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Last modified / updated Jan. 01, 2016
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Bleeding or open injury bleeding

DEFINITION : To lose blood from the blood vessels. This can occur internally, externally through a natural opening (such as the vagina), or externally through a break in the skin.

CONSIDERATIONS : Direct pressure will stop most external bleeding. Bruises usually result from a blow or a fall. They are dark, discolored areas on the skin. Apply a cool compress to the area as soon as possible to reduce swelling. Do not put ice directly on the skin. The amount of blood is not a good way to judge the severity of an injury. Serious injuries don't always bleed heavily, and some relatively minor injuries (for example, scalp wounds) bleed profusely. The blood of people who take blood-thinning medication or who have a bleeding disorder such as hemophilia may not clot easily. Always wash your hands before (if possible) and after giving first aid to avoid the risk of infection and transmission of disease. If possible, use latex gloves before giving first aid. Puncture wounds, which usually don't bleed very much, are dangerous because of the risk of infection. Seek medical care to prevent tetanus or other infection. Abdominal wounds can be very serious because of the possibility of severe internal bleeding which may not be obvious externally, but which may result in shock. Seek medical care immediately if internal bleeding is suspected. If organs have been displaced by the wound, do not try to reposition them; cover the injury with a dressing, and do not apply more than very gentle pressure to stop the bleeding. Always seek emergency assistance if internal bleeding is suspected. This can rapidly become life-threatening. Immediate medical intervention may be needed to stop the bleeding; this can range from medications and intravenous fluids, to use of an internal scope (endoscope), to surgery. Seek emergency assistance for severe bleeding, loss of a body part, or head injury if appropriate.

CAUSES : Damage to a blood vessel causes bleeding, which can range from minor to life-threatening.

SYMPTOMS : Internal: - abdominal pain - swollen abdomen - dizziness or lightheadedness after an injury - external bleeding through a natural opening - signs of shock (see below) External through a natural opening: - blood in the stool (can appear black or bright red) - blood in the urine - vaginal bleeding (heavier than usual or for a prolonged time) - blood in the vomit (looks bright red, or brown like coffee-grounds) External - blood coming from an open wound - bruising Shock - paleness - clammy skin - bluish lips and finger nails - decreasing alertness - rapid pulse (heart rate) - low blood pressure - confusion - weakness.

DO NOT : -DO NOT APPLY A TOURNIQUET TO control BLEEDING, EXCEPT AS A LAST RESORT; DOING SO MAY CAUSE MORE HARM THAN GOOD. - DO NOT probe a wound or pull out any embed object from a wound. This will usually cause more bleeding and harm. - DO NOT try to clean a large wound. This can cause heavier bleeding. - DO NOT remove a dressing if it becomes soaked with blood. Instead, add a new one on top. - DO NOT peek at a wound to see if the bleeding is stopping. The less a wound is disturbed, the more likely it is that you'll be able to control the bleeding. - DO NOT try to clean a wound after you get bleeding under control. Get medical help. CALL IMMEDIATELY FOR EMERGENCY MEDICAL ASSISTANCE IF - the bleeding can't be controlled or is associated with a serious injury. - the wound might need stitches, or if embed gravel or dirt cannot be removed easily with gently cleaning. - internal bleeding or shock is suspected. - signs of infection develop including increased pain, redness, swelling, discharge, swollen lymph nodes, fever, or red streaks spreading from the site toward the heart. (This is usually treated with topical or oral antibiotics; if untreated an infection can cause a skin abscess or other complications). FIRST AID :

  1. - First aid is appropriate for external bleeding. If bleeding is severe, or if shock or internal bleeding is suspected, get emergency help immediately!
  2. Calm and reassure the victim. The sight of blood can be very frightening.
  3. Lay the victim down. This will reduce the chances of fainting by increasing the blood flow to the brain.
  4. Remove any obvious loose debris or dirt from a wound. However, do not remove any objects impale in the victim.
  5. Put pressure directly on an external wound with a sterile bandage, clean cloth, or even a piece of clothing. If nothing else is available, use your hand.
  6. Direct pressure is usually best for external bleeding, except for an eye injury, on a wound that contains an embed object, or on a head injury if there is a possibility of a fractured skull.
  7. If the wound is superficial, wash it with soap and warm water and pat dry. However, don't wash a wound that is deep or profusely. When the bleeding has subsided, even if the wound is still oozing, place a clean dressing over the wound. Bandage the dressing firmly (dressings should be large enough to extend at least 1 inch beyond the edges of the wound), but not so tightly that the victim's skin beyond the wound becomes pale and cool, which indicates that the circulation is cut off.
  8. Maintain pressure until the bleeding stops. When it does, bind the wound dressing tightly with adhesive tape. If none is available, use a piece of clean clothing.
  9. If bleeding continues and seeps through the material being held on the wound, do not remove it. Simply place another cloth over the first one.
  10. If the bleeding doesn't stop after 15 minutes of direct pressure or if the wound is too extensive to cover effectively, use pressure-point bleeding control. For example, in the case of a wound on the hand or lower arm, for example, squeeze the main artery in the upper arm against the bone. Keep your fingers flat; with the other hand, continue to exert pressure on the wound itself.
  11. If the bleeding is severe, get medical help and take steps to prevent shock. Immobilize the injured body part. Lay the victim flat,raise the feet about 12 inches, and cover the victim with a coat or blanket. However, do not place the victim in this position if there has been a head, neck, back, or leg injury or if the position makes the victim uncomfortable. Get medical help as soon as possible.

PREVENTION : - Use good judgment and keep knives and sharp objects away from small children. - Stay up-to-date on vaccinations. Generally, the tetanus immunization (vaccine) is renewed every 10 years. Immunization is indicated at 5 years if the person has had 2 or fewer prior immunizations; the wound is heavily contaminated (foreign material); or there is extensive crush injury or devitalized tissue.

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