Emergency First Aid for Children 7. Wounds and Bleeding
Types of WoundABRASION LACERATION INCISIONPUNCTURE DOG BITE HUMAN BITE GRITTY GUNSHOT
Protect YourselfWhere possible avoid direct contact withblood or other body fluids such as vomit.
External Bleeding AIMS Reduce blood loss by applying direct pressure and elevating the injured part To prevent shock Cover any open wound with a dressing, to protect it from infection and promote natural healing Minimise the risk of infection, between the casualty and yourself, pay scrupulous attention to hygiene.Page 28-33
Major External Bleeding Raise and support injured limb. It may help to lay casualty down. Apply a sterileApply direct pressure over the wound dressing Dial 999 for an ambulance. Treat the casualty for shock. Check the dressing for seepage, and check the circulation beyond the bandage. Page 31
Embedded Object Wounds Apply Place padding Bandage over Do not pressure to around object. padding or onremove surrounding Build padding either side of object. area. up as high as it if object still embedded protrudes. object.
Nose Bleeds Aim: • To control blood loss, and maintain an open airway Treatment • Sit the casualty down with head well forward • Casualty should breath through the mouth and pinch the nose just below the bridge. • After 10 minutes release the pressure. • If nosebleed persists, reapply pressure for further periods of 10 minutes • If nosebleed persists beyond 30 minutes, casualty should go to hospital in the treatment position.Page 32
Bleeding from the Mouth Aims • To control bleeding • Safeguard airway by preventing inhalation of bloodPage 33
Bleeding from the Mouth Possible causes • Cuts to tongue, lips or lining of the mouth • Tooth socket bleeding may be the result of loss of toothPage 33
Bleeding from the Mouth Treatment • Lean casualty forward • Place a gauze dressing pad over the wound and ask casualty to apply pressure • If bleeding has not stopped after 30 minutes, the casualty should go to hospitalPage 33
Knocked Out Tooth An “Adult” tooth may be replanted. Do not clean it. Put the tooth in milk. Place a pad over the tooth socket, making sure that it is higher than the adjacent teeth so that the casualty can bite on it. Ask the casualty to sit down with their hand supporting their jaw. Tell them to bite hard on the pad. A younger child may need you to hold the pad in place.Page 33
Crush Injuries • Ensure it is safe to approach the scene. • Monitor and maintain airway and breathing. • Treat major bleeding and cover smaller wounds. • Keep casualty still and reassure them while waiting for help. • Treat for shock.. Keep them warm.IF THE INJURED PERSON IS STILL TRAPPED ?
Crush Injuries Casualty Still Trapped • Additional risks to casualty if still trapped, releasing the body may bring on severe shock. • Even greater concern is “crush syndrome”IF THE CASUALTY HAS BEEN TRAPPED FOR LESS THAN 15 MINUTES Crush syndrome takes some time to develop. If you can do so, safely remove the object. Treat as for crush injuries.IF THE CASUALTY HAS BEEN TRAPPED FOR LONGER THAN 15 MINUTES DO NOT RELEASE THE CASUALTY Make an early call for help. Treat as for crush injuries.
Recognising Internal Bleeding• Casualty show signs of shock (cold, clammy, pale skin, loss of consciousness , thirst, general weakness, a fast weak pulse)• Casualty coughs up blood• Passing blood from rectum• Casualty has been in an accident where they fell from height, stopped suddenly etc• Casualty has bruising and/or swelling – may be “pattern bruising” at site of injury• Blood coming from nose or mouth after head injury
Internal BleedingAims• Arrange urgent removal to hospital• Minimise shock
Internal BleedingTreatment• If injury is cause by penetrating object do not try to take it out• Lie casualty flat and raise their legs• Do not let casualty eat or drink• Keep casualty warm, loosen tight clothing• Watch their ABC• It they become unconscious, place them in recovery position (but still keep legs elevated)
Palm WoundsAIMS• Control blood loss• Arrange transport to hospital The palm is richly supplied with blood and a wound may bleed profusely. A deep wound may sever tendons and nerves.
Palm WoundsTreatment – Fist Bandage• Press a sterile dressing firmly into the palm and ask casualty to clench fist over it• Bandage the fingers so that they are clenched over the pad• Support the arm in an elevation sling• Ensure casualty receives treatment in hospital Bandage fingers over pad, leaving thumb exposed
AmputationAims• To minimise blood loss and shock• To preserve the amputated partTreatment• Control blood loss by applying direct pressure and raising the injured part. (Do NOT use tourniquet).• Apply a sterile dressing or non-fluffy clean pad secured with a bandage.• Treat the casualty for shock. Dial 999 for an ambulance.
Care of the Amputated Part• Wrap the severed part in kitchen film or a plastic bag.• Wrap the bag in soft fabric.• Put a bag filled with ice cubes around the fabric.• Put the whole package in another container. Mark with the time of injury and the casualty’s name. Give it to the ambulance attendant.
Chest Wound• A chest wound may cause sever internal damage.• The lungs are particularly vulnerable, and breathing problems, shock, and collapsed lung may follow an injury.• It is important to make an airtight seal over the wound to prevent air entering the cavity.
Chest Wound TREATMENT Cover the wound with the palm of your hand and support the casualty in a semi-upright position. With the casualty supported over the wound with a sterile dressing or clean pad and tape it in place.
Chest Wound TREATMENT cont’d Create a seal over the wound with a kitchen film. Secure on 3 sides with tape. Incline the casualty towards the injured side, supported on cushions.Continue to monitor ABC and be prepared to resuscitate if necessary