WOUND AND BLEEDING

BY : FASIL.WAGNEW

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1. wound and bleeding
learning objectives

After the end of this session the student will be able to;

1. Define wound and bleeding

2. Identify different causes of wound.

3. Give first aid measures for different wounds and sever

bleeding.

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 Cont….
Definition:- Wound is breaking in continuity to tissue of the
body, either internal or External.

Common Causes of Wounds:

 Wounds usually result from external physical forces.

 The most common accidents resulting in open wounds are

accidental falls and handling of sharp objects, tools,

machinery and weapons.

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Cont….
 Classification of Wound based on skin

involvement

1.Open: An open Wound is a break in the skin or mucous

membrane.

2. Closed: A closed wound involves injury to underlying

tissue with out a break in the skin or mucous membrane.

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Types of open Wound based on
mechanism of injuries
1. Abrasions

2. Incisions

3. Laceration

4. Punctures

5. Avulsions

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 Figure below shows Abrased Wounds

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 Incised Wound

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 Laceration Wound

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 Puncture wound

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 Avulsed wound

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 Bleeding
Bleeding is the escape of blood from vessels into surrounding tissue
whether
External-obvious bleeding or
Internal-concealed or hidden

Types of bleeding
1. Arterial bleeding:- bright red in color, flow from the wound
inside Blood loss, flow is raped
2. Venous bleeding:- dark red in color, flow is steady
3. Capillary bleeding –oozing from bed of capillaries, red in
color,
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usually less bright than arterial blood with slow flow.
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 Internal bleeding
 Bleeding inside body cavity may follow an injury such as a

fracture or a penetrating wound, but can also occur

spontaneously for example bleeding from gastric ulcer.

 the main risk from internal bleeding is hypovolemic shock.

 Check for any bleeding from body orifices such as the ear,

mouth, or anus

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 Cont….
How to recognize internal bleeding
1. Initially pale cold, clumpy skin.
2. If bleeding continue cyanosis
3. Rapid, weak pulse
4. Rapid, shallow breathing
5. Confusion, restlessness
6. Possible collapse and unconsciousness
7.
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Bleeding
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3.3 first aid measures for sever bleeding
 Need for Immediate Action:-The reason why intervention

of first aider needed is to stop any large rapid loss of blood

and to treat for shock and prevent death.

 Techniques to stop severe bleeding simple to complex

A-direct pressure

It is the preferred method for the control of sever bleeding

since it prevents blood loss from the body with out
interference with normal blood circulation.
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 Cont..
 Apply direct pressure by placing the palm of the hand over a

thick pad directly on the entire area of an open wound;

 protecting the hand from contact to the blood in order to

prevent HIV/ AIDS transmission.

 Apply the pressure bandage, maintain a steady pull on the

bandage, and then tie the bandage with the knot directly over
the pad.

 DO NOT TAKE THE FIRST BANDAGE OFF

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 Cont….

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B-elevation
 Unless there is evidence of a fracture, a severely bleeding

open wound of the hand, neck, arm or leg should be elevated

above the level of the victim’s heart.

 Elevation uses the force of gravity to help reduce blood

pressure in the injured area and slows down the loss of blood
through the wound.

 it should be aided by direct pressure.

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 C-Pressure on the Supplying Artery
 If severe bleeding from an open wound of the arm or leg does

not stop after the application of direct pressure plus elevation,

the pressure point technique may be required

 Use the pressure point technique by temporarily compressing

the main artery(which supplies blood to the affected limb)

against the underling bone and nearby tissues.

 the technique also stops circulation within the limb.

 Use it for short duration of time.

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 cont.…
 Use the brachial artery for the control of severe bleeding

from an open arm wound (it is situated in the inside of the

arm between the biceps and triceps about mid way
between the armpit and the elbow).

 E.g. use femoral artery for the control of severe bleeding

from an open leg wound.

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 Cont….

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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.

1. BRACHIAL ARTERY - FOR BLEEDING FROM UPPER LIMB.

2. FEMORAL ARTERY - FOR BLEEDING FROM LOWER LIMB.
3. CAROTID ARTERY - FOR BLEEDING FROM NECK.
4. TEMPORAL ARTERY - FOR BLEEDING FROM SCALP.
5. FACIAL ARTERY - FOR BLEEDING FROM FACE.
6. SUB CLAVIAN ARTERY - FOR BLEEDING FROM CHEST
WALL & ARMPIT

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 PRESSURE POINTS

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 APPLICATION OF INDIRECT PRESSURE

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 D Tourniquet

 The use of a tourniquet is dangerous and the tourniquet should

be used only for a severe life threatening hemorrhage that can

not be controlled by other means.

 Precaution: release the tourniquet every 15 minutes, and

notify others as tourniquet is applied not to forget in its

applied site

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3.4 Prevention of Contamination

 Open wounds are subject to contamination and

infection.

 This danger can be prevented or minimized by

appropriate first aid measures, depending up on the

severity of bleeding.

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 A. Safeguards.
 Whenever a dressing is applied to control bleeding, whether bleeding

is severe or not, safeguards must be taken.

 Do not remove or disturb the cloth pad initially placed on the

wound.

 Do not try to cleanse the wound, since the victim requires medical

care.

 Watch for signs of shock before and during transportation.

 Immobilize the injured area.

 Adjust the victim in a lying position so that the affected limb can
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elevated.
B. Measures to be taken with wounds without severe
bleeding
 To cleanse a wound, wash your hands thoroughly with
soap and water.
 Wash in and around the wound to remove bacteria and
other foreign materials (wash the wound from inside to
outer side).
 Rinse the wound thoroughly by flushing with clean water.
 Blot the wound, dry with a sterile gauze pad or clean cloth.
 Apply a dry bandage or clean dressing and secure it firmly
in place.
 Inform the victim to see a physician immediately if
evidence of infection appears
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 3.5 Removal of foreign objects

 In small open wounds, some foreign materials often

remain in the skin, tissues or underlying surfaces.

 Such objects irritate the victim, and unless they are

removed they can cause infection.

 Use tweezers, sterilized over a flame or in boiling

water, to pull out any foreign matter from the surface

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tissue.
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 Cont…
 Lift out those objects embedded just beneath the skin with a tip

of a sterilized needle (with alcohol or flame).

 Deeply embedded foreign objects in the tissues, regardless

of size should be left for removal by health personnel.

 Immobilize the protruding end with massive dressing around

the protruding part, and then transport the victim to a hospital

without delay.

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