FIRST AID IN CASE OF BLEEDING

Asst. Prof. Merve ÖZSOY DURMAZ

Bleeding
The outflow of blood out of the vein (arterial,
venous, capillary) whose integrity is impaired for
any reason is called bleeding.

10% of the total amount of blood is lost: The body can balance it.
More than 20% of the amount of blood: Dangerous !!!
More than 50% of the amount of blood: SHOCK or DEATH
Severity of Bleeding depends on...

the amount of the speed of

bleeding bleeding

the area where blood

the physical condition of
flows in the body
the person

Age the characteristics of the

bleeding organ.

Types of Bleeding
Bleeding According to
the Characteristics of the Bleeding Vessel

ARTERIAL HEMORRHAGES
most severe and urgent type of bleeding
rapid and profuse
spurting with heart beat
bright red.

Bleeding According to
the Characteristics of the Bleeding Vessel

VENOUS HEMORRHAGES
steady flow
easier to control
dark red
Bleeding According to
the Characteristics of the Bleeding Vessel

CAPILLARY HEMORRHAGES
slow and oozing
easily controlled
stops spontaneously
 Bleeding According to
the Area of the Body Where The Blood Flows

EXTERNAL BLEEDING
They are easily controllable hemorrhages in which
blood flow can be monitored visually as a result of
deterioration of skin integrity. Bleeding occurs
from the wound to the outside of the body.

Examples for the External Bleeding

Head (face and scalp), chest, abdomen, arm,
finger injuries or ruptures, open fractures, skin
incisions...

Disease that prolongs the time of

clot formation

The usage of anticoagulants

Bleeding According to
the Area of the Body Where The Blood Flows

INTERNAL BLEEDING
It is the invisible, difficult to stop vessel rupture of
the vessels in the body for any reason, which is
caused by trauma, impact, major bone fractures,
gunshot and cutting tool injuries, and blood flows
into the cavities in the body.

Examples for the Internal Bleeding

It can occur in arm and leg tissue, head,

abdomen, chest and pelvis.

symptoms of shock
should be monitored.
 Symptoms of Internal
Bleeding • Restlessness
• Visual and hearing impairment
• Drowsiness
• Pain, swelling, tenderness in the abdomen
Confusion
• Cold and pale skin
• Fast-weak pulse (filiform pulse)
• Rapid breathing
• Hypotension
• Feeling of excessive thirst

First Aid in External Bleeding

The purpose of first aid in case of bleeding is to eliminate

the danger to life, to prevent the formation of shock
table, to control the bleeding as soon as possible and to
keep the wound clean.
Various bleeding stopping methods are used in
external bleeding.

Applying direct pressure on the bleeding area

Lifting up the bleeding area (elevation)

Applying pressure to pressure points (special

points/arteries on the path of the bleeding vessel
from the heart)
Tourniquet application

DIRECT PRESSURE
 ELEVATION

During external bleeding first thing to do is start putting pressure on the nearest artery

PRESSURE POINTS
1. Neck ( Carotid Artery )
2. Upper part of the clavicular artery
3. Arm pit (Axillary Artery)
4. Upper part of the arm (brachial
artery)
5. Thigh (Femoral Artery)
6. Leg (Tibial artery)
TOURNIQUET APPLICATION

First Aid in External Bleeding

• Assess the injured person’s situation (ABC)

• Assess the wound or the bleeding
• Ask for medical help from emergency call center
• Put pressure on the bleeding with a clean cloth.
• If the bleeding doesn’t stop increase the pressure with a second clean cloth.
• If necessary put on a bandage to increase the pressure even further
First Aid in External Bleeding

• The pressure must be on the nearest pressure point.

• If possible elevate the bleeding part of the body.
• If there are multiple injured on the scene and you are the only first
aider or if there is an extremity amputation apply a tourniquet.
• Give the injured a shock position.

First Aid in External Bleeding

• Assess the injured person’s vital signs every 2-3 minutes.

• Cover the patient with a blanket but leave the bleeding part of the body
exposed.
• Write your interventions on the injured.
• Transfer the injured to a healthcare provider as soon as possible.
First Aid in Internal Bleeding

Internal bleedings can be caused by

trauma, impact and sometimes because of
certain diseases. Person with internal
bleeding generally have symptoms of
shock. (Tachycardia, hypotension, pale
skin, sweating, loss of consciousness,
nausea, blurred vision etc.)

First Aid in Internal Bleeding

• Assess the injured person’s current situation and ABC.

• Cover the patient with a blanket and lift their legs up approximately 30
centimeters.
• Ask for medical help from emergency call center.
• Never give patient anything to drink or eat.
• Don’t move the patient especially if there is a broken bone present.
• Assess the vital signs.
• Transfer the injured to a health provider as soon as possible.
When should the tourniquet be applied?

• If there are multiple injured on the accident field and the first aider is alone
tourniquet is a technique to help first aider with the external bleeding .
• If you are going to transfer the injured to another location
• If there is an extremity amputation.
• If putting the pressure on is not enough to stop the bleeding.

Things to Consider During the

Tourniquet Application

• Cloths to be used as a tourniquet must be at least 8-10 centimeters.

• During the tourniquet application materials such as wire or strings which can
cut the injured person even more mustn’t be used.
• A piece of wood or a pen/pencil can be used to tighten the tourniquet.
• Only the tighten the tourniquet to stop the bleeding and do not tighten it
anymore further once the bleeding stops.
Things to Consider During the
Tourniquet Application

• Do not cover the body part which the tourniquet is applied.

• Write the time on a piece of paper when you started to tourniquet and place
on the patient.
• Loosen the tourniquet in every 15-20 minutes to ensure proper tissue
oxygenation.

Steps to Apply Tourniquet

• Take a wide, durable, and non-flexible cloth

• Fold in two and wrap around the extremity
• Take two ends of the tourniquet and knot it to the supportive material
• Start turning the supportive material to stop the bleeding.
• Secure the supportive material in place
• Place a piece of paper on the injured person which has the injured person’s
name and the time of the tourniquet
• If there are multiple injured on the scene write the letter T on the forehead of
the injured with a marker or lipstick.
• Cover the injured with a blanket while leaving the tourniquet visible.
• Loosen the tourniquet every 15-20 minutes and tighten it again.
Youtube Video: How to apply an improvised tourniquet
First Aid in Bleeding from Natural Holes

They are hemorrhages that occur in the mouth, ears, nose,

rectum and reproductive organs.

First Aid in Nosebleed

• Calm the person down

• Sit the patient down
• Tilt their head onwards
• Make them pinch their nose for 5 minutes
• Transfer them to a healthcare provider
First Aid in Ear Bleeding

• Calm the person down.

• If the bleeding is minor, clean the ear with a clean cloth.
• If the bleeding is major, plug the ear with a clean cloth.
• If the patient has consciousness lay them down on a flat surface, if they are
unresponsive lay them on their ear on a flat surface.
• Transfer the injured to the nearest healthcare provider.

First Aid in Limb Ruptures

• The patient is given a shock position.

• The place where the limb is severed is closed with a clean cloth.
• The limb is lifted up from the level of the heart and bleeding is controlled by
applying pressure.
• If the bleeding cannot be controlled, a tourniquet is applied.
• Vital signs are checked at frequent intervals.
First Aid in Limb Ruptures

• The severed limb fragment is wrapped in a clean cloth and stored in a clean
and waterproof plastic bag.
• The limbs stored in the plastic bag are put in a second bag with 1 part of water
and 2 parts of ice.
• On the bag are recorded the identity information of the owner of the limb
fragment and the time at which the limb was found.
• Within 6 hours at the latest, the injured person and the severed limb part are
transferred to the health institution with the same vehicle.

What is SHOCK?

Shock is defined as an acute circulatory failure which is presented by

hypotension and caused by vital organs to not get adequate amount
of blood.

There are 4 basic types of shock

• Cardiogenic Shock (Heart Related)

• Hypovolemic Shock (Fluid Insufficiency)
• Toxic Shock (Toxication related)
• Anaphylactic Shock (Allergy related)
 Youtube video: What is shock? I Circulatory System and Disease I NCLEX-RN I Khan Academy

Amounts of Blood that Cause Shock

Adults: 600-700 ml

Children: 250-300 ml

Infants: 40-50 ml
 Symptoms of Shock
• Hypotension
• Fast and thready pulse
• Fast and shallow breathing
• Pale, cold and damp skin
• Anxiety
• Dizzyness
• Cyanosis around the lips
• Thirst
• Decrease in consciousness

First Aid in Shock

• Ensure your and person’s safety

• Ensure an open airway
• Take the injured to the open air
• Stop the bleeding if there is bleeding present
• Give the injured shock position
• Keep the injured warm
• Do not move the injured
• Transfer the injured to the nearest healthcare provider as soon as possible
Shock Position

• Lay down the injured on a flat surface

• Elevate the injured person’s leg 30 centimeter high.
• Cover the person with a blanket to keep them warm
• Stay with the injured until help arrives
• Assess their vital signs every 2-3 minutes.

THANK YOU