First aid for
• Definition of bleeding
• Definition of Hemorrhage
• Classification of bleeding
• Forms of external bleeding
• Signs and symptoms of hemorrhage
• Complications of bleeding:
• First aid for bleeding
• Bleeding from special areas(epistaxis, ear, scalp)
• International first aid and resuscitation guidelines
It is escape of blood from the blood vessels.
Bleeding may occur externally or internally.
.
• Refers to a large amount of bleeding in
a short time
According to blood vessels
– Arterial bleeding: is Bright red. The blood spurts as
a jet, which rises and falls in time with the pulse.
•
•
– Venous bleeding: is a darker red and escapes as
a steady flow.
– Capillary bleeding: is bright red, often rapid ooze. If
continuing for many hours blood loss can become
serious.
According to time of onset
– Primary bleeding: is that which occur at the time of
injury.
– Reactionary bleeding: occurs 24-48 hours after an
injury as a result following a rise in blood pressure It
may be due to rise of blood pressure, vomiting or
coughing.
• – Secondary bleeding: occurs 3-10 days after an injury
as a result of damage to a blood clot (or ligature)
following bacterial invasion.
According to site
• Internally: where blood leaks from blood
vessles inside the body
• Externally: either through a natural opening
such as the vagina ,mouth, nose ,or anus, or
through a break in the skin.
Other forms of external bleeding
• 1-Hematemesis: vomiting of blood.
• 2- Melena: tary stool (black faeces due to
presence of blood).
• 3- Epistaxis: bleeding from nose.
• 4- Hemoptysis: coughing of blood, the most
common causes are pulmonary infection (T.B),
lung abscess, and neoplasms.
• 5 - Rectal bleeding: passage of blood in stool this
may occur in case of cancer colon & rectum,
hemorrhoids & anal fissure and liver disease.
• 6- Vaginal bleeding: passage of blood from
vagina as in case of cancer cervix.
Signs and symptoms of hemorrhage
Pale face and lips.
Cold clammy skin.
Faint and dizzy.
Rapid and weak pulse "thready".
Subnormal temperature.
Restlessness.
Respiration are rapid and shallow. and air hunger
Complications of bleeding
• Shock
• Organ failure
• Death
HOW TO CONTROL BLEEDING
Dr.Heba Elsayed
Internal bleeding
• It occurs when the skin is unbroken & blood is
not visible.
• It may be more serious than external bleeding.
• It comes from injuries that do not break the
skin or from non traumatic disorders such as
ulcers.
• It can occur in the abdominal cavity as
a result of perforation of organ or as a result
of accident.
Signs of internal bleeding
Bruises or contusion of the skin.
Painful, tender, rigid, bruised abdomen.
Fractured ribs or bruises or chest.
Vomiting or coughing up blood.
Stool that are black or contains bright red blood.
1- Lay the victim down with his head low and to
one side to ensure a good blood supply to his/her
brain & prevent aspiration if vomiting occurs. Advise
him/her not to move.
2- If his injuries allow, raise his/her leg to aid the
return of blood flow to the vital organs.
3- Loosen any constricting clothing around
his/her neck, chest and waist.
4- Reassure him/her and explain the necessity for
him/her to relax.
5- Check breathing and pulse rate and level of
responsiveness at 10-minute intervals, and record these for
the doctor.
6- Examine the victim for other injuries and treat as
necessary.
7- If he becomes unconscious, keep his/her airway open and
check breathing and complete the ABC of resuscitation .
8- Keep the victim covered and place a blanket underneath
him/her if possible.
5- Keep a record of any specimen passed or vomited by the
victim.
10- Arrange urgent transfer tElosayehd ospital.
1.Sit the victim down.
2.Lean slightly forward to prevent blood from running
into victim's throat.
3.Instruct the victim to breath through mouth and
avoid blowing coughing spitting and sniffing.
4.Place cold, wet cloths or an ice pack over the nose
area to constrict the blood vessels in nose and stop the
bleeding.
5. Pinch nostrils together for at least 10 minutes.
6.Ifbleeding continues, apply pressure for
another 10 minutes.
7.If the bleeding is the result of direct injury to
the nose, only gentle pressure should be applied.
8.Insert a piece of gauze saturated with local
vasoconstricting drug (Adrenaline) into nostril.
9.If bleeding does not stop within short time,
victim should be transferred immediately to the
hospital.
• Place the victim in dorsal position, head raised
and inclined to side of injury.
• Place a dressing or pad over the ear and secure it
in position (avoid packing of the ear canal.
• Observe respiration and pulse.
• Transfer victim immediately to the hospital.
1- Apply clean dressing around the wound but not
on the fracture or foreign body.
2- Observe pulse and respiration and level of
responsiveness at 10 minutes intervals.
3- If the victim becomes unconscious open his/her
airway and complete the ABC of resuscitation if
required and place him/her in recovery position.
Transfer victim immediately to hospital.
International first aid and resuscitation guidelines
• First aid providers must control external bleeding by
applying direct pressure.
• Elevation if possible.
• Localized cold therapy with or without pressure
may be beneficial in hemostasis for closed bleeding
in extremities.
• The out-of-hospital application of a topical
haemostatic agent to control life threatening
bleeding not controlled by standard techniques.
