ST JOHN’S AMBULANCE BRIGADE

PUBLIC SERVICE DEPT.

FIRST-AID LESSON

WOUNDS & BLEEDING1. Incised wound (severe), Abrasion, Punctured wound

2. Lacerated wound

3. Contused wound, internal bleeding

4. Gunshot wound

5. Impalement

6. Amputation

7. Crush injuries

8. Abdominal wound

9. Chest wounds

OBJECTIVES

To distinguish between the different types of bleeding

To be able to control bleeding

To minimize shock and infection

THE FOLLOWING PICTURES SHOWN MAY BE VERY DISTURBING AND GORY!

YOU MAY COVER YOUR EYES IF YOU DO NOT WANT TO LOOK.

DISCLAIMER!

TYPES OF WOUNDIncised wound

Lacerated wound

TYPES OF WOUND

TYPES OF WOUNDAbrasion

TYPES OF WOUNDContused wound

Punctured wound

TYPES OF WOUND

TYPES OF WOUNDGunshot wound

Impalement

TYPES OF WOUND

TYPES OF WOUNDAmputation

TYPES OF WOUNDCrush injuries

TYPES OF WOUNDAbdominal wound

TYPES OF WOUNDChest wounds

Internal bleeding

TYPES OF WOUND

Arterial bleeding Venous bleeding Capillary bleeding

Bright red in color

(oxygenated blood)

Dark red in color

(deoxygenated blood)

Flows in spurts in time

with heartbeat

(pumped from heart to

other parts of body; higher

pressure )

Blood gushes out profusely

(lower pressure in veins; blood

flow is more smooth)

Blood oozes out at site

of wound

(lowest pressure in

capillaries)

Severed main artery

(e.g.carotid artery) may jet

blood several feet high

(pressure is highest in main

arteries)

Blood loss is usually slight

Rapidly reduce the volume of circulating blood

TYPES OF BLEEDING & THEIR CHARACTERISTICS

CAROTID ARTERY

GENERAL

Minor extent of bleeding (external)

Treatment (PCEDM)

1. Apply direct Pressure with a sterile dressing

2. Clean the wound by rinsing lightly under running water,

or using an antiseptic wipe.

3. Elevate above heart level

4. Apply small adhesive, sterile Dressing

5. Seek Medical aid if bleeding does not stop, or if there is risk of infection.

GENERAL

Severe extent of bleeding (external)

1. Dial for Ambulance (995).2. Expose the wound3. Apply direct Pressure over the wound with a sterile dressing 4. Elevate and support the wound above heart level.5. Lay the casualty down

Treatment (AEPELDLS)

Severe extent of bleeding (external

Treatment (AEPELDLS)

• 6. Apply sterile Dressing and secure it firmly in place with a

• bandage • 7. If bleeding seeps through, apply another

Layer of • bandage on top• 8. Treat for Shock.

Incised wound (severe), Abrasion, Punctured wound

An open wound

Rapid, weak pulse

Swell

Pain

Signs & Symptoms

Incised wound (severe), Abrasion, Punctured wound

Treatment

1. Apply direct pressure using a sterile dressing.2. Elevate the wound above heart level.3. Apply a sterile dressing over the wound and bandage firmly to secure it in place.4. If bleeding seeps through the bandage, apply another layer of bandage over the previous layer.5. Apply cold compress to the swell.6. Check and treat for shock.

Moving the fractured/dislocated limbs may aggravate the condition.

For casualties suffering from lower body fractures/dislocations, it may not be possible to treat for shock.

Limitations

Incised wound (severe), Abrasion, Punctured wound

Incised wound (severe), Abrasion, Punctured wound

Warning!

DO NOT bandage too tightly.

Constantly check for circulatory refill.

DO NOT remove the previous layer of bandage.

DO NOT apply cold compress for more than 10 minutes as it may result in frostbite.

• Large area of raw flesh

• Bleeding

• Rapid, weak pulse

• Pain

Lacerated woundSigns & Symptoms

TreatmentLacerated wound

1. Apply direct Pressure with a sterile dressing

2. Elevate above heart level

3. Apply sterile Dressing, and secure with micropore

4. If bleeding seeps through, Apply another layer of dressing over the previous layer.

5. Check and treat for shock.

• may not be applicable for casualties who are also suffering from fractures or dislocations on the limbs

• If casualty is suffering from lower body fractures/dislocations, it may not be possible to treat for shock

Limitations

Lacerated wound

• Ensure that the sterile dressing is larger than area of wound

• Do not remove the previous layer of dressing

• Do not apply cold compression for more than 10 minutes

Warning!

Lacerated wound

• Blue-black colouration

• Swell

Contused wound, internal bleeding

Signs & Symptoms

1. Apply cold compression to the area of injury

2. If blue-black colouration persistently remains, consult a qualified medical worker. (contusion)

3. Dial for ambulance, 995 if it is in the case of internal bleeding.

Contused wound, internal bleeding Treatment

• Do not apply for more than 10 minutes as it may result in frostbite.

Contused wound, internal bleeding

Warning!

• open wounds, entry and exit, with shapes of a bullet tip

• Rapid, weak pulse

• Swell

• Pain

Gunshot wound Signs & Symptoms

1. Douse entry and exit wounds with water for 10 minutes.

2. Apply direct pressure using a sterile dressing.

3. Elevate the wound above heart level.4. Apply a sterile dressing over the wound

and bandage firmly to secure it in place.

TreatmentGunshot wound

1. If bleeding seeps through, apply another layer of bandage over the previous layer.

2. Apply cold compress to the swell.

3. Check and treat for shock.

Gunshot wound Treatment

• This may not be applicable for casualties who are also suffering from fractures or dislocations on the limbs

• If casualty is suffering from lower body fractures/dislocations, it may not be possible to treat for shock

Gunshot wound

Limitations

• Do not bandage too tightly such that circulation is impeded.

• Do not remove the previous layer of bandage

• Do not apply cold compression for more than 10 minutes

Warning!

Gunshot wound

• An object embedded onto the skin of the casualty

• Bleeding

• Rapid, weak pulse

• Swell

• Pain

Impalement Signs & Symptoms

1. Using sterile dressings, build up padding on both sides of the object, until the object is stabilized.

2. Secure the padding with bandages.

Impalement Treatment

1. If bleeding seeps through, apply another layer of bandage over the previous layer.

2. Apply cold compress to reduce swelling.

3. Check and treat for shock

Impalement Treatment

• If casualty is suffering from lower body fractures/dislocations, it may not be possible to treat for shock

Impalement

Limitations

Impalement

Warning!

• Do not bandage too tightly such that circulation is impeded.

• Do not remove the previous layer of bandage

• Do not apply cold compression for more than 10 minutes

• A stud on the casualty

• Amputated body part nearby

• Rapid, weak pulse

• Pallor

AmputationSigns & Symptoms

Wound:• Apply direct pressure with a sterile

dressing.• Elevate the wound above heart level.• If bleeding seeps through, apply another

layer of bandage over the previous layer.• Check and treat for shock.

TreatmentAmputation

Amputated part:1. Collect the amputated part and wrap it in

gauze, after which you wrap it in a plastic bag and place it in another plastic bag of crushed ice.

2. Send the amputated part to the hospital together with the casualty.

TreatmentAmputation

• This may not be applicable for casualties who are also suffering from fractures or dislocations on the limbs

• If casualty is suffering from lower body fractures/dislocations, it may not be possible to treat for shock

Amputation

Limitations

• Do not remove the previous layer of bandage

• Make sure the plastic bag is not damp

Amputation

Warning!

• A fallen object crushing onto the casualty

• Pain

Crush injuries Signs & Symptoms

If casualty is crushed for less than 15mins:

1. Release him/her as soon as possible.

2. Treat any possible wounds/fractures found on the casualty.

3. Check and treat for shock.

4. Dial for ambulance 995

Crush injuries Treatment

If casualty is crushed for more than 15mins:

1. do not release the casualty.

2. Instead, call for ambulance and

3. reassure casualty.

Crush injuries Treatment

• An open wound

• Rapid, weak pulse

• Pallor

• Possible protruding intestine

Abdominal wounds Signs & Symptoms

1. If intestine is protruding, cover with large, moist sterile dressing, then cover with a plastic sheet and secure it lightly.

2. If there is no protruding intestine, check if wound is horizontal or vertical.

Abdominal wounds Treatment

For vertical wounds,

1. Do not raise legs. Instead,

2. just apply pressure at site of wound to control bleeding.

3. Check and treat for shock.

Abdominal wounds Treatment

If wound is horizontal

• keep legs propped up/raised and

• cover wound with sterile dressing.

• Check and treat for shock.

Abdominal wounds Treatment

• Do not raise leg if wound is vertical.

Warning!

Abdominal wounds

• An open wound• Rapid, weak pulse• Possible foreign object still embedded at

wound• Pallor• Sucking wound (if lung is punctured)• Wheezing sound (if lung is punctured)

Chest wounds Signs & Symptoms

1. Cover the wound and apply pressure with a sterile dressing.

2. Cover with a plastic sheet and tape 3 sides of the plastic, leaving the bottom side open (apply airtight bandage).

3. Apply a chest bandage.4. Check and treat for shock.

Chest wounds Treatment

1. For casualties with punctured lungs, tilt him/her to the injured side.

2. Regulate casualty’s breathing

Chest wounds Treatment

ST JOHN’S AMBULANCE BRIGADE

PUBLIC SERVICE DEPT.

FIRST-AID LESSON

Any Questions?