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Bleeding

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Blood loss; Open injury bleeding

First Aid:

First aid is appropriate for external bleeding. If bleeding is severe, or if shock or internal bleeding is suspected, get emergency help immediately!

1. Calm and reassure the victim. The sight of blood can be very frightening.
2. If the wound is superficial, wash it with soap and warm water and pat dry. Superficial wounds or scrapes are injuries that affect the top layers of skin and bleeding from such wounds is often described as "oozing," because it is slow.
3. Lay the victim down. This will reduce the chances of fainting by increasing the blood flow to the brain. When possible, elevate the bleeding area.
4. Remove any obvious loose debris or dirt from a wound. If an object such as a knife, stick, or arrow becomes embedded in the body, DO NOT remove it. Doing so may cause more damage to the victim and may increase the amount of bleeding. The object also might be embedded in an artery or organ. Place pads and bandages around the object and tape the object in place.
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. Direct pressure is best for external bleeding, except for an eye injury.
6. Maintain pressure until the bleeding stops. When it has stopped, bind the wound dressing with adhesive tape or a piece of clean clothing. A cold pack should be applied over the dressing. Do not peek to see if the bleeding has stopped.
7. 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. Be sure to seek medical attention.
8. 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.

Do Not:

• DO NOT apply a tourniquet to control bleeding, except as a last resort. Doing so may cause more harm than good. A tourniquet should be used only in a life-threatening situation and should be applied by an experienced person. A tourniquet can be used if there is torrential bleeding and if continuous pressure isn't stopping the bleeding. A tourniquet should be applied to the limb between the bleeding site and the heart. The tourniquet should be tightened to the point where the bleeding can be controlled by applying direct pressure over the wound. To make a tourniquet, use bandages 2 to 4 inches wide and wrap them around the limb several times. Tie a half or square knot, leaving loose ends long enough to tie another knot. A stick or a stiff rod should be placed between the two knots. Twist the stick until the bandage is tight enough to stop the bleeding and then secure it in place. Check the tourniquet every 10 to 15 minutes. If the bleeding becomes controllable, (manageable by applying direct pressure), release the tourniquet.
• DO NOT probe a wound or pull out any embedded 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 the 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 embedded gravel or dirt cannot be removed easily with gentle 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.)
• If the injury involves an animal or human bite.
• If you are not up-to-date on tetanus immunization (within 5-10 years).

• Review Date: 6/7/2006
• Reviewed By: J.A. Lee, M.D., Division of Surgery, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.

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