The document provides detailed first aid procedures for severe bleeding, emphasizing the importance of stopping blood loss quickly to prevent shock. Key steps include applying direct pressure, securing a bandage, and calling for emergency help while monitoring the casualty's condition. It also discusses the use of pressure bandages and tourniquets, along with their appropriate application and potential risks.

1. Kyrgyz Russian Slavic
University
Bishkek
General and Facultative Surgical
Department
Dr. Ruslang Rasujanovich Sherov
-Aayush Rajendraprasad
Hasanpalli
-LDI 4-22
First aid for severe bleeding: Application a
pressure bandage, tourniquet, direct pressure to an
artery

2. Severe bleeding
 Fisrt priority to stop bleeding
If severe bleeding isn’t controlled quickly, it is possible for someone
to lose a lot of blood, become unresponsive and possibly
develop shock. Shock is a life-threatening emergency condition,
caused when the body doesn't have sufficient blood circulating to
supply the vital organs with oxygen.

3. What to do
1) With open wounds,
there’s a risk of
infection, so wear
protective first aid
gloves (if available) to
help prevent any
infection passing
between you both.
1

4. Apply direct firm pressure to
the wound using a sterile
dressing if possible or a clean
non-fluffy cloth, to stop the
bleeding.
 if you don't have a dressing
you can ask the casualty to
do this themselves.
 If the wound is covered by the
casualty's clothing, remove or
cut the clothes to uncover the
wound.
 If there’s an object in the
wound, don’t pull it out. It may
be acting as a plug to reduce
the bleeding. Instead apply
pressure on either side of the
object to push the edges
together.
2

5. Ask helper to call 999 or
112 for emergency help
and give Ambulance
Control details of where
the wound is and the
extent of the bleeding.
 If you are on your own,
use the hands-free
speaker on a phone so
that you can treat while
speaking to ambulance
control
3
https://www.sja.org.uk/get-advice/first-aid-
advice/bleeding/severe-bleeding/

6. 4
 Firmly secure the dressing with
a bandage to maintain pressure
on the wound. Make it firm
enough to maintain pressure
but not so tight that it restricts
their circulation.
 Check their circulation beyond
the bandage. Press one of the
nails or the skin beyond the
bandage for five seconds until it
turns pale, then release the
pressure. If the colour does not
return within two seconds, the
bandage is too tight. If
necessary, loosen and reapply
the bandage.
https://www.sja.org.uk/get-advice/first-aid-
advice/bleeding/severe-bleeding/

7. 5
 The loss of blood could
cause the casualty to
develop shock. Treat
them for this by helping
them to lie down on a
rug or blanket. Raise
and support their legs,
so they are above the
level of their heart. You
should then loosen any
tight clothing around
their neck, chest and
waist and cover the
casualty with a blanket
to keep them warm.

https://www.sja.org.uk/get-advice/first-aid-
advice/bleeding/severe-bleeding/

8. 6  Support the
injured part with
a sling or
bandage and
keep checking
the circulation
beyond the
bandage every
10 minutes.
https://www.sja.org.uk/get-advice/first-aid-
advice/bleeding/severe-bleeding/

9. 7  Keep monitoring their level of
response until help arrives. If
they become unresponsive at
any point, prepare to
start CPR.

If the bleed is not controlled
with pressure, it is possible
that the call handler will ask
you to improvise a tourniquet
if you do not have one or are
not trained. They may ask
you to use items such as a
triangular bandage. belt or tie
and instruct you what to do.
https://www.sja.org.uk/get-advice/first-aid-
advice/bleeding/severe-bleeding/

10. Pressure Bandage
 A pressure bandage (also called a pressure
dressing) is a bandage that’s designed to
apply pressure to a particular area of the
body.
 Pressure bandages are used to control
bleeding and encourage blood clotting
without constricting normal blood
circulation. They help:
1.minimize swelling
2.protect the wound from contamination
3.protect the injured area from additional trauma
4.prevent heat and fluid loss

11. When to apply a pressure
bandage
 Initial wound treatment
 Call for emergency medical help to come to you, or decide how to get the
wounded person to emergency medical help.
 If necessary, expose the entire wound by removing any clothing around it.
You may have to cut the clothing away. If any clothing is stuck to the wound,
work around it.
 Don’t try to wash the wound or remove any objects that have been impaled.
 Apply a dressing over the wound. If you don’t have a first aid kit with sterile,
nonstick gauze, use the cleanest, most absorbent cloth you have.
 Fold a 3-foot length of cloth into a ribbon about 4 inches wide and tightly but
gently wrap it around the limb, then tie it off with a secure but easily
adjustable knot. The knot should be over the nonaffected part of the limb,
not over the wound.
 Look for signs that you’ve tied the bandage too tightly. For example, if the
injured limb is turning blue or becoming cool, slightly loosen the bandage.
 Elevate the wound above the injured person’s heart. If broken bones are
involved, you’ll need to splint the limb before elevating it.
 Use your hand to apply manual pressure to the wound for 5 to 10 minutes.

12. Excessive blood loss can result in:
 a drop in blood pressure
 a drop in blood volume
 heart rate or rhythm abnormalities
 a low oxygen saturation
 death

13. How to apply a pressure
bandage
 If the injured person’s wound is stabilized and
they’re fully awake, have them drink liquids to
help replace blood volume.
 Use strips of cloth, cut from clothing if
necessary, to make a pressure bandage.
 Wad up some strips and put them over the
wound.
 Wrap a longer piece of cloth around the limb
and the wad of strips and tie the ends
together. You want the pressure to be enough
to stop the bleeding, but not so tight as to act
as a tourniquet (completely cut off the blood
supply to the area). As a tightness test, you
should be able to fit your finger under the
knot.

14.  As an alternative to the steps above, if
available, you can also use an elastic
pressure bandage, like an ACE wrap,
placed over gauze and an underlying
absorptive bandage pad.
 Check the injured person’s toes and
fingers further beyond the pressure
bandage to make sure the bandage isn’t
too tight. If they’re not warm and pink,
loosen the bandages.
 Check often to make sure bleeding has
stopped.
 If you see signs of decreased
circulation in the limb (pale or blue, cool,
numb), loosen the bandage.

15. Tourniqeut
 A tourniqeut is a device that is used
to apply pressure to a limb or
extremity in order to
create ischemia or stopping the flow
of blood. It may be used in
emergencies, in surgery, or in post-
operative rehabilitation.

A simple tourniquet can be made
from a stick and a rope, but the use of
makeshift tourniquets has been
reduced over time due to their
ineffectiveness compared to a
commercial and professional
tourniquet. This may stem the flow of
blood, but side effects such as soft
tissue damage and nerve damage
https://en.wikipedia.org/wiki/Tourniquet#:~:text=A%20tourniquet%20is%20a%20device,o
r%20in%20post%2Doperative%20rehabilitation.

16. Types
 Surgical tourniquet
Surgical tourniquets prevent blood flow to a limb and enable
surgeons to work in a bloodless operative field.[35] This allows
surgical procedures to be performed with improved precision, safety
and speed.[35] Surgical tourniquets can be divided into two groups:
pneumatic tourniquets and non-pneumatic tourniquets.[35]
 Surgical pneumatic tourniquets
Surgical pneumatic tourniquets are routinely and safely used
orthopedic and plastic surgery, as well as in intravenous regional
anesthesia (Bier block anesthesia) where they serve the additional
function of preventing the central spread of local anesthetics in the
limb.[35] Modern pneumatic tourniquet systems consist of a
pneumatic tourniquet instrument, tourniquet cuffs, pneumatic tubing,
and limb protection sleeves.
https://en.wikipedia.org/wiki/Tourniquet#:~:text=A%20tourniquet%20
is%20a%20device,or%20in%20post%2Doperative%20rehabilitation
.

17. Thank you