BLEEDING

OBJECTIVES

At the end of this session, each student should be able to:Determine type of bleeding.Describe how to control bleeding. Identify common signs of internal bleeding.Describe how to control epistaxis.

Bleeding (hemorrhage) is the escape of blood from capillaries, veins, and arteries.

Bleeding can be external (i.e., outside the body), internal (i.e., inside the body), or external and internal.

Note:Uncontrolled bleeding (massive bleeding نزيف

whether external or internal, is life ,( شديدthreatening.

Bleeding also has three types:Arterial Bleeding شرياني :نزيف

The BRIGHT RED blood "spurts" from the wound.

Arterial bleeding is life-threatening and difficult to control.

Loss of blood is pulsating شكل على الدم تدفقاتفقد. كالنبض

Venous Bleeding وريدي : نزيف The DARK RED (reddish purple) blood flows in a

steady stream ومستمر منساب . بشكلCapillary Bleeding الدموية للشعيرات نزيف

: A slow medium red blood "oozes" from the

wound site.

Notes:Capillary bleeding is usually not serious

and can easily be controlled.Arterial and Venus bleedings are more

serious and can be life-threatening.

METHODS TO CONTROL BLEEDING

There are four methods to control bleeding: 1. Direct Pressure, 2. Elevation, 3. Indirect Pressure, and 4. The Use of a Tourniquet.

1. Direct Pressure Direct pressure is the first and most effective

method to control bleeding. In many cases, bleeding can be controlled by

applying pressure directly to the wound. Place a sterile dressing or clean cloth on the

wound, tie a knot ) ربطة ) عقدة or adhereاعملtape directly over the wound, only tight enough to control bleeding.

If bleeding is not controlled, apply another dressing over the first or apply direct pressure with your gloved hand or fingers over the wound.

2. ElevationElevation of an injured arm

or leg (extremity) above the level of the heart will help control bleeding.

Elevation should be used together with direct pressure.

Do NOT elevate an extremity if you suspect a broken bone (fracture) until it has been properly splinted.

3. Indirect Pressure (ONLY) In cases of severe bleeding when

direct pressure and elevation are not controlling the bleeding, indirect pressure must be used.

Bleeding from an artery can be controlled by applying pressure to the appropriate pressure point. Pressure is applied with the fingers, thumb, or heel of the hand.

Pressure Points are areas of the body where the blood flow can be controlled by pressing the artery against an underlying bone.

Indirect Pressure Points

Indirect Pressure Points

Notes: Indirect pressure is used in addition to direct

pressure and elevation. Indirect pressure can cause damage to the extremity

due to inadequate blood flow. Pressure points should be used with caution.

Do NOT apply pressure to the two neck (carotid) pressure points at one time, it can cause cardiac arrest.

The brachial artery is used to control severe bleeding of the lower part of the arm.

The femoral artery is used to control severe bleeding of the thigh and lower leg.

4. The Use of Tourniquet A tourniquet should be used only as a last resort حل آخر

to control severe bleeding After all other methods have failed. It is used ONLY on the extremities.

Tourniquets cause tissue damage and loss of extremities when used by untrained individuals. Tourniquets are rarely required and should only be

used when an arm or leg has been partially or completely severed and when bleeding is uncontrollable.

A tourniquet can be a strap, belt, towel, or other similar item. NEVER use wire, cord, or any material that will cut the skin.

Application of TourniquetLeave at least 2 inches (5 cm) of uninjured

skin between the tourniquet and wound. Place a pad (roll) over the artery. Wrap the tourniquet around the extremity

twice.Never cover a tourniquet. Identify the time in which tourniquet was

applied.

INTERNAL BLEEDING

INTERNAL BLEEDING

Internal bleeding, although not usually visible, can result in serious blood loss.

  Victims with internal bleeding can develop

shock before you realize the extent of their injuries.

  Bleeding from the mouth, ears, nose, rectum,

or other body opening (orifice) is considered serious and normally indicates internal bleeding.

Common Causes of Internal BleedingDeep chest or abdominal wound.Any cut into muscle or fracturing of bone.Bleeding ulcers ( المعدة في الداخلية التقرحات نزيف

) مثال . واألمعاء

Signs of Internal BleedingAnxiety and restlessness راحة وعدم .قلقExcessive thirst (polydipsia) شديد . عطشNausea and vomiting. Coolبارد , moistرطب , and pale skin جلد

اللون شاحبRapid breathing (tachypnea). Rapid, weak pulse (tachycardia). Bruising ازرقاقor discoloration at site of

injury (contusionرضات ).

If you suspect internal bleeding, do the following:Apply ice or cold pack [inside a cloth to

prevent damage to the skin], to reduce pain and (edema) swelling.

Call local emergency or medical personnel. Monitor circulation, airway, and breathing

(CAB). Treat for shock. Place the victim in most comfortable

position. Maintain normal body temperature. Reassure the victim.

EPISTAXIS (NOSE BLEEDING)

األنف رعاف

It is hemorrhage from the nose, due to mainly rupture of minute vessels.

ألوعية تفجر بسبب عادة ينتج األنف، من نزيف هي) صغيرة ) دقيقة

Common CausesTrauma due to:

(1) blow on the nose األنف على and ,ضربة(2) foreign body غريب . جسم

Violent sneezing وقوي شديد . عطس

Blood diseases دموية . أمراض

Hypertension الشرياني الدم ضغط . ارتفاع

First Aid TreatmentApply pressure by pinching the

nostrils for 5-10 minutes.

Keep the patient in a sitting, leaning forward position.

Apply ice over the nose.Keep the patient quite.

Hospital Emergency CareSimple packing of the nose.Use of adrenaline nasal pack. In hypertension cases: sedation and

decreasing blood pressure.Check for blood coagulative disorders.

الدم بتجلط متعلقة أمراض عن استفسر