Trauma & Bleeding
Types of Wounds
Wounds are injuries in our skin or tissues. They often bleed and if treated improperly, the 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 edges and it bleeds as blood vessels are lacerated. This type of wound is usually covered with dirt, mud or dust.
(3) Contused Wound- Inner skin tissue bleeds and the wound swells.
(4) Punctured Wound- The wound is generally small but it can be very deep and cause damage inner skin tissue.
(5) Gun Shot Wound- The bullet may remain in the body or pass through it. Therefore it is possible to have one or more wounds. A bullet entering a body will cause damage to its inner tissue, organs or spine.
Symptoms of Bleeding
Bleeding occurs when blood vessels are damaged or torn. It 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:
(1) Pulse accelerating but weakening
(2) Blood pressure dropping
(3) Feeling thirsty
(4) Skin perspiring, cold and pale
(5) Feeling feeble and weak
(6) Feeling restless
(7) Respiration shallow and quick
(8) Showing signs of air hunger
(9) Cyanosis etc
Treatment for Bleeding
Bleeding can be stopped by the direct pressure method or the indirect pressure method, both of which are most commonly used in first aid:
(1) When using the direct pressure method, let the injured lie down and rest with the limb elevated (except for fracture victims).
(2) Inspect the wound, wash it with distilled water, expert direct pressure on it by hand over a dressing, and bandage it. Do not bandage it too tightly in order not to affect the normal blood circulation.
(3) If there are impaled objects or protruding bones, exert direct pressure on the edge of the wound to stop the bleeding.
(4) If the direct pressure method cannot control the bleeding, apply pressure over the arterial pressure points to facilitate blood coagulation. The bleeding will normally stop if the points are pressed for 5 to 10 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 deeply inserted into the wound. Place a piece gauze with a hole in the middle over the wound and apply a ring pad around the foreign body, or surround the wound with a dressing built up like a dam before finishing it up with bandaging.
Nose Bleeding
Nose bleeding results from the injury of 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 swallows or inhales the blood, it will cause vomiting or difficulty in breathing.
Clinical Features
(1) Blood oozes from nostrils.
(2) 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 and pinch the soft part below his nasal bone forcefully. Apply a cold dressing to his forehead.
(3) Ask the injured not to swallow the blood lodged in his throat.
(4) Loosen his tight clothing.
(5) If the 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 the bleeding stops.
(7) If the nose bleeding still continues, send the injured to hospital immediately.
Treatment for Severed Limbs
If a limb of the injured is severed, the first aider must control the bleeding and preserve the severed limb, which should be taken to hospital together with the injured for a rejoining operation.
Treatment
(1) Stop the bleeding with the treatment for external bleeding.
(2) Place the severed limb in a clean plastic bag. Then fill a container such as a plastic case or plastic bag with ice cubes and put the severed limb inside. Do not soak the severed limb in water or wash it with water. Do not allow the severed limb to have direct contact with the ice cubes.
(3) Send the injured to hospital together with the severed limb.