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© 2016 National Safety Council CHAPTER 8 Controlling Bleeding Video – Bleeding and wound care

CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

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Page 1: CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

© 2016 National Safety Council

CHAPTER 8

Controlling BleedingVideo– Bleedingandwoundcare

Page 2: CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

Chapter 8 • Controlling Bleeding

1. Explain the effects of blood loss and the body’s mechanisms to control bleeding.

2. Describe the different types of external bleeding.

3. Demonstrate the steps for controlling external bleeding.

4. Demonstrate the steps for applying a pressure bandage.

© 2016 National Safety Council

Lesson Objectives

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Chapter 8 • Controlling Bleeding

5. List the steps for caring for a bruise.

6. List the signs and symptoms of internal bleeding and describe the first aid to give.

© 2016 National Safety Council

Lesson Objectives continued

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Chapter 8 • Controlling Bleeding

• Many injuries cause external or internal bleeding.

• Injuries may be minor or life threatening.

• Most external bleeding is not severe and can be controlled.

© 2016 National Safety Council

Bleeding

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Chapter 8 • Controlling Bleeding

• Body can compensate for small blood loss (with a loss of 15-30% the victim remains alert and blood pressure and puls are close to normal)

• Severe blood loss (> 30%) results in lack of oxygen and shock.

• In infants and children, severe bleeding becomes critical more quickly.

Effects of Blood Loss

8-5© 2016 National Safety Council

Page 6: CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

Chapter 8 • Controlling Bleeding

• Vascular spasm constricts blood vessel.

• Platelets form platelet plug.

• Clotting seals leak in the blood vessel.

• These mechanisms may not be enough to stop severe bleeding.

© 2016 National Safety Council

The Body’s Control of Bleeding

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Chapter 8 • Controlling Bleeding

• Occurs when skin and other tissues damaged and blood escapes

• Rate of bleeding depends on size and type of damaged vessels:• Injury to major vessel close to skin surface as in the

case of the scalp and face may cause heavy bleeding.

© 2016 National Safety Council

External Bleeding

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Chapter 8 • Controlling Bleeding

Types of External Bleeding

© 2016 National Safety Council

8-8

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Chapter 8 • Controlling Bleeding

• Give first aid immediately to stop bleeding.

• Apply direct pressure on wound covered with sterile dressing.

• Press directly with gloved hand or improvised barrier.

© 2016 National Safety Council

Controlling External Bleeding

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Chapter 8 • Controlling Bleeding

• A new, special kind of dressing to help control bleeding

• Promote rapid blood clotting

• Used if other methods cannot control bleeding

© 2016 National Safety Council

Hemostatic Dressings

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© 2016 National Safety Council

CHAPTER 8

Skill: Controlling Bleeding

Page 12: CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

Chapter 8 • Controlling Bleeding

1. Put on gloves.

Improvise a barrier if no barrier is available.

© 2016 National Safety Council

Skill: Controlling Bleeding

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Chapter 8 • Controlling Bleeding

Skill: Controlling Bleeding continued

2. Place a sterile dressing or clean cloth on the wound.

3. Apply firm, direct pressure with your hand for about 5 minutes.

• Do not put pressure on an object in a wound.

• Do not put pressure on the scalp if the skull may be injured.

8-13© 2016 National Safety Council

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Chapter 8 • Controlling Bleeding

4. Reevaluate the bleeding:

Skill: Controlling Bleeding continued

a. If direct pressure does not control the bleeding and you have a hemostatic dressing, remove dressings already used and apply the hemostatic dressing directly on the wound using direct pressure.

b. If a hemostatic dressing is not available, continue to apply direct pressure. If blood soaks through the first dressing, place additional dressings on top of the blood-soaked dressing and keep applying pressure.

8-14© 2016 National Safety Council

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Chapter 8 • Controlling Bleeding

Skill: Controlling Bleeding continued

5. If needed, apply a pressure bandage to keep pressure on the wound, wrapping from theend of the extremity toward the center of the body.

The pressure is sufficient if the bandage is snug but you can slip a finger under it. Use a tourniquet when direct pressure and a pressure bandage do not control severe bleeding from a limb. Tourniquets should only be used as an extreme last resort by rescuers trained in their use.

8-15

© 2016 National Safety Council

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Chapter 8 • Controlling Bleeding

6. If appropriate, treat the victim for shock and call 9-1-1.

© 2016 National Safety Council

Skill: Controlling Bleeding continued

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Chapter 8 • Controlling Bleeding

• Apply, if needed, over wound on extremity to maintain direct pressure.

• Use roller bandage to completely cover wound and maintain pressure.

• Make sure it doesn’t cut off circulation.

• Check victim’s fingers and toes for circulation.

Pressure Bandages

8-17© 2016 National Safety Council

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Chapter 8 • Controlling Bleeding

• May be needed to help control bleeding from an extremity not otherwise controlled.

• Consider in these situations:• There are multiple victims to care for.• The victim has multiple injuries requiring care.• The environment is unsafe and you need to evacuate the victim.• You are unable to access the wound.

© 2016 National Safety Council

Tourniquets

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Chapter 8 • Controlling Bleeding

1. To make a tourniquet, use a non-stretchy material, such as terry cloth or a triangular bandage, folded lengthwise to be 1-2 inches wide.

2. Tie the tourniquet around the injured arm or leg, several inches above the injury. If the injury is below the elbow or knee, you may need to tie the tourniquet above the joint. Use a common square knot (like tying your shoes without the bow).

© 2016 National Safety Council

Steps for Improvising a Tourniquet

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Chapter 8 • Controlling Bleeding

Steps for Improvising a Tourniquet continued

© 2016 National Safety Council

3. Above the first knot in the tourniquet, position a stick or other long object as a windlass that can be twisted to tighten the tourniquet, and tie a secondsquare knot. Use any long object that is strong enough to hold the tourniquet and can be secured in place (a pencil, stick, spoon, pipe, etc.).

4. Twist the windlass to increase the pressure until the bleeding stops.

5. Secure the windlass in place by tying one or both ends to the victim’s arm or leg.

6. If possible, mark the time the tourniquet was placed by putting a “T” on the victim’s forehead with the time/day.

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© 2016 National Safety Council

CHAPTER 8

Skill: Applying a Pressure Bandage

Page 22: CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

Chapter 8 • Controlling Bleeding

1. Place a sterile dressing or clean cloth on the wound.

Start wrapping an elastic or self-adhering roller bandage below the wound dressing, wrapping from the end of the extremity toward the center of the body.

Skill: Applying a Pressure Bandage

8-22© 2016 National Safety Council

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Chapter 8 • Controlling Bleeding

2. Make several circular turns, then overlap turns by about½ of previous turn.

Skill: Applying a Pressure Bandage continued

8-23© 2016 National Safety Council

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Chapter 8 • Controlling Bleeding

3. Work up the limb to cover the dressing completely.

The pressure is sufficient if the bandage is snug but a finger can be slipped under it.

Skill: Applying a Pressure Bandage continued

8-24© 2016 National Safety Council

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Chapter 8 • Controlling Bleeding

4. Fix or tie the end of the bandage in place.

Skill: Applying a Pressure Bandage continued

8-25© 2016 National Safety Council

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Chapter 8 • Controlling Bleeding

• Follow standard precautions.

• Use a barrier (e.g., gloves, plastic wrap, victim’s ownhand).

• Wash hands immediately before touching anythingelse.

• Dispose of soiled supplies appropriately.

• Disinfect all contaminated items.

© 2016 National Safety Council

Preventing Bloodborne Infection

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© 2016 National Safety Council

CHAPTER 8

Learning Checkpoint 1

Page 28: CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

Chapter 8 • Controlling Bleeding

• Any bleeding within body when blood does not escape

• Can be life threatening

• Consider the mechanism of injury

© 2016 National Safety Council

Internal Bleeding

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Chapter 8 • Controlling Bleeding

• Closed wound may cause a bruise:• Minor local bleeding in the skin

• More serious injury can cause deeper organs to bleed severely – do not give the victim anything to eat or drink.

© 2016 National Safety Council

Internal Bleeding continued

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Chapter 8 • Controlling Bleeding

1. Check for signs and symptoms of a fracture or sprain and give appropriate first aid.

2. Put ice or cold pack on area.

3. With arm or leg, wrap area with elastic roller bandage. Keep the part raised to help reduce swelling.

© 2016 National Safety Council

First Aid: Simple Bruises

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Chapter 8 • Controlling Bleeding

1. Have victim lie on his or her back. 2. Call 9-1-1.

3. Be alert for vomiting. Put a victim who vomits or becomes unresponsive in the recovery position.

4. Keep the victim from becoming chilled or overheated.5. If the victim becomes unresponsive, monitor breathing and

be ready to give CPR.

© 2016 National Safety Council

First Aid: Internal Bleeding

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© 2016 National Safety Council

CHAPTER 8

Learning Checkpoint 2

Page 33: CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

© 2016 National Safety Council

Chapter 8 • Controlling Bleeding

You receive a call that a worker in the shipping department is injured. You grab the first aid kit and arrive at the scene within a minute. The injured woman is holding a bloody rag wrappedaround her hand. She says she was using a box cutter, whichslipped and made a gash in her hand. She unwraps the rag toshow you, and you see a deep laceration that is still bleeding.

What are the important steps you should take?

Chapter – Opening Scenario

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© 2016 National Safety Council

CHAPTER 8

Critical Thinking Challenge Questions

Page 35: CHAPTER8 Controlling Bleedingwebsites.rcc.edu/daddona/files/2016/09/NSC-Chapter-8-1.pdfChapter 8 • ControllingBleeding 1. Explain the effects of blood loss and the body’s mechanisms

Chapter 8 • Controlling Bleeding

A coworker who was repairing a piece of equipment suddenly yells and grabs at his arm. You see blood flowing from between his fingers. You check him and see the blood is spurting from a severed artery.

What do you do to try to stop the bleeding?

© 2016 National Safety Council

Scenario 1

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Chapter 8 • Controlling Bleeding

Even with your pressure on the wound, the bleeding continues through the dressing.

What do you do next?

© 2016 National Safety Council

Scenario 1 continued

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Chapter 8 • Controlling Bleeding

You are riding the bus home from work in the evening. As the bus stops where you will get off, an inebriated passenger in front of you staggers and trips on the last step and lands on the sidewalk. Not seeing what happened, the bus driver pulls away. The man rolls over, and you see that his shirt over his shoulder is rapidly becoming soaked with blood –he apparently landed on a piece of broken glass. You have neither a cell phone or a first aid kit with you.

What do you do?

© 2016 National Safety Council

Scenario 2

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Chapter 8 • Controlling Bleeding

You respond to a scene where a construction worker is lying unresponsive on his back. Another worker tells you that a few minutes ago the victim was struck in the abdomen by a concrete block that tumbled from on top of a wall. This other person unbuttoned the man’s shirt to see if he was bleeding, and although his skin is abraded and bruised, there is no active external bleeding.

What are the first actions you should take?

© 2016 National Safety Council

Scenario 3

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Chapter 8 • Controlling Bleeding

You carefully check his abdomen. It is hard and swollen, and his skin is cool and moist.

Now what should you do?

© 2016 National Safety Council

Scenario 3 continued

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© 2016 National Safety Council

CHAPTER 8

Discussion and Questions