Wounds and Bleeding

WOUND AND BLEEDING

 

A wound is a break in the continuity of skin of the body. There will be bleeding from the injured part and it also forms an opening through which germs can get into the body. The depth of a wound is often more important than its area, small deep wounds caused by knives, bullets etc. are often more dangerous.

 

Types of Wounds

Abrasions (Graze) - a superficial wound on which the top layers of skin are scraped off - by a sliding fall or a friction - contains embedded foreign particles.

 

Incised Wounds are caused by sharp instrument like knife, razor etc. The blood vessels are clean cut and so these wounds bleed very much.

 

Contused Wounds are caused by blows by blunt instruments or by crushing. The tissues are bruised.

 

Lacerated Wounds are caused by machinery, falls on rough surfaces, pieces of shells, claw of animals etc. These wounds have torn and irregular edges and they bleed less.

 

Punctured Wounds are caused by sharp instrument such as a knife or a dagger. They have small openings, but may be very deep.

 

Gun Shot Wounds: A small entry may be associated with extensive internal injuries and with a large exit wound.

 

Complications of wounds

 

Wounds cause two great dangers

 

Bleeding and

 

Infection

 

Bleeding - when the blood comes out of a blood vessel it is called bleeding. Bleeding is the immediate complication of wound and must be treated promptly.

 

Infection - is caused by germs getting into the body through the broken skin. The germs multiply in wound and make it infected or septic. They may then get into the blood stream and cause blood-poisoning (Septicemia).

Management

 

Stop bleeding

 

Apply direct pressure to the wound with a sterile dressing or a clean cloth piece. If necessary press the relevant arterial pressure point.

 

Handle the injured part as gently as possible.

 

Make the patient sit or let him lie down. If the wound is in a limb, and there are no broken bones, raise the limb. This will lessen the bleeding.

 

Wash your hands thoroughly or clean them with an antiseptic lotion.

 

Remove any foreign objects like glass, stones, etc. if you can easily get at them. This should not open up the wound again which will cause more bleeding. Do not disturb any blood clot already formed.

 

Place a clean dressing over the wound and bandage firmly.

 

Get a doctor.

 

If you cannot get a doctor or nurse, you will have to transport him as early as possible to the hospital.

 

Bleeding

 

Bleeding (Haemorrhage) is a common cause of death in accidents. It is caused by the rupture of blood vessels due to severity of the injury.

 

External and Internal Bleeding

 

If the bleeding is from the surface of the body it is called external bleeding.

 

If the bleeding is within chest, skull or abdomen etc. it is called internal bleeding. This cannot be seen immediately but later the blood may ooze out through the nose or ear or coughed up from the lungs, or vomited from the stomach.

 

Types of Bleeding

 

Bleeding may occur from

 

Bleeding from Arteries

 

The blood comes out in jets because it corresponds to the beats of the heart in action. The blood will be bright red. This kind of bleeding may cause death very quickly.

 

b. Bleeding from Veins

 

Blood flows out in a continuous stream and is dark red in colour.

 

c. Bleeding from Capillaries

 

Blood oozes out slowly, if it is on the surface of the body. It is not at all serious.

Signs and symptoms of bleeding

The casualty feels faint and may even collapse.

Skin becomes pale, cold and clammy.

Pulse gets rapid but very weak.

 

Breathing becomes shallow, casualty gasps for breath and sighs deeply.

There is profuse sweating

The casualty feels thirsty.

Management

 

Minor Bleeding

 

Minor Bleeding is usual at work and play. It results from injured capillaries. There is no need to get frightened. The bleeding will stop by itself or by firm pressure and bandaging, keeping the limb elevated.

b. Major Bleeding

 

Major bleeding is the result of an injury to a large blood vessel or when persons suffer from some blood disease.

 

The Aims of the first aid are

To stop the bleeding quickly.

 

To get immediate medical aid, if necessary take the casualty to a hospital for blood transfusion etc.

In the case of severe external bleeding

Bring the sides of the wound together and press firmly.

 

Place the casualty in a comfortable position and raise the injured part (if no bone fracture is suspected).

Press on the pressure point firmly for 10 to 15 minutes,

 

Apply a clean pad larger than the wound and press it firmly with the palm until bleeding becomes less and finally stops.

 

If bleeding continues, do not take off the original dressing, but add more pads.

Finally, bandage firmly but not too tightly.

 

Keep the part elevated and immobilized.

Treat for shock

 

Get the casualty to hospital as soon as possible.

Note : Embedded objects or protruding bone in a bleeding wound.

 

In the case of internal bleeding

 

The aim of first aid is to prevent the condition from getting worse.

 

Lay the casualty down with head low, raise his legs by use of pillows etc.

 

Keep him calm and relaxed. Reassure him. Do not allow him to move.

Keep up the body heat with thin blankets, rugs or coats.

 

Do not give anything to eat or drink because he may have to be given an aneasthetic later.

 

Do not apply hot water bottles or ice-bags to chest or abdomen. This might only make things worse.

Take him to a hospital as quickly as possible. Transport gently.