• describes the steps or actions taken to
• Explain the effects of blood loss and the
body’s mechanisms to control bleeding.
• Describe the different types of external
• List the signs and symptoms of internal
bleeding and describe the first aid to give.
Types of wounds
Incision: Straight edges to the wound margins, as if
sliced with a knife
• Laceration: The wounded tissue is random rather than
straight in direction, and may have multiple branches.
• Most often caused by an object with a broken or
serrated edge, such as a piece of broken glass or metal,
• Puncture: Sharp object penetrates the tissue, and travels
• Abrasion: A scraping or scratching. Generally quite
superficial, and affecting only the surface layers of the
epidermis. No internal organs, nerves, or blood
vessels other than capillaries, are affected
• Contusion: Simple bruising. In this type of injury, the
capillaries in the epidermis and dermis are
damaged, without breaking the skin. Blood oozes out
of these vessels into the spaces between cells or
interstitial space, causing swelling and discoloration.
Blood loss is generally limited, and not of serious
• Avulsion: A full thickness laceration-type wound, often
semi-circular in shape.
• Avulsions are difficult to repair, and no avulsion should
ever be considered a minor injury.
Principles for bleeding
External Bleeding Management
Direct Pressure Method.
Apply firm, direct pressure sufficient to stop the bleeding.
Apply pressure using hands or pad ensuring that sufficient pressure is
maintained and that pressure remains over the wound.
To assist in controlling bleeding; where possible:
- elevate the bleeding part.
- restrict movement.
- immobilize the part.
- advise the victim to remain at total rest.
In Direct Pressure Method:
a) Don’t remove the embedded object it may plugging the
wound and restricting bleeding.
b) Pace padding around or above and below the object and
apply pressure over the pads.
As a LAST resort and only when other methods failed.
It may be applied to a limb to control life – threatening
bleeding like traumatic amputations of limb or injury with
massive blood loss.
• Check the tourniquet every 10 to 15 minutes. If
the bleeding becomes
controllable, (manageable by applying direct
pressure), release the tourniquet
• Some times it difficult to recognize.
• Signs and symptoms – Universal :
Pain. Tenderness or swelling over or around the affected
Changing of vital signs (Tachycardia +
Hypotension), Orthostatic hypotension
Drop of RBC, HgB, Platelets,
The appearance of blood from a body open:
Bright red and / or frothy blood coughed up from the lungs.
Vomited blood which may be bright red or dark brown “ coffee
Blood - stained urine, Vaginal bleeding.
Rectal bleeding which may be bright red or black “tarry”.
• Blood tests may be performed to check for a low red
blood cell count, or anemia. However, if the bleeding
occurs rapidly, the initial hemoglobin reading or red
blood cell count may be normal.
• The initial treatment plan of any patient with internal
bleeding begins with assessing the patient's stability and
making certain the ABCs are well maintained.
1. apply a tourniquet to control bleeding, except as a last
2. peek at a wound to see if the bleeding is stopping.
3. probe a wound or pull out any embedded object from a
wound. This will usually cause more bleeding and harm
4. remove a dressing if it becomes soaked with blood.
Instead, add a new one on top
5. try to clean a large wound. This can cause heavier
6. try to clean a wound after you get the bleeding under
control. Get medical help