Trauma & Bleeding

1.	Various Types Of Wound Wounds are injuries to our skin or tissues. Wounds often bleed and if treated improperly bleeding will result in deterioration of the injury or infection.
	(1)	Incised Wound The skin tissue is cut evenly. If the major vessels are injured, heavy bleeding will occur.
	(2)	Lacerated Wound The wound has ragged edge and bleeding is caused by laceration of the blood vessels. This type of wound is usually covered with dirt, mud or dust.
	(3)	Contused Wound The inner skin tissues are bleeding and the epidermis will change colour.
	(4)	Punctured Wounds Wounds are generally small but they can be so deep that inner skin tissues will be damaged.
	(5)	Gun Shot Wounds The bullet may remain in the body or pass through it. Therefore it is possible to have one or more wounds. A bullet entering the body will cause damage to our inner tissues, organs or the spine.
2.	Symptoms Of Bleeding Bleeding occurs when blood vessels are damaged or torn. Bleeding can be divided into three main categories: arterial bleeding; venous bleeding and capillary bleeding. When heavy bleeding occurs, the injured will have these clinical features: pulse accelerating but weakening, blood pressure dropping, feeling thirsty, skin perspiring, cold and pale, feeling feeble and weak, feeling restless, respiration shallow and quick, showing signs of air hunger and cyanosis.
3.	Treatment For Bleeding The ways to stop bleeding include direct pressure method and indirect pressure method. Direct pressure and indirect pressure methods are most commonly used in first aid. When using the direct pressure method, the injured should lie down and rest with the injured limb cushioned above the ground (except for fracture victims). Inspect the wound, cover and bandage it with dressing. Exert pressure but avoid bandaging it too tightly by which may impair blood circulation to the end of the limb. If there is any foreign body or broken bone protruding from the wound, pressure may be exerted on the edge of the wound. If the direct pressure method cannot control bleeding, apply pressure over the arterial pressure points to facilitate blood coagulation. Press for 5 to 10 minutes and never exceed 15 minutes. If there is any foreign body in the wound, rinse away any loose bit on the surface with water. Then treat the wound as if there were no foreign body. Do not try to remove any foreign body which is inserted deep into the wound. Place gauze with a hole in the middle over the wound and apply a ring pad around the foreign body or surround the wound with dressing built up like a dam before finishing up with bandage.
4.	Nose Bleeding Nose bleeding results from injury of the blood vessels inside the nose. Nose picking, sneezing, forceful nose rubbing or trauma to the nose can cause damage to the nasal blood vessels. Nasal polyp and nasopharyngeal carcinoma can also cause heavy nose bleeding. If the injured person swallows the blood, it will cause vomiting or difficulty in breathing. Clinical Features : - Blood oozing from nostrils. - In the case of basilar cranial fracture, there will be cerebrospinal fluid in the blood. Treatment
	(1)	Sit the injured up with his head dropping forward.
	(2)	Ask the injured to breathe with his mouth. Then forcefully pinch the soft part below his nasal bone and apply a cold dressing to the forehead.
	(3)	Ask the injured not to swallow the blood lodged in his throat.
	(4)	Loosen his tight clothing.
	(5)	If bleeding continues after kneading his nose for 10 minutes, continue to knead his nose for another 10 minutes.
	(6)	Ask the injured not to blow his nose within four hours after bleeding stops.
	(7)	If nose bleeding still continues, send the injured to hospital immediately.
5.	Treatment of Amputations If the limb of the injured has been amputated, the first aid personnel must control bleeding and preserve the broken limb which should be taken to hospital together with the injured for rejoining operation.
	(1)	Stop bleeding with treatment for external bleeding.
	(2)	Place the amputated limb in a clean plastic bag. Then fill another container such as a plastic case or plastic bag with ice cubes and put the amputated limb inside. Do not soak the amputated limb in or wash it with water. Do not allow the amputated limb to have direct contact with ice cubes.
	(3)	Send the injured to hospital together with the amputated limb.

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