BLEEDING

Reported by: Harris Tokpah

Tehran University of Medical Sciences
School of Nursing & Midwifery
 What is Bleeding?
 Bleeding, also called hemorrhage, is the name used to
describe blood loss. It can refer to blood loss inside the body,
called internal bleeding, or to blood loss outside of the body,
called external bleeding. Blood loss can occur in almost any
area of the body.
 Some bleeding, such as gastrointestinal bleeding, coughing up
blood, or vaginal bleeding, can be a symptom of a disease.
Types of Bleeding
Bleeding can be categorized into two types:
 Internal bleeding
 External bleeding
Types of External Bleeding
Bleeding Management

In Bleeding management, we use the SEEP

method.

S Sit or lay

E Examine the patient

E Elevate

P Pressure (Direct or indirect)

Direct Pressure

Place a sterile bandage or clean cloth on the wound. Hold your

both hands firmly and keep Pressing the bandage to control
bleeding Apply constant pressure until the bleeding stops.

Note: Don't put direct pressure on an eye injury or embedded

object.
Indirect Pressure
In cases of severe bleeding when direct pressure and elevation are
not controlling the bleeding, indirect pressure must be used. Press
your hand or finger on against bone if the there is a massive
bleeding apply a firm pressure directly to bleeding site.

 For arteries bleeding you need to press the pressure points for
longer than 5 minutes

 As the bleeding slows down release your hands gently from the
bleeding site.

 Do not remove a pad that is soaked through with blood you will
disturb any blood clots that have started to form to help stop the
bleeding

Note: Do not press the pressure points too firmly to stop

blood flow in temporal and carotid arteries
Apply Ice Pack
 As you are pressing and elevating the bleeding organ apply
an ice pack to the bleeding site.
 This will help stop bleeding by constricting the blood flow.
Pressure Bandage
 Use appropriate dressing size
 Apply the dressing firmly to control the bleeding
 Keep using your hands for additional pressure to bleeding
site

Note: Check distal pulses to assure the sufficient blood

flow to the organ.
Splint and Anti-shock trousers
Bleeding must be controlled if there is joint
injury
It will provide pain relief

MAST ( medical anti shock trousers) are used to pump blood

flow to vital organs

 Never use MAST for chest injuries

MAST

Use MAST to;l

Immobilize the extremities to stop bleeding

Reduce blood flow to lower part of body

Pump blood flow to heart in a short time

Tourniquet

Using tourniquet is the last resort

 If there is not a shock tourniquet use pressure cuff

 there is the possibility of nerve injury by placing the tourniquets at
an unsafe site
 There is no evidence that applying the tourniquet closer to the site
of bleeding is preferable, and no reason to believe that normal
tissue is at risk by placing the tourniquet too high
 Using Tourniquet
1.Hold direct pressure over the bleeding site and place the
tourniquet

2.Pull the band tightly and secure the band back on itself

3. Tighten the rod (windlass) until the bleeding stops

4.Secure the rod inside the clip. Ensure bleeding is still

controlled and assess for a distal pulse.

Write TK and time on the band

Never cover a tourniquet with a bandage. Leave it open
and in full view
Never use wire, rope, a belt, or any other narrow material
 MANAGEMENT OF
INTERNAL BLEEDING
Management of a patient with internal hemorrhaging focuses on
the treatment of shock, minimizing movement of the injured or
bleeding part or region, and rapid transport.

For the patient in shock includes airway maintenance, the

administration of oxygen, and preserving body temperature.
Increasing the blood’s oxygen saturation will improve oxygen
supply to the tissues
Keep the patient NPO

Insert two 18-gauge IV catheter

Blouse fluid of 250 mL of normal saline or lactated Ringer solution

Keep the patient warm

Provide 12 lead ECG

Consider giving pain medication if the patient’s vital signs are

stable
Fluid Resuscitation

Normal Saline 0/9%

Serum Albumin

Ringer Lactate

P.C
THANK
YOU