wounds and bleeding

3. Wounds may be classified by several methods;
their etiology, location, type of injury or presenting
symptoms, wound depth and tissue loss or clinical
appearance of the wound.

4. TYPES OF WOUND:
closed (blunt trauma)
or
open (penetrating trauma),

5. In open wounds, the skin is cracked
open, leaving the underlying tissue
exposed to the outside environment,
which makes it more vulnerable to
bleeding and infections.
open (penetrating trauma).

6. open (penetrating trauma).

7. open wounds

8. Abrasions: These are shallow irregular
wounds of the upper layers of skin, due to skin
brushing with either a rough surface or a
smooth surface at high speed (running);
usually present with minor to no bleeding,
with some pain that subsides shortly after
initial injury.
Lacerations: These wounds are tear-like
wounds with irregularly torn edges that are
usually deeper than abrasions and cause more
pain and bleeding. Lacerations are generally
caused by trauma or contact with an object;
such as hard blows, collusions or accidents.
Incisions: These are most likely the result of
a surgical procedure or skin cut with a sharp
object; like scalpels, knives and scissors.
Incisions are mostly linear in shape with sharp,
smooth edges.

9. Punctures: These are small rounded wounds
that result from objects with thin pointed tips;
such as needles, nails or other tapered objects,
and teeth, in cases of human or animal bites.
The wound size, depth, bleeding and pain are
directly related to the size and force of the
causative object
Gunshot wounds: These are considered to
be penetrating wounds that are exclusively
caused by bullets from firearms . The entrance
wounds may have burn marks or soot on the
edges and surrounding tissue, depending on
the distance from which the bullet was fired.

10. closed (blunt trauma)
CONTUSED WOUND

11. closed (blunt trauma)
Closed wounds are usually caused by
direct blunt trauma sustained when
falling down or in motor vehicle
accidents. Even with the skin intact, the
damage can reach down to the
underlying muscle, internal organs and
bones.

12. DANGERS OF WOUNDS:
• BLEEDING
• INFECTION
AIMS OF FIRST
AID:
STOP BLEEDING.
MINIMISE GERMS ENTERING THE
WOUND
GERMS COME
FROM:
• OBJECT CAUSING THE WOUND.
• HANDS OF THE FIRST AIDER.
• CLOTHES OF THE PATIENT.
• DIRTY DRESSING.
• AIR.
• CONTAMINATED WATER.
MANAGEMENT:
STOP BLEEDING.
HANDLE GENTLY.
WASH YOUR HANDS
THOROUGHLY.
REMOVE ANY FOREIGN BODY, IF
POSSIBLE.
DO NOT REMOVE EMBEDDED
OBJECTS.
DON’T DISTURB BLOOD CLOTS.
PLACE CLEAN DRESSING &
BANDAGE FIRMLY.
SHIFT TO HOSPITAL.

13. BLEEDING

15. BLEEDING RESULTS DUE TO RUPTURE OF BLOOD
VESSELS

16. TYPES OF BLEEDING:
EXTERNAL BLEEDING
Outside the body when blood moves through a break in the skin
INTERNAL BLEEDING
Inside the body when blood leaks
from blood vessels or organs
EXTERNAL BLEEDING

17. ARTERIAL BLEEDING:
BLOOD COMES FROM AN ARTERY.
BLOOD IS BRIGHT RED IN COLOUR.
BLOOD COMES IN JETS & IT
CORRESPONDS TO HEART BEAT.
BLOOD LOSS IS RAPID & PROFUSE &
CAN CAUSE DEATH QUICKLY
CLASSIFICATION
of bleeding:

18. VENOUS BLEEDING:
BLOOD COMES FROM A VEIN.
BLOOD IS DARK RED IN COLOUR.
BLOOD FLOWS AS A CONTINUOUS
STREAM & MAY BE PROFUSE.
CLASSIFICATION
of bleeding:

19. CLASSIFICATION
of bleeding:
CAPILLARY BLEEDING:
BLOOD COMES FROM CAPILLARIES.
BLOOD SLOW AND OOZES.
COLOUR IS LESS RED THAN ARTERIAL
BLOOD.
NOT SERIOUS.

20. SIGNS & SYMPTOMS OF BLEEDING:
 FAINT & GIDDINESS.
 COLD & CLAMMY SKIN.
 WEAK & RAPID PULSE.
 SHALLOW BREATHING WITH GASPS & SIGHS.
 PROFUSE SWEATING.
 THIRST.
 BLURRED VISION.
 UNCONSCIOUSNESS.

21.  DIRECT PRESSURE.
 ELEVATION.
 INDIRECT PRESSURE ON PRESSURE POINTS.
 BLOOD PRESSURE CUFF.

22. DIRECT PRESSURE:
CAN BE APPLIED BY:
FIRST AIDER’S HAND.
DRESSING & FIRST AIDER’S HAND.
PRESSURE DRESSING.
PRESSURE TO BE APPLIED FOR 10 TO 30 MINUTES.
AFTER CONTROL, APPLY FIRM BANDAGE.
Don’t remove dressing

23. NOT TO BE USED IN CASES OF
FRACTURES & SPINAL INJURIES.
GRAVITY HELPS TO LOWER BLOOD
PRESSURE & BLEEDING IS SLOWED.
ELEVATION
 Used the same time as direct pressure
 Above the level of the heart

24. •DO NOT peek at a wound to see if the bleeding is stopping. The less a wound is
disturbed, the more likely it is that you'll be able to control the bleeding
•DO NOT probe a wound or pull out any embedded object from a wound. This
will usually cause more bleeding and harm
•DO NOT remove a dressing if it becomes soaked with blood. Instead, add a new
one on top
•DO NOT try to clean a large wound. This can cause heavier bleeding
•DO NOT try to clean a wound after you get the bleeding under control. Get
medical help
DO NOT

25. PRESSURE POINTS:
PRESSURE POINT IS A SITE WHERE MAIN ARTERY LIES NEAR THE SURFACE OF
THE BODY, DIRECTLY OVER A BONE.
PULSATION CAN BE FELT IN THESE AREAS.
THERE ARE 22 PRESSURE POINTS(11 ON EACH SIDE).
OF THESE 11 ARE USED TO CONTROL PROFUSE BLEEDING.
BRACHIAL ARTERY - FOR BLEEDING FROM UPPER LIMB.
FEMORAL ARTERY - FOR BLEEDING FROM LOWER LIMB.
CAROTID ARTERY - FOR BLEEDING FROM NECK.
TEMPORAL ARTERY - FOR BLEEDING FROM SCALP.
FACIAL ARTERY - FOR BLEEDING FROM FACE.
SUB CLAVIAN ARTERY - FOR BLEEDING FROM CHEST
WALL & ARMPIT

26. PRESSURE POINTS

28. APPLICATION OF INDIRECT
PRESSURE

29. 1. Have patient sit down and lean forward
2. Apply or instruct patient to apply direct pressure
3. Keep patient quiet and calm
4. Do not let patient lean back
5. Position patient on side of unconscious
Special situations epistaxis

30. NOTE:
PRESSURE POINT TECHNIQUE IS USED ONLY
AFTER DIRECT PRESSURE & ELEVATION FAILS TO
CONTROL BLEEDING.
RELAX THE MUSCLES OF THAT AREA, WHICH
WILL HELP IN APPLYING PRESSURE BETTER.
CONTINUE PRESSURE TILL BLEEDING IS
CONTROLLED OR TILL MEDICAL HELP ARRIVES.
RELEASE PRESSURE ONCE IN 15 MINUTES AND
REAPPLY.
SPLINTING
INFLATABLE SPLINTS
BLOOD PRESSURE CUFF
TOURNIQUET : APPLIED AS A LAST RESORT, AS
IN CASES OF AMPUTATION, ETC.

31. INTERNAL BLEEDING:

32. THIS IS SUSPECTED WHEN YOU DETECT:
WOUNDS THAT HAVE PENETRATED THE SKULL.
BLOOD IN EARS & NOSE.
PATIENT VOMITING OR COUGHING BLOOD.
PENETRATING WOUND OF CHEST & ABDOMEN. LARGE AREA OF
BRUISED ABDOMEN.
ABDOMINAL TENDERNESS, RIGIDITY OR SPASM.
BLOOD IN URINE.
RECTAL OR VAGINAL BLEEDING.
FRACTURES.

33. DIAGNOSIS:
HISTORY OF SUFFICIENT INJURY TO CAUSE INTERNAL
BLEEDING.
HISTORY OF MEDICAL CONDITION WHICH CAN CAUSE
INTERNAL BLEEDING. (PEPTIC ULCER, ETC.)
PAIN & TENDERNESS OVER THE AFFECTED AREA.
SIGNS & SYMPTOMS OF SHOCK.
BLEEDING FROM BODY ORIFICES

34. 1. Injuries to surface of body
2. Bruising
3. Painful, swollen, or deformed extremities
4. Bleeding from mouth, rectum, vagina, etc.
5. Tender, rigid, or distended abdomen
6. Vomiting
7. Dark, tarry stools or bright red blood
8. Signs and symptoms of shock
Signs of Internal Bleeding
Intra abdominal bleeding

35. MANAGEMENT:
LAY THE CASUALTY DOWN, WITH HEAD LOW & TO ONE SIDE, SO AS TO
ENSURE GOOD BLOOD SUPPLY TO THE BRAIN.
RAISE THE LEGS IF THERE IS NO FRACTURE.
CONTROL ALL SERIOUS EXTERNAL BLEEDING.
LOOSEN CONSTRICTIVE CLOTHING.
REASSURE.
CHECK VITAL SIGNS & RESPONSIVENESS AT 10 MINUTES INTERVALS &
RECORD.
IF UNCONSCIOUS, ENSURE OPEN AIRWAY & RESUSCITATE IF NEEDED.
AFTER RECOVERY PUT IN RECOVERY POSITION.
KEEP CASUALTY COVERED.
KEEP RECORD OF ANY SPECIMEN PASSED OR VOMITED & SEND THE SAMPLES
TO HOSPITAL.
SHIFT TO HOSPITAL ON PRIORITY.
DON’T GIVE ANYTHING TO EAT OR DRINK.

36. Thank you for your
attention