Life threatening Emergency

Bleeding
Definition
Bleeding It is the escape of the blood from arteries, veins or capillaries.
Hemorrhage It is the large amount of bleeding occurring in small amount of time.
It can be of two types internal and external.
Blood and blood vessels
Blood components: It consists of liuid and solid component and comprises
approximately ! percent of body"s total weight. #he liuid part of blood is $nown as
plasma. #he solid components are Red blood cells, White blood cells Platelets.
Plasma is the fluid that ma$es up about half of the total blood volume. %ontains mostly
of water, plasma contains the blood volume needed for normal function of the circulatory
system. It also contains nutrients essential for energy production, growth, and cell
maintenance, and carries waste products for elimination.
White Blood Cells are a $ey disease fighting part of the immune system. #hey defend
the body against invading microorganisms. #hey also aid in producing antibodies that
help the body resist infections.
Red Blood Cells account for most solid components of the blood. #hey are produced in
the bone marrow in the hollow center of large bones such as large bone of the arm and
thigh. It numbers nearly &'( million in each drop of blood. #he )B% transports oxygen
from the lungs to the body cells and carbon dioxide from body cells to the lungs.
Platelets are the disc shaped structures in the blood that are made up of cell fragments. It
is essential part of blood clotting mechanism because of their tendency to bind together.
#hey help stop bleeding by forming blood clots at wound sites. Blood clots form the
framewor$ for healing. *ntil blood clot forms bleeding must be controlled artificially.
Blood Functions
+. #ransporting ,xygen, nutrients and wastes.
&. -rotecting against disease by producing antibodies and defending against germs.
.. /aintaining constant body temperature by circulating throughout body.
Blood Vessels
Arteries carry oxygen0rich blood away from the heart.
1rteries become smaller throughout the body until they connect to the capillaries.
Capillaries are microscopic blood vessels lin$s arteries and veins.
#hey transfer oxygen and other nutrient from blood into the cells.
%apillaries pic$ up waste products from the cells and move them into the veins.
he veins carry waste products from the cells to the $idneys, intestines, and lungs, where
waste products are eliminated.
Because blood in the arteries is closer to the pumping action of the heart, blood in the
arteries travel faster and under great pressure than the blood in the capillaries or veins.
Blood flows in the arteries pulses with the heartbeat2 blood in the veins flows more
slowly and evenly.
When bleeding occurs
3hen bleeding occurs the body begins a complex chain of events.
#he brain, heart, and lungs immediately attempts to compensate for blood loss in
order to maintain flow of oxygen0rich blood to the body, particularly to the vital
organs.
,ther important reaction also occurs at the microscopic level.
-latelets collect at the wound site in an effort to stop blood loss through clotting.
3hite blood cells prevent infection by attac$ing microorganisms that commonly
enters through brea$s in the s$in.
#he body manufactures extra red cells to help transport more oxygen to the cells.
Blood volume is also affected by the bleeding.
4ormally excessive fluid is absorbed from the blood stream by $idneys, lungs,
intestinal tract, and s$in. 5owever, when bleeding occurs, this excessive fluid is
reabsorbed into the bloodstream as plasma. #his helps to maintain critical
balance of fluid needed by the body to $eep blood volume con stant.
!"ternal bleeding
It occurs when the blood vessels is opened externally, such as through tear in the s$in.
Each type of blood vessel bleeds differently.
Arterial bleeding is often rapid and profuse, since there is more pressure in the arteries
than in vein there is difficulty in clotting of blood. #he high concentration of oxygen
gives arterial blood bright red color#
Venous bleeding is easier to control than arterial bleeding. 6eins are damaged more
often as they are often more closer to the s$in surface. 7ue to less pressure in the veins
the flow of blood is steady, without sprouting. ,nly damage to veins deep in the body,
such as those in the trun$ or thigh, produces profuse bleeding that is hard to control.
Because it is oxygen0poor, venous blood is dar$ red or maroon in color.
Capillar% bleeding, the most common type of bleeding, is usually slow because the
vessels are small and the blood is under low pressure. It is often described as 8oo9ing:
from the wound. %lotting occurs easily the blood is usually less red than arterial blood.
Control of !"ternal Bleeding
Direct pressure pressure created by directly placing hand over the wound can control
bleeding. #he pressure restricts the blood flow thus the clotting ta$es place easily.
Elevating the in;ured area also slows the blood flow and encourages the blood clotting.
-ressure on wound can be maintained by snugly applying a bandage to the in;ured area
this is $nown as -ressure Bandage.
1lthough rare, in some cases of severe bleeding, direct pressure or elevation of the
wounded area may not control bleeding. In these cases, you will have to compress the
artery supplying the area against an underlying bone at specific sites on the body. #hese
sites are $nown as pressure point.
#he pulse can be ta$en best where the artery can be pressed against a bone. #he various
pressure points are
+. &ec$ or carotid pressure point It is located at the point of triangle between the
shaded muscle which runs from the ear to the collar bone and the muscles
covering the voice box <larynx= and the wind pipe.
&. Arm or Brachial pressure point It is felt halfway down the inside of the arm
between the bands of muscles above and below the arm bone. 1 nerve runs along
this artery and if it is rolled on the bone it will produce a tingling sensation. In the
arm and little finger.
.. high or femoral pressure point -ositioned half way between the centre of the
pubic bone and in front of the hip bone. #his point is ;ust on the inside of the leg
below the groin s$in crease.
o control e"ternal bleeding, follo' these general steps (
+. -lace direct pressure on the wound with a sterile gau9e pad or any clean cloth.
-lace your hand over the cloth and apply direct pressure. If you do not have a
cloth or gau9e available, have the in;ured person apply pressure with his or her
hand. 1t last resort, use your own bare hand.
&. Elevate the in;ured area above the level of the heart if you do not suspect a bro$en
bone.
.. 1pply pressure bandage to hold the gau9e or cloth in place.
>. If blood soa$s through the bandage, add more pads to help absorb the blood. 7o
not remove any blood soa$ed pads.
?. If bleeding continues, apply pressure at pressure points to slow the flow of blood.
'. ,bserve the victim closely for signals that may indicate that the condition is
worsening.
)# Wh% should 'e not remove blood soa$ed pads from the 'ound 'hen tr%ing to
control the bleeding*
+nternal bleeding it is the escape of blood from arteries, veins and capillaries into the
spaces in the body. %apillary bleeding, indicated by mild bruising, is beneath the s$in is
not serious. 5owever, deeper bleeding involves arteries and veins and results in severe
blood loss.
It can be caused by
1 violent blunt force such as in a car crash when the driver is thrown against the
steering wheel.
3hen someone falls from the height.
3hen a sharp ob;ect penetrates the s$in and damages the internal organs.
@ractured bone damaging some blood vessel or internal structure.
,ignals of internal bleeding (
+. 7iscoloration of the s$in <bruising= in the in;ured area.
&. Aoft tissues, such as those in the abdomen, those are tender, swollen, or
hard.
.. 1nxiety or restlessness.
>. )apid or wea$ pulse.
?. )apid breathing.
'. A$in that feels cool or moist or loo$s pale or blush.
B. 4ausea and vomiting.
!. Excessive thirst.
C. 7ecline of level of consciousness.
Control of internal bleeding
+. %ontrolling internal bleeding depends on the severity and site of the bleeding. @or
minor bleeding, such as a bruise on an arm, apply ice or cold pac$ wrapped in a piece of
cloth or hand$erchief or small towel to the in;ured are to reduce pain and swelling.
&. %all E/A.
) Ho' does the application of ice reduce s'elling*
&ote 3hen applying the pressure bandage, remember when you have
applied it and do not forget to remove it well in time other wise it may cause
damage to the organ due to lac$ of blood supply. Aubseuent release is
advisable.
&ose bleeding
&ose bleeding is usuall% caused b% (
+. Blow from a blunt ob;ect.
&. 5igh blood pressure.
.. 5igh temperature during summers.
>. %hange in altitude.
?. @racture in nose.
'. %old and other respiratory infections.
B. -ic$ing out crusts and hairs from nose.
!. Bleeding disorders.
C. @ever.
-anagement (
+. Let the patient sit up, with head slightly bent forwards.
&. -ress the nostrils together, holding pressure for several minutes.
.. 1s$ the patient to breath through mouth.
>. 1pply a towel, wet with cold water or crac$ed ice, over the nose, face
and forehead and at the bac$ of the nec$.
?. Loosen the tight clothing.
'. 7o not let the patient tal$, cough, laugh, wal$ about or blow the nose.
1ctivity and excitement may increase the bleeding or causes it to
restart.
&ose care after a nose bleeds
+. 7o not pic$ your nose or insert anything into it <such as cotton swabs,
hand$erchiefs=.
&. 7o not blow your nose forcefully.
.. If you must snee9e expel the snee9e through your open mouth.
>. 7o not stoop, or exert. 3hen you lie down, elevate your head using
two or three pillows.
?. ,n the second day, put a little petroleum ;elly inside your nostril to
soften the crusts that form after a nose bleed.
'. 1void hot drin$s and alcoholic beverages.
B. 7o not smo$e or ta$e aspirin for ? days.