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:
| C | Colour | Capillary refill time |
| S | Sensation | Can you feel hand? |
| M | Motor | Wriggle 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 Loss | BR | PR | BP |
|---|---|---|---|
| 0 - 15% | 14 - 20 | < 100 | Normal |
| 15 - 30% | 20 - 30 | > 100 | Normal |
| 30 - 40% | 30 - 40 | > 120 | Decreased |
| > 40% | > 30 | > 140 | Decreased |
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 Site | Volume Lost |
|---|---|
| Rib fracture | 150+ ml |
| Lower arm | 250+ ml |
| Upper arm fracture | 500+ ml |
| Lower leg fracture | 750+ ml |
| Haemothorax | 1000+ ml |
| Upper leg fracture | 1500+ ml |
| Pelvis fracture | 2000+ ml |
| Abdomen | 3000+ ml |