UNIT- THREE

WOUNDS AND BLEEDING

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Learning Objectives
• Define wound and bleeding
• Classify different types of wound
• Identify common causes of wound
• Give first aid measures for different types of
wounds.
• Apply first aid measures to stop severe bleeding

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 Definition of wound
• A wound is a break in the continuity of the tissue of
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the body either internal or external.

• Common Causes of Wounds ?
• The most common accidents resulting in open
wounds are:
• Accidental falls and
• Mishandling of sharp objects,Tools,
• Machinery and weapons

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 Classification of Wounds
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1. Open wound: an open wound is a break in the skin

or the mucus membrane.
2. Closed wound: a closed wound involves injury to
underlying tissues without a break in the skin or
mucous membrane.

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 Types of Open Wounds
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a) Abrased Wounds
 damage/ scrape of outer
layer of skin.
 Cause- scraped against
hard surface, bleeding is
limited.

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 Laceration

Types of Open Wounds…….

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b) Laceration
jagged, irregular or blunt
breaking or tearing of soft
tissue.
 Cause- machinery,
barbed wire. Paid and
extensive bleeding, tissue
can be destructed and
contamination of wound.

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 Types of Open Wounds…..
c) Puncture
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• wounds produced by a
piercing of skin layer creating a
small hole.
• Cause- knives, nails or
anima teeth.
• Internal organ may be
damaged causing internal
bleeding patient may be
exposed to Tetanus.

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 Types of Open Wounds…..
d) Incisions: - clean cut wounds
• Cause -by sharp instrument Such as knives or
broken glass.
- Rapid and heavy bleeding from the site may
contain fragments of glass or other material.
e) Avulsion-
- tissue is forcibly separated or torn with heavy
and rapid bleeding.
- The separated organ can be reattached.
• Cause- vehicle accident, gunshots, explosion,
animal bites crashed injuries.
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 Bleeding
• Bleeding is the escape of blood from the vessels into
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surrounding tissues, body cavities or externally from the
body as a result of trauma, infection or surgical incision.
Types of bleeding:-
• External bleeding- Obvious bleeding
• Internal bleeding- concealed or hidden bleeding
• Internal bleeding:
 Bleeding inside body cavity may follow an injury, such
as a fracture or a penetrating wounds, but can also occur
spontaneously for example, bleeding from a stomach
ulcer.
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 Internal bleeding conti..
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• Bleeding from Nose/Ears

• Bleeding from Lungs with cough
• From Stomach with Vomiting
• Through Urine (Bladder, Urinary track, Kidney
• Through Rectum with Stool (injury in intestines)

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 How to recognize internal bleeding
• Initially, pale, cold, clammy skin. If bleeding
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continues, skin may turn blue- grey (cyanosis).

• Rapid, weak pulse
• Thirst
• Rapid, shallow breathing
• Confusion, restlessness, and irritability.
• Possible collapse and unconsciousness
• Bleeding from body openings (orifices)

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 First Aid for Severe Bleeding
• Need for Immediate Action
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• To stop any large rapid loss of blood and to treat

for shock and prevent death.
Techniques to stop severe bleeding:
1.Direct Pressure:-
• apply pressure on the bleeding site direct and firm.
• NB. Apply pressure for 5-15min.

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 Technique conti…
2.Elevation:Unless there is evidence of a fracture,
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a severely bleeding open wound of the hand, neck,

arm or leg should be elevated above the level of
the victim’s heart.
3. Applying Pressure on the Supplying Artery
If severe bleeding from an open wound of the arm or
leg does not stop after the application of direct
pressure plus elevation, the pressure point
technique may be required.

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 Technique conti…
• Use the pressure point
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technique by temporarily
compressing the main artery
which supplies blood to the
affected limb
4. Tourniquet: should be used
only for a severe life
threatening hemorrhage that
cannot be controlled by
other means.
Applying a Tourniquet
- Never cover a tourniquet.
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 Prevention of wound Contamination and
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Infection

• Open wounds are subject to contamination and

infection. This danger can be prevented or
minimized by appropriate first aid measures,
depending up on the severity of bleeding.
A. Safeguards.
-Whenever a dressing is applied to control bleeding,
whether bleeding is severe or not, safeguards must
be taken.
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 Prevention of wound Cont…

B. Measures to be taken with wounds without

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severe bleeding
• To cleanse a wound, wash your hands thoroughly
with soap and water
• Rinse the wound thoroughly by flushing with clean
water.
• Blot the wound, dry with a sterile gauze pad or
clean cloth
• Wash in and around the wound to remove bacteria.

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 Unit-four
Dressing and Bandaging
• Dressing ; is a protective covering applied to
a wound to help control bleeding, to absorb
blood discharge from the wound, and prevent
further contamination and infection.
• Dressing should be sterile or clean, highly
absorbent and porous to keep the wound dry,
compressible, thick and soft for severe
bleeding, non adherent and lint-free to reduce
possibility of dressing sticking to wound
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 Dressing conit…
To use dressing as first aider has to observe the
following principle:
• Cleanliness; essential to minimize
contamination and infection. Before dressing
wash hands and use cleanest material. In placing
material over a wound do not touch or breathe
on any part of it.
• Completely cover the wound: extend the
dressing beyond the edges of the wound.
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 Dressing conit…
• Reinforce gauze dressing with absorbent
cotton bandage
• Secure dressing place with tape or bandage.
• Do not remove a dressing that has been
applied over a wound.
• If blood soaks, place over additional dressing
and bandage.

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 Equipment for clean wound dressing
• Sterile bowel or kidney dish
• Sterile gauze
• Sterile galipot
• Three sterile forceps
• Pick up forceps
• Bandage or adhesive tap
• Scissor west receiver
• Spatula, ointment, antiseptic
• Cotton pad
• Rubber and draw sheet
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 Procedure
– Explain the procedure
– Wash hands and prepare equipments
– Prepare the patient in a comfortable position
– Place rubber and draw sheet under the wound
– Remove old dressing ,with forceps
– With the second sterile forceps clean the
wound with sterile cotton ball soaked in a
solution from inside to out side of the wound.
– Clean the skin around the wound
– Apply a medication if any ordered
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 Procedure conti…
– Dress the wound with gauze using the third
forceps
– Make sure the wound is properly covered
– Apply bandage or adhesive tape
– Recorded condition of wound and leave the
patient comfortable
– Clean equipments and wash hands

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 Septic wound dressing

• Septic or dirty wound is a wound in w/c the

disease causing micro organism and foreign
bodies are present.
 Cause
• Contamination during injury or trauma
• Non sterile procedure during surgery, dressing
• Poor personal hygiene of the patient

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 Sign of septic or infected wound

• Swelling
• Discharge from the wound
• Swelling ,redness ,hotness around the wound
• Usually pain full than clean wound
Purpose of dressing
– To absorb discharge from the wound
– To apply local medication
– To apply pressure to the area
– To relive pain and prevent injury

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 Equipments
• The same to clean wound except that septic
wound dressing needs test tube (sterile) for
specimen and strong antiseptic solution like
hydrogen per oxide.
Procedure
• Same to clean wound dressing except Using
one stroke during cleaning
• Clean from clean area to most dirty area (from
out side to inside)
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 Bandages
• Bandages are strips or rolls of gauze or other
materials that are used for wrapping or binding
any part of the body and to hold compresses in
place
• Some of the most commonly used bandages
are the roller bandage and the triangular
bandage.

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 Roller Bandages
• The roller bandage consists of a long strip of
material (usually gauze, or elastic) that is
rolled and is available in several widths and
lengths.
• Most are sterile, so pieces may be used as a
compress on wounds.
• A strip of roller bandage can be used to make
a four-tailed bandage

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 TRIANGULAR BANDAGE

• One of the most versatile prepared or

improvised bandages.
• It is made by cutting a one meter square of
linen or cotton the diagonal.
• They are useful because they can be folded in
a variety of ways to fit almost any part of the
body.
• Padding can be added to areas that may
become uncomfortable.
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 Precautions
• Bandages should be applied firmly but not too
tight.
• A loose bandage will slip off the wound.
• A bandage that is too tight can cut off the
blood supply to the injured part and cause
damage to the blood vessels and tissues
• When you fasten a bandage around an arm or
leg, leave the fingers or toes uncovered. If
they become blue or swollen, you will know
that the bandage is too tight and should be
loosened.
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 Precautions conti…

• Apply firmly to ensure that bleeding is

controlled or immobilization is achieved.
• Check circulation frequently: ensure that the
bandage is not too tight.
• Do not use bandage as padding or dressing for
wounds when other materials are available.

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