Introduction

Serious bleeding must be controlled immediately or the victim may die within minutes.  External bleeding falls into the following classifications:

Arterial

Arteries carry blood from the heart throughout the body.  A cut to an artery will result in bright red blood which spurts of pulses each time the heart beats.  Because the blood in arteries is under a higher pressure, cuts to arteries can result in significant blood loss and are difficult to control.

Venous

Veins carry blood from the body and return it to the heart.  A cut to a vein will result in dark red or bluish blood.  Cuts to veins are much easier to control than cuts to arteries.

Capillary

Capillaries are small blood vessels that connect arteries and veins.  Small cuts or abrasions result in capillary bleeding.

You can control bleeding using the following methods:

Controlling Bleeding with Direct Pressure

Direct pressure is the most effective means to stop bleeding.  Apply pressure directly over the wound and hold pressure firm enough and long enough to stop and “seal off” the point of bleeding.

If bleeding continues after having applied direct pressure for 30 minutes, apply a pressure dressing to the wound. A pressure dressing consists of a thick dressing of gauze material applied directly over the wound and held in place with a tightly wrapped bandage or tape.  It should be tight but not tight enough to impair circulation to the rest of the limb.  Keep the dressing on even if it becomes blood soaked.  Each day you should change the  dressing and inspect the victim for signs of infection.  After 2 days you may remove the dressing and replace it with a smaller dressing.

Dressing a bleeding would with direct pressure dressing

Controlling Bleeding with Elevation

You can slow the blood loss by raising the injured area as high as possible above the heart’s level.  This lowers the blood pressure at the sight of the injury and aids in the return of blood to the heart.

Note: In the case of a snakebite injury, keep the injured extremity below the level of the heart.

Controlling Bleeding with Pressure Points

A pressure point is a location where the main artery lies near the surface of the skin or when the artery passes over a bony prominence providing an area where pressure can be applied to slow arterial bleeding until the application of a pressure dressing is complete.  Pressure point control is not as effective for controlling bleeding as direct pressure exerted on the wound.  In addition, the effectiveness may be reduced when more than one artery supply blood to the wounded area.

The following are major pressure points in the human body (if you cannot remember all of these pressure points, just remember wrist, ankle, and neck).

Pressure points on the human body

Note: be careful when applying pressure to the neck area.  Too much pressure applied to the neck can cause death.  Also, never place a tourniquet around a victim’s neck.

To manipulate these pressure points, you can place a stick on the joint area and bend the joint over the stick.  Then lash the joint keeping it tightly bent.

Controlling Bleeding with Digital Ligation

To stop or slow down bleeding immediately, apply pressure with a finger on the bleeding end of the vein or artery.  Maintain the pressure until the bleeding stops or slows down enough to allow application of a pressure bandage.

Controlling Bleeding with aTourniquet

A tourniquet is a last resort and should only be used when applying direct pressure over the bleeding point does not control the bleeding.  A tourniquet that is left in place too long can cause long-term damage to the tissues that are deprived of blood flow.  This damage can lead to gangrene and the loss of the limb altogether.

Place a tourniquet between the wound and the heart, about 2-4 inches above the wound.  As illustrated below, a rope can be tied around the limb and a stick used to tighten the tourniquet.

How to create a tournequet

After the tourniquet has been applied, clean and bandage the wound.  You may allow blood to flow to the tissues by releasing the tourniquet every 10 to 15 minutes and leaving it released for a minute.  If you are applying the tourniquet to yourself, do not release the tourniquet (you could potentially pass out while the tourniquet is released and bleed to death).

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