First Aid
Injuries and Hemorrhage
 

Are all hemorrhages equal in various blood vessels? 
Of course, no. The degree of seriousness and bleeding types vary according to the bleeding blood vessel, as each vessel has its own specific pressure. Types of hemorrhage are:
 
Arterial bleeding:
Arteries are muscular and elastic tubes that transport oxygenated blood under a high pressure from one’s heart to the rest organs. Pulse results as the beating heart forces blood circulation into arteries. When an artery is cut, the wound bleeds as pulses due to the high pressure. Bleeding is rated as highly serious as soon as making sure that both one’s heart and lungs function properly. If not stopped, bleeding leads to losing most of the blood due to the high blood pressure in arteries.
 
Venous bleeding: 
Veins carry the blood from various organs back to one’s heart. Veins are not as strong as arteries, with no high pressure.

Venous bleeding: the blood flows from the damaged vein, not as pulse spurts. Venous bleeding is less serious than arterial bleeding, as the former stops automatically after 6-8 minutes. Off course, major venous incised wounds are exception if any.
 
Capillary bleeding: 
Capillary is any of the minute blood vessels that form networks throughout the bodily tissues; it is through the capillaries that oxygen and wastes - like carbon dioxide - are exchanged between the blood and the tissues.

Capillary bleeding is generally no big deal. Usually from an abrasion rather than a cut. Just a slow blood red ooze or drip that’s easy to fix later after attending to other more important issues.

This bleeding stops automatically after 2-3 minutes. This is most common bleeding type encountered by paramedics.
 
How to stop bleeding? 
99% of bleeding cases are stopped by pressing the bleeding site using absorbent pads.
 
What is an absorbent pad? 
An absorbent pad is a piece of any material put on the wound to stop bleeding. The ideal absorbent pad is made of medical gauze known for absorbing liquids and not sticking to wounds. Yet, this type of pad is not available all the time at the incident site. If medical gauze is not available, use any alternate material provided that it clean and non-sticky.
 
As a paramedic, you can use cloth, towels and bed sheets as pads to bleeding wounds. Paper towels and toilet paper are not a good option since they crumble when in water. They also stick to wounds, which may contaminate injuries and result in untold complications later.
 
What is a dressing? 
Dressing refers to any material used to bandage the pad on the bleeding wound. There are specific rolls used to bandage wounds, yet if not available, you can use anything found, such as neckties, headbands or even leather belts.
 
Bandage the wound firmly but check for blood circulation to ensure dressing is not too tight.
 
How to stop bleeding? 
Make sure that you and the victim take a safe position, the victim’s airway is clear, as well as his lungs and heart function normally. This is extremely important.
  • Put on latex gloves if any to prevent bacterial and viral infection.
  • Lay the victim down to prevent loss of consciousness. 
  • Try to an absorbent non-sticky material to pad the bleeding wound.
  • If possible, hold the injured part a bit higher than the rest of the body.
  • Put a thick cloth on the wound pad and press firmly to stop bleeding, this usually takes less than (5) minutes.
  • If saturated with blood, make sure to press directly on the bleeding wound. Add more cloth and press harder on the wound.
  • When bleeding stops, bandage the pad on the wound using a dressing.
  • If bleeding persisted for long period, call the ambulance. The ambulance team will give oxygen, along with many other things to stop the bleeding if direct pressing fails to stop it.
 
How to stop Epistaxis (nosebleed)?
  1. Get the victim sit down and lean his body and head slightly forward. 
  2. Pinch together the outer soft parts of the nose using clean cloth.
  3. Keep pinching for 3-5 minutes.
  4. Take the victim immediately to the hospital in the following two cases:
    • If epistaxis is not stopped.
    • If the victim suffers from hypertension.
 
How to stop Ear Bleeding: 
If due to incident, this type of ear bleeding is very serious as it could be caused by skull fracture.
Do not try to stop ear bleeding. Immediately call the ambulance.
 
What are incised cuts that require taking the victim to hospital? 
Seek medical consultation on the following cases:
  • If bleeding is not stopped.
  • If wound is more than 1 inch long.
  • If wound is more than 2cm deep.
  • If wound if forked and wide-open.
  • If wound is dirty or with a foreign object inside.
  • If victim is vaccinated with tetanus in the last five years.
  • If you find an emergency to call a specialist.
 
If not, a paramedic can wash the wound with water and soap, then apply a dressing. Keep the dressing on the wound till it heals completely, as the dressing helps keep the wound hydrated to expedite its healing.




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