BLEEDING Is a loss of blood from the blood vessels.Severe or continuedbleeding may lead to collapse and death.

Thus, the first aider must aim tocontrol severe bleeding. The total quantity of blood in the human body variesaccording to size. An adult can lose 500 ml of blood without any harm, butthe loss of 300 ml might cause death in an infant. Remember :severe bleeding is serious. The extent of bleeding may be hidden EXTERNAL BLEEDING Symptoms and signs obvious bleeding. Management - DRABC- lay casualty down- apply direct pressure to the site of bleeding- raise and rest the injured part when possible- loosen tight clothing- give nothing by mouth- seek medical aid urgently. Direct pressure 1. Apply direct pressure to the wound with your fingers or hand. 2. As soon as possible , place a clean dressing over the wound. Apply a bulky padextending beyond the edges of the wound, and firmly bandage. If bleedingcontinues , leave the dressing in place and relocate the pad. 3. Do not disturb pads or bandages once bleeding is controlled. Uncontrolled Bleeding If severe bleeding cannot be controlled by direct pressure , it may be necessary toapply pressure to the pressure points. These are found on the main artery above thewound. When bleeding has been controlled, remove pressure to the point andreapply direct pressure to the wound. Occasionally, in major limb injuries such aspartial amputations and shark attack , severe bleeding cannot be controlled bydirect pressure. Only then, it may be necessary to resort to the application of aconstrictive bandage above the elbow or knee. Using a constrictive bandage 1. Select a strip of firm cloth, at least 7.5 centimetres (3 inches) wide and about 75centimetres (30 inches)long. This may be improvized from clothing or a narrowfolded triangular bandage.

2. Bind the cloth strip firmly around the injured limb above the bleeding point until apulse can no longer be felt beyond the constrictive bandage and bleeding iscontrolled. Tie firmly. 3. Note the time application. After 30 minutes, release tje bandage and check for bleeding . If there is no bleeding, remove it .If bleeding recommences, applydirect pressure. If this is unsuccessfully, reapply the constrictive bandage, andrecheck every 30 minutes. 4.Ensure that the bandage is clearly visible and inform medical aid of thelocation and time of its application. INTERNAL BLEEDING Symptoms and signs Evidence of internal bleeding from some organs may be seen by the first aider. For example : coughing up red frothy blood vomiting blood the colour of coffee grounds or bright red. The blood may bemixed with food. passing of faeces with a black, tarry appearance passing of faeces which are red in colour passing urine which has a red or smoky appearance.Concealed bleeding within the abdomen may be suspected when there is : pain tenderness Management - lay the casualty down- raise the legs or bend the knees- loosen tight clothing- seek medical aid urgently- give nothing by mouth- reassure the casualty rigidity of abdominal muscles.Internal bleeding will be accompanied by any of the following symptons and signs : faintness or dizziness restlessness nausea thirst weak , rapid pulse cold , clammy skin rapid , gasping breathing pallor sweating.