Department of Medical Education

Ayub Medical College

Abbottabad

Module # V
Wound Management, Hemorrhage Control
and Injections
 OUTLINE OF THE SESSION
 Types of Wounds

 Types of Bleeding

 Hemorrhage Control

 Dressings and Bandages

 Injection – IM. IV, Infusion

 Video Presentation

 Practice Session 2
 SOFT-TISSUE INJURY AND
BLEEDING
 Damage to soft tissues and organs
can be life threatening.
 More trauma patients die from shock
than from any other reason.
 BODY SUBSTANCE
ISOLATION (BSI)
 Most soft-tissue injuries involve
bleeding.
 Take appropriate measures to prevent
contact with patient’s body fluids.
 Gloves must be worn to avoid contact
with patient’s blood.
 You may also need a mask and eye
protection.
 TYPES OF WOUNDS
 Contusion
• Blunt instrument, may have underlying
fractures or crushed tissues
 Laceration
• Snagging & tearing of tissues(barbed wire,
jagged metal),
 Bleeds less freely, healing can be
prolonged
 Incision
• Sharp object (knife), Bleeds freely, heals
quickly
 TYPES OF WOUNDS
 Puncture
• Caused by a pointed object,
 Small wound penetrated deeply caused damage
to underlying surfaces - blood vessels & organs
 Shot
• Bullet, shot or bomb shrapnel
• may have an exit wound mush larger than
the entry wound
AVULSIONS AND AMPUTATIONS
 Tearing away of body tissue
 Part may be totally severed from body or
attached by flap of skin.
 Locate amputated part, place in clean plastic
bag, and keep cool.
 TYPES OF BLEEDING
 Capillary
• Blood oozes out.

 Venous
• Has a steady flow

 Arterial
• Blood spurts or surges.

• Can result in death from blood loss

 TYPES OF BLEEDING

Recognizing types of external bleeding.

A. Capillary. B. Venous. C. Arterial.
 CONTROLLING EXTERNAL
BLOOD LOSS
 Use proper BSI

 Apply direct pressure

using sterile dressings

 Elevate extremity if you

do not suspect a fracture.

 Locate and apply pressure

to brachial or femoral
pressure points.
 DRESSINGS
 An object placed directly on a wound
to control bleeding

 Sterile dressings come in many

different sizes.

 Touch only one corner of the dressing

when opening a sterile package.
 BANDAGES
 Used to hold dressings in place
 Roller gauze and triangular bandages
commonly used in the field.
 Wrap bandage just tightly enough to
control bleeding.
 Ensure circulation is not cut off
 Check Circulation, Sensory & Motor
(CSM) functions
 PRINCIPLES OF WOUND
TREATMENT
 Control bleeding as quickly as possible.

 Prevent further contamination of wound.

 Immobilize injured part.

 Stabilize impaled object.

 FACE AND SCALP WOUNDS
 Cause large amounts of bleeding

 Most bleeding can be controlled by

applying direct pressure.
 EYE INJURIES
 For lacerations, cover entire eye.

 For impaled objects:

• Cover injured eye with a dressing.

• Place a paper cup over injured eye.

• Bandage both eyes.

 EXTREMITY WOUNDS
 Apply dry, sterile dressing and bandage.
 Elevate area to decrease bleeding and
swelling.
 Splint injured area if fracture is
suspected.
TYPES OF INJECTIONS

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 INTRAMUSCULAR INJECTION
 Skin and the muscles under the skin, cover
nerves, blood vessels, and bones.
 It is important to give injection where you will
not hurt any of these body parts.
 SITE FOR INJECTION
The most favoured sites are:
• Middle third of the deltoid muscle in the
shoulder
•Upper outer quadrant of the buttock
• These areas avoid major blood vessels and
nerves.
• 19
 SUPPLIES NEEDED
 Alcohol swabs.
 Band-Aid.
 1cc, 3cc or 5cc syringe.
 Medicine (vail or Ampule)
 Proper gauge needle.
 Dry gauze or tissue.

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 PROCEDURE
 Introduce yourself
 Obtain consent
 Explain the procedure
 Ask for any allergies
 Check the identity
 Select the area for injection
 Prepare & check the drug
 Wash or Sanitize hands
 Fill syringe with the required amount of drug
 Swab the injection site with alcohol
 PROCEDURE
 Allow it dry for few second
 Hold the muscle firmly between thumb & fingers
 Insert the needle quickly but gently at 90 degree angle
 Pull plunger slightly backwards to look for any traces of blood
 Inject the medication slowly
 Remove the needle apply little pressure on injection site
 If oozing continue apply pressure bandage
 Say thanks to patient

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Video Presentation
&
Practical Session

23
Thank You