Bleeding

            "Profuse bleeding is a life-threatening condition that requires immediate emergency care.  Bleeding has a devastating effect on perfusion.  There is only so much blood to circulate.  Once a certain amount of the body's blood volume is lost, perfusion of all capillaries will not occur.  The parts of the body that are not perfused will eventually experience tissue death.  The brain, nerve cells, and kidneys are especially sensitive to decrease perfusion."  (Emergency Care, 6^th edition, Brady, 1994).  Below you will find the step-by-step procedures for treating bleeding on an adult.  There is no theory, just the steps.  Again, this is NOT a substitute for formal hands-on training, but for information as a memory refresher.

h             Pressure Dressing - this may be applied over a dressing if bleeding does not stop

·       Place wadding material (bandages, hankerchief, t-shirt, etc.) over initial bandage

·       Tie a hankerchief, tie, strips of cloth around wound site so that knot is directly over site and wadding material.

·       Tie tightly but not so tight as to cut of circulation to area below wound site (this is NOT a tourniquet) - check pulses below wound site

h             Elevation - used with direct pressure.

·       Hold wound above the level of the heart, this decreases the blood pressure at the site

h             Tourniquet - this is a LAST RESORT as it completely stops blood flow below application site.

·       Use only when all other methods fail and loss of life is imminent.

·       Tourniquet should be made of a wide material to prevent cutting into the skin

·       Place tourniquet between heart and the wound, about 2 inches from the wound

·       Tie a knot to secure the material in place, place end of a stick or rod over knot, tie another knot over this.

·       Twist rod, tightening the material around the limb, until bleeding stop and no further.

·       Secure rod by tying another piece of material around other end and securing to limb.

·       Once in place, DO NOT REMOVE.  Doing so may cause the patient to go into shock, resume bleeding, or dislodge any clots that may have formed.

·       Mark the patient's forehead with a "T" or "TK" and time tourniquet was applied so that when EMS arrives, they will not overlook the tourniquet.