Emergency bleeding control

Emergency bleeding control describes the steps or actions taken to control bleeding from a patient who has suffered a traumatic injury or who has a medical condition which has led to bleeding. Many bleeding control techniques are taught as part of first aid throughout the world, although some more advanced techniques such as tourniquets, are often taught as being reserved for use by health professionals, or as an absolute last resort, in order to mitigate the risks associated with them, such as potential loss of limbs. In order to manage bleeding effectively, it is important to be able to readily identify both types of wounds and types of bleeding.

Wounds are normally described in a variety of ways. Descriptions may include wound size (length) and thickness; plainly visible wound characteristics such as shape and open or closed; and origin, acute or chronic. The most common descriptors of wounds are these:

Laceration moulage

Abrasion on the palm of the hand

Contusion

External bleeding is generally described in terms of the origin of the blood flow by vessel type. The basic categories of external bleeding are:

The type of wound (incision, laceration, puncture, etc.) will have a major effect on the way a wound is managed, as will the area of the body affected and the presence of any foreign objects in the wound. The key principles of wound management are:

Elevation was commonly recommended for the control of haemorrhage. Some protocols continue to include it, but recent studies have failed to find any evidence of its effectiveness and it was removed from the PHTLS guidance in 2006.

Placing pressure on the wound will constrict the blood vessels manually, helping to stem any blood flow. When applying pressure, the type and direction of the wound may have an effect, for instance, a cut lengthways on the hand would be opened up by closing the hand into a fist, whilst a cut across the hand would be sealed by making a fist. A patient can apply pressure directly to their own wound, if their consciousness level allows. Ideally a barrier, such as sterile, low-adherent gauze should be used between the pressure supplier and the wound, to help reduce chances of infection and help the wound to seal. Third parties assisting a patient are always advised to use protective latex or nitrile medical gloves to reduce risk of infection or contamination passing either way. Direct pressure can be used with some foreign objects protruding from a wound; padding is applied from each side of the object to push in and seal the wound - objects are never removed.

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Wikipedia