WOUNDS and

BLEEDING
Wounds
• is damage to the soft tissue of the body, including
the blood vessels.

Two types of Wounds

OPEN WOUND

CLOSED WOUND
Open wound
- is when the top layer of skin has broken; there is risk
of infection, and of losing blood.

D – Direct pressure
E – Elevate the affected part
P – Pressure on the supplying artery
P – Pressure bandage
Closed wound
 is when the skin does not break, but the soft tissue,
including the blood vessels, is damaged; blood leaks
into the tissue from the blood vessels

R - rest
I – ice application
C – compression
E – Elevate the injured part
S – Splinting (if necessary)
Kinds of Open Wounds:

• Incision – clean cut caused

by a sharp-edged object

• Abrasions and lacerations

– caused by an accident
and can be a small graze
(abrasion) or a deep,
jagged opening in the
tissue (laceration)
Puncture or stab wound
- caused by an object
with a sharp point, such
as a knife or nail

Sucking chest wound –

wound in the chest that
has gone deep enough
to make a hole in the
lungs
Gun-shot wound – this
wound may have both an
entry and an exit wound

Amputations – a wound
where an arm or leg or
finger or toe has been
completely or partly cut off
Abdominal wound

• If the abdominal contents do

protrude through the wound, do
not attempt to put them back,
instead cover with a large dressing
until further treatment given

• if the abdominal contents do not

protrude, cover the wound with a
large standard dressing and place
the casualty in the half-sitting-up
position
Bleeding
 Bleeding from small blood vessels occurs when
there is a minor cut of the skin.

 Blood oozes from the wound; it usually stops by

itself or when a dressing is applied.

 volume of blood loss depends on the number of

blood vessels damaged
 Bleeding

 The human body contains 5–6 Liters of blood.

 Healthy adult can lose up to 500 ml of blood

without a harmful effects,

 It should be controlled immediately to prevent

excessive loss of blood.
Kinds of Bleeding:
1. Arterial Bleeding
–Bright red in color
–Blood spurts from the blood
vessels
2. Venous Bleeding
–Dark red
–Blood oozes from the
wound
3. Capillary Bleeding
–Dark red
–Little blood can be lost
–Clotting is spontaneous
The signs and symptoms of excessive loss of blood are:
• Weakness or fainting
• Dizziness
• Pale, moist and clammy skin
• Fast, weak & irregular pulse
• Shortness of breath
• Restless
 The number of symptoms and their severity are
generally related to how fast the blood is lost and in
what amount.

 Once the bleeding has been controlled, the patient

should be placed in a reclining position, encourage
to lie quietly, and treated for shock.
In all cases of external bleeding, follow the three
cardinal rules:
1. Lay the patient down;
2. Examine the wound
3. Elevate the affected part if possible;
4. Provide pressure where the blood comes from.
Use a dressing or a clean cloth or handkerchief.
5. tie a dressing firmly round the wound to
maintain the pressure;

• If possible disposable gloves should be worn to

protect yourself.
 Do not disturb the dressings until you are prepared to
undertake definitive treatment.

 The bleeding stops because of the formation of a clot.

 if blood continues to come through the dressing, apply

another bandage on the top of the first one. Bandage
more firmly.

 If you remove the dressing, the clot will break and

bleeding will start again.
 keep the injured part as still as possible and the
casualty at rest because movement disturbs (and
destroys) the blood clot;

 after bleeding has been controlled, rest the limb

You can remember the treatment for severe
bleeding as:

E – Expose the wound if under clothing

X – Examine the wound
P – Apply pressure
E – Elevate (raise) the injured part
C – Cover to prevent infection
T – Treat for shock
Tourniquets
• device used to control severe bleeding
• It is only required when large arteries are
severed
• only used as an absolute last resort after all
other methods have failed
• used only for life threatening hemorrhage that
cannot be controlled by other means
• Improper use of a tourniquet may cause tissue
injury
Apply Tourniquet
• If you do not have a specially designed tourniquet,
find a length of strong, pliable cloth like gauze or
clothing such as a shirt or a skirt
• Place the tourniquet around the arm or leg between
the wound
• Tie a half-knot
• Place a stick above the knot
• Tie a full knot over the stick.
• Twist the stick until the material is tight around the
limb
Your aims for bleeding:
• Control blood loss.
• Prevent infection.
• Treat for shock, if necessary.
• Try to arrange removal to the nearest health
facility, if necessary

As always, assess D R A B, respond as needed,

and treat any more urgent conditions. Whatever kind
of open wound you are dealing with, you should first
control the bleeding; and then clean and dress the
wound to stop infection.