoms and signs

Evidence of internal bleeding from some organs may be seen by the first aider. For example :

• coughing up red frothy blood

• vomiting blood the colour of coffee grounds or bright red. The blood may be mixed with food.

• passing of faeces with a black, tarry appearance

• passing of faeces which are red in colour

• passing urine which has a red or smoky appearance.

Concealed bleeding within the abdomen may be suspected when there is :

• pain

• tenderness

• rigidity of abdominal muscles.

Internal bleeding will be accompanied by any of the following symptons and signs :

• faintness or dizziness

• restlessness

• nausea

• thirst

• weak , rapid pulse

• cold , clammy skin

• rapid , gasping breathing

• pallor

• sweating.

Management

- lay the casualty down

- raise the legs or bend the knees

- loosen tight clothing

- seek medical aid urgently

- give nothing by mouth

- reassure the casualty