Treating wounds

All First Aiders need to be able to deal safely with a casualty who is injured and bleeding. The typical physiological responses to trauma:

Bandages hold dressing in place. Do not apply any bandage too tightly or too lightly or it will not do its job.

Consider:

CColourCapillary refill time
SSensationCan you feel hand?
MMotorWriggle your toes

Direct pressure

Most bleeding stops after 10 – 15minutes of direct pressure, the best pressure points:

Brachial artery – inside upper arm Femoral artery - groin

How much blood loss?

Vital signs can help to estimate blood loss.
Simply; the less blood, the less oxygen, the faster the vital signs These are typical adult values, indicating the relationship between blood loss and vital sign performance:

% Blood LossBRPRBP
0 - 15%14 - 20< 100Normal
15 - 30%20 - 30> 100Normal
30 - 40%30 - 40> 120Decreased
> 40%> 30> 140Decreased

Internal Bleeding

Blood loss is concealed, careful casualty assessment is important. The abdomen is the common site for concealed haemorrhage.
Press all areas of abdomen for tenderness, look for rigidity in the unresponsive casualty. If there is any pain response from the alert casualty then immediate medical attention is required.

Typical blood loss per injury

Blood loss is a major cause of preventable deaths.

Intact 70 kg adult - blood volume 5600 ml

Injury SiteVolume Lost
Rib fracture150+ ml
Lower arm250+ ml
Upper arm fracture500+ ml
Lower leg fracture750+ ml
Haemothorax1000+ ml
Upper leg fracture1500+ ml
Pelvis fracture2000+ ml
Abdomen3000+ ml