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  Control of External Bleeding
 
External bleeding is usually associated with wounds, those injuries that are caused by cutting, perforating or tearing the skin. Serious wounds involve damage to major blood vessels.

 
Types of Wounds:
  • Incision is the type of wound made by cutting with a sharp knife or sharp piece of metal.
  • Laceration is a deep wound with associated loss of tissue — the type of wound barbed wire would cause.
  • Abrasion is a wound where the skin layers have been scraped off.
  • Puncture wounds are perforations, and may be due to anything from a nail, knife or bullet.
Serious bleeding:
  • Quickly check the wound for foreign matter.
  • Immediately apply pressure to the wound to check bleeding.
  • Call for medical aid.
  • Apply a non-adherent pad.
  • Lay the casualty down.
  • Raise and support the injured part above the level of the heart if possible.
Incisions and lacerations:
  • Quickly check the wound for foreign matter.
  • Immediately apply pressure to stop any bleeding.
  • Apply a non-adherent dressing.
  • Immobilise and elevate the injured limb if injuries permit.
Abrasions:
  • Check the wound for foreign matter.
  • Swab with a diluted antiseptic solution.
  • Apply a non-adherent dressing or a light, dry dressing if necessary.
Puncture wound:
  • check the wound — do not remove any penetrating object.
  • Apply pressure to stop any bleeding.
  • Stabilise with a pad and non-adherent dressing.
  • Apply a firm bandage.
  • Rest and elevate the injured part of the body, if injuries permit.
Amputation:  The casualty must reach the nearest hospital as soon as possible. 
       In the meanwhile:
  • Apply immediate pressure to stop any bleeding.
  • Apply a large pad or dressing to the wound.
  • Treat for shock.
  • Collect amputated part — keep dry, do not wash or clean.
  • Seal the amputated part in a plastic bag or wrap in waterproof material.
  • Place in iced water — do not allow the part to come in direct contact with ice. Freezing will kill the tissue.
  • Ensure the amputated part is sent to the hospital with the casualty.

   Care should be taken to obtain medical advice to prevent tetanus. Remember, so as not to disturb the clotting of the wound, do not remove the initial dressing. If bleeding continues and seeps through the bandage and padding, remove and replace these, leaving the initial dressing in place.
   
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