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| health information | health factsheets
Bleeding
Bleeding occurs when one or more blood vessels is damaged. Bleeding can be external from a wound or from the nose for instance, or it can be internal, when blood vessels insidethe body are damaged but the skin remains unbroken: this type of bleeding is harder to detect than external bleeding. There are three different types of bleeding:
There are three different types of bleeding:
- Arterial bleeding – bright red blood which spurts with each beat of the heart from damaged arteries (blood vessels which carry blood from the heart to the rest of the body).
- Venous bleeding – dark red blood which comes from veins (blood vessels that carry blood back to the heart). Blood loss may be severe but it occurs at a steady rate.
- Capillary bleeding – oozing blood from capillaries (tiny blood vessels found throughout the body). Only slight blood loss normally occurs.
The seriousness of the injury depends on the depth of the cut, the amount of bleeding, the time it takes to control the bleeding and the type of blood vessels damaged.
What are the possible complications of bleeding?
An average- sized adult has about 5 litres of blood and can safely lose half a litre.
However, rapid loss of larger volumes of blood leads to a dramatic fall in blood
pressure, general weakness, confusion and sweating, known as shock. In addition,
there is a risk of infection with any bleeding injury, especially if a foreign
object is present in the wound.
What should I do if someone is bleeding?
Be aware that coming into contact with blood and body fluids may expose you to infections such as hepatitis B and C, and HIV, so whenever possible, put on a pair of disposable, preferably sterile gloves before touching the person who is bleeding. If gloves are not available, use a thickly folded, smooth- textured cloth, such as a dish towel and wash your hands thoroughly before and after touching the person.
The aim of first- aid treatment of a bleeding wound is to stop or reduce blood loss and help the person cope with the effects of the blood already lost. Before giving any first aid, you should assess the degree of seriousness of the bleeding.
Major wound bleeding
- Phone 999 for an ambulance
- Check the injured person's ABC (see box bellow)
- If necessary, and you are trained to do so, perform cardiopulmonary resuscitation
- Check to see if an object, such as glass, is in the wound. Do not put direct pressure on a wound with an embedded object or a protruding bone. Instead, press down
firmly on either side. If there are no embedded objects or broken bones, apply
firm, direct pressure over a clean covering, if possible.
- Raise the injured body part above the level of the heart, while continuing to apply pressure
- Place a sterile dressing or clean piece of
cloth over the wound and bandage or wrap it firmly, but not too tight so that it
stops circulation. If the dressing becomes soaked with blood, do not remove it – this
may remove any blood clot that has begun to form. Instead, add another dressing or
piece of clean cloth on top.
ABC of first aid
Airway
Is the airway clear? If it is blocked: Place 2 fingers under the chin, put your other hand on the forehead, lift the jaw and tilt the head back slightly
Breathing
Is the person breathing? Look for chest movement, listen for breathing from the person's mouth, feel for the person's breath against your cheek
Circulation
Is the heart pumping blood around the body? Check the person's pulse in the neck, using finger tips (not thumbs).
Internal bleeding
Internal bleeding is always serious and requires immediate medical assistance.
Causes of internal bleeding include bone fractures, ulcers, certain drugs, or a
forceful external impact such as a road traffic accident. It can be difficult to know
if internal bleeding is occurring, but signs to look out for include a fast weak pulse,
marks or fresh bruises on the chest or abdomen, bleeding from mouth or blood
in urine, confusion or restlessness, or pale appearance with cold, clammy skin.
If you suspect internal bleeding:
- Have the person lie down and raise and support their legs
- Phone 999 for an ambulance and check the person's ABC every 10 minutes
- If necessary and you are trained to do so, perform cardiopulmonary resuscitation
Minor external bleeding
Minor bleeding can usually be stopped by applying pressure to the wound:
- First, rinse the wound under running water to clean it
- Pat the wound dry with a sterile gauze swab or any clean, non-textured cloth
- Put a sterile dressing or a clean, non-textured cloth on the wound and apply firm pressure to control bleeding
- Cover the wound with an adhesive dressing or a piece of cloth that you can tie securely in place.
If you can't stop the bleeding in a few minutes, seek medical help
Nosebleeds
Nosebleeds can occur spontaneously or
when a person has banged their nose or
been hit on the nose by someone else.
- Have the person sit down and loosen
any tight clothing around the neck.
- While the person is leaning forward,
pinch their nostrils just below the bony
part of the nose. The person should be
breathing through the mouth. Keep
pinching for at least 10 minutes.
- If the bleeding hasn't stopped, continue
pressure for another 10 minutes.
- If the nose is still bleeding after 30
minutes, seek medical help.
Bleeding from the mouth
Bleeding from the mouth can happen when a tooth is knocked out or a person bites their lip, tongue or cheek.
- Have the person sit down and lean their
head forward, towards the injured side
to let the blood drain out of their
mouth. The person should be
encouraged not to swallow the blood
because it induces vomiting.
- Apply a sterile gauze pad or any clean
non- textured cloth over the wound and
have the person squeeze it to stop the
bleeding.
- If the wound is large or the bleeding doesn't stop, seek medical help
What else can I do?
Bleeding injuries can happen anywhere,
anytime. Proper first aid can significantly
improve a person's chances of a full
recovery. Consider taking a first aid course,
where you can learn about providing first
aid in a wide range of accidents and
emergencies. Several organisations offer
first aid courses, including vital instruction
on cardiopulmonary resuscitation. You can
contact St John Ambulance by calling 020
7278 7888 or the British Red Cross on 020
7235 5454.
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