This document discusses measures for emergency situations focusing on hemorrhage (bleeding) and shock. It defines hemorrhage as the escape of blood from damaged blood vessels. There are three types of bleeding - arterial, venous, and capillary. Arterial bleeding is the most serious as it involves large pulsing blood vessels. Signs of internal bleeding include vomiting blood, coughing up blood, black tarry stools, and blood in urine. First aid for bleeding involves applying direct pressure, elevating the injured area, and seeking immediate medical attention for serious or uncontrolled bleeding. Shock is a life-threatening condition where blood flow to vital organs is reduced, which if not treated promptly can lead to organ failure and death.

1. MEASURES IN EMERGENCY
SITUATIONS

2. Emergency situations
• Hemorrhage
• Shock
• Sprain
• Dislocation
• Asphyxia
• Drowning

3. • Strangulation
• Electric shock
• Poisoning
• Burns and scalds
• Convulsion
• Bite and stings
• fainting

4. HEMORRHAGE

5. Hemorrhage – Bleeding
 Escape of the blood from vessels due to the damage of vessels.
 Uncontrol bleeding may cause in shock or death.
 There are three types.
 Arterial bleeding
 venous bleeding
 capilary bleeding

6. Characteristics of bleeding
1. Arterial bleeding
Must always be treated first. ( Major arterial bleeding is the
most serious )
o Blood carried in the arteries
rapid pulsing spurts normally fully oxygenated
bright red in colour

8. වේගවෙන් විහිදුවනවා
துடிக்கிறது
Tuṭikkiṟatu

9. Commonly affected arteries
o Femoral arteries
o Radial arteries
o Brachial arteries
o Carotid arteries

11. CAROTID ARTERY

12. FEMORALARTERY

15. Venous bleeding
o Normally darker red
o It contains less oxygen
o Will not spurt.
o Slow drain.

16. Capillary bleeding
o Common type of bleeding.
o Slightly comes from injured capillaries.
o Very slow and small in quantity.
o Can cause infections.

18. TYPES OF BLEEDING
• External bleeding
Bleeding that flows out of the body
• Examples:
Nose bleeding
Bleeding from a minor skin cut.

19. INTERNAL BLEEDING
• Bleeding that occurs inside the body when a blood vessel is damaged.
• Examples:
may occur in :
abdominal cavity
chest cavity
digestive tract
tissues surrounding broken large bones:
the thighbone (femur)
pelvis

20. The most serious sources of internal bleeding
due to trauma
• Head trauma with internal bleeding (intracranial hemorrhage)
• Bleeding around the lungs (hemothorax)
• Bleeding around the heart (hemopericardium and cardiac
tamponade)

22. Hemopericardium

24. Treatment or First aid for external bleeding
• Wash your hands.
• If the wound is dirty, lightly rinse with running water, until clean.
• Temporarily protect the wound with a sterile cotton.
• Apply direct pressure until bleeding is control.
 (Press down firmly on either side)

26. Cont: external bleeding care:
• Raise the injured part and support it.
• Handle the bleeding part carefully. (If there is fracture)
• Wrap the site by using cloth or bandage if possible.
• Send the person to the hospital as soon as possible.

27. First aid for internal bleeding
• Causes –
1) Fracture
2) Crush or penetrating injuries (Bullet injuries)
3) Head injuries
4) Organ injuries
5) Ruptured aneurisms

28. abdominal aortic,
thoracic aortic, and
cerebral.

31. Internal bleeding may be more serious than external bleeding.
Get a quick assessment.
• Haematemesis
- Vomiting out blood
• Haemoptysis
- Coughed out blood

32. • Malaena-dark tarry stool
-Blood in stool
•Epistaxis
-nose bleeds
•Blood in urine
-Haematurea

33. Signs and symptoms for internal bleeding
 Pallor
 Shallow rapid respiration
 Weak or thread pulse
 Restlessness
 Confusion

34.  Thirsty
 Cold clammy skin
 Low blood pressure
Hypotension
 Hypothermia
Low temperature

35. First aid for internal bleeding
 Lay the casualty down with his head low
– supine position
 Loosen the clothing
 Reassure the patient
( For relaxation )

36. Trendelenburg position

37.  Examine for other injuries and treat.
 If unconscious:
Open his mouth and remove foreign particles
Check for ABCDE
Start resuscitation.
 Do not give anything by mouth
 Arrange urgent transportation to hospital

38. Techniques to control bleeding
Apply terniquet
A scarf or large handkerchief can be used.
Applied the terniquet over the wound.
Do not applied too tightly.
Release pressure within 5 - 15 minutes. ( Gangrene )
Raised the injured part.

41. Epistaxis (Nose bleeds)
Bleeding from the blood vessels inside the nostrils.
Common condition
Causes :-
1. Head injury
2. Fracture of the skull and nasal bone

42. First aid or treatment
1) Reassure the patient.
2) Firmly pinch the entire soft part of the nose just above the nostrils.
3) Sit and lean forward (this will ensure that blood and other secretions
do not go down your throat).

43. 4) Breathe through your mouth.
5) Hold this position for 5 minutes.
6) Loosen any tight clothing.
7) Do not plug the nose.
.

44. 8) Avoid speak swallowing and cough.
9) Apply a cold swabs onthe nose.
10) Release the applied pressure after 10 minutes.
11) Still bleeding reapply pressure.
12) Seek medical aid

45. Bleeding from the ear
Bleeding from inside the ear canal.
Causes :-
Ear drum rupture
Skull fracture

46. First aid
 Reassure the patient.
 Cover the ear with a sterile dressing. Do not plug the ear.
 Head is turn to the injured side.
 Arrange removal to hospital.

47. Bleeding from the mouth
Causes :-
• Laceration of the gums
• Fracture of the jaw
• Tooth socket after accidental loss of a tooth
• Dental extraction

48. First aid
1) Sit down with his head forward and inclined (bend towards the
injured side)
2) Place clean dressing.
3) Allow him to dribble out any blood in his mouth.
4) Maintain pressure on the dressing. After 10-20 minutes carefully
remove dressing.
 If the bleeding persists, seek medical advice.

49. Haematemesis (Vomitting of blood)
Causes :-
- Can occur any site of GI Tract
- Usually from gastric ulcers
.

50. First aid
• Keep the patient in supine position.
• Raise the patient head.
• Nil by mouth.
• Seek medical advice

51. Shock
 The state due to stop blood supply into vital organs of the
body.
 Life threatening situation.
 Medical condition of lower blood perfusion to the tissues,
resulting inadequate tissue function.
 It is not treated as early as possible vital organ such as heart
and brain may fail, can lead to death.

52. Causes :-
- Severe haemarrhage
- Severe pain
- Sepsis
- Trauma