Awareness and First Aid
Uncontrolled bleeding needs rapid intervention. An ER24 expert explains how to staunch blood flow.
Understand the type of bleeding
Reinhard Podges, a Quality Assurance Officer at ER24 North Metro, says it’s vital to quickly assess the type of bleeding and rapidly control it. He identifies the three types:
- Arterial bleeding: “This is a pressurised spurt of bright-red blood that gushes in time with the heartbeat,” says Podges. “It’s the most dangerous type of bleed and needs immediate medical attention.”
- Venous bleeding: “It's when darker red blood flows from veins that carry blood away from the heart. The flow is steady and is often caused by deep lacerations to large veins. It can cause rapid blood loss.”
- Capillary bleeding: Usually the least severe type of bleeding, but it still needs attention. It’s often caused by bumps or scrapes. The blood oozes slowly from the wound and usually clots by itself. “Clean the site of the bleed with lukewarm water because if bacteria enter the circulatory system, it can cause infection or sepsis,” advises Podges. “Then apply a household disinfectant like Savlon or Dettol before bandaging the area.”
A guide to bleeding control
Podges describes the four main ways you can help in a bleeding emergency:
1. Ensure a safe environment and call for help
Make sure there are no hazards, such as oncoming traffic or falling debris, that can hurt you while you’re helping the patient. Stay calm.
“If the person is pale, sweaty or cold to touch, these are signs of shock, which needs immediate medical attention. Rapid breathing, lethargy, and confusion are also signs of serious injury.
Call ER24 for real help, real fast.
2. Apply direct pressure
If it’s a controllable bleed, apply firm, direct pressure to the wound using a clean cloth, piece of clothing or even your hand if nothing else is available. Ideally you would use a trauma dressing (absorbent gauze).
Apply constant pressure for at least 15 minutes, without pulling the dressing away to check the wound.
If blood soaks through the material, add more layers and apply more pressure, without removing the original dressing.
For deep, severe lacerations caused by gunshot or stabbings, push loose bandage into the wound to absorb the blood as much as possible before wrapping the area.
3. Elevate the wound
If it’s an arm or leg that’s bleeding, try to keep the limb above the level of the heart while applying pressure. Gravity will help lessen the blood flow to the area and assist with clotting.
Never try to remove an embedded object, such as a knife or large piece of glass, as it could be controlling the bleed. Rather roll a bandage into a doughnut shape around the object until medical help arrives.
4. Apply a tourniquet
If direct pressure and elevation aren’t controlling the bleeding, tie a tourniquet a couple of centimetres above the bleed. In the absence of a bandage, use a belt, scarf, or cloth, and tighten it until the bleeding stops. Try to remember the time you first applied the tourniquet and tell ER24 medics when they arrive. This is because if blood flow to a limb is restricted for an extended length of time, it could cause serious complications.
For areas where a tourniquet can’t be applied, such as the groin, armpit or neck, push loose bandage into the wound to absorb the blood as much as possible before wrapping the area and applying direct pressure. For a neck injury, apply pressure only to one side of the neck to prevent further injury or risk of obstructing the airway or opposite side blood vessels.
Don’t remove the tourniquet until medical help arrives. Removing it can cause a sudden rush of blood back into the limb, potentially causing worsening shock. ER24 paramedics may be able to apply haemostatic agents – an intervention that reduce bleeding by helping blood to clot.
“Knowing how to stop severe bleeding is a crucial life-saving skill,” Podges adds. “In an emergency, your quick action can make the difference between life and death.”