# Bleeding

# Severe Bleeding

#### <span style="color: rgb(224, 62, 45);">**What is it?**</span>

##### <span style="color: rgb(0, 0, 0);">Blood pumping from a wound, bleeding that does not slow down with pressure, and/or bleeding that is quickly soaking through bandage after bandage.</span>

#### <span style="color: rgb(224, 62, 45);">**Plan of Action:**</span>

##### **Call 911 or your local emergency number if the wound is deep or you're not sure how serious it is.** Don't move the injured person except if needed to avoid further injury.

- ##### Before checking for the source of the wound, put on disposable gloves and other personal protective equipment if you have them.
- ##### **Remove any clothing or debris from the wound.** Look for the source of the bleeding. There could be more than one injury. Remove any obvious debris but don't try to clean the wound. Don't remove large or deeply embedded objects, and don't probe the wound.
- ##### **Stop the bleeding.** Cover the wound with sterile gauze or a clean cloth. Press on it firmly with the palm of your hand until bleeding stops. But don't press on an eye injury or embedded object. Don't press on a head wound if you suspect a skull fracture.
    
    ##### Wrap the wound with a thick bandage or clean cloth and tape. Lift the wound above heart level if possible.
- ##### **Help the injured person lie down.** If possible, place the person on a rug or blanket to prevent loss of body heat. Elevate the feet if you notice signs of shock, such as weakness, clammy skin or a rapid pulse. Calmly reassure the injured person.
- ##### **Add more bandages as needed.** If the blood seeps through the bandage, add more gauze or cloth on top of the existing bandage. Then keep pressing firmly on the area.
- ##### **Tourniquets:** A tourniquet is effective in controlling life-threatening bleeding from a limb. If needed, apply a commercially made tourniquet if it's available and you're trained in how to use it. Don't use an improvised tourniquet, such as a scarf or a belt.
    
    ##### When emergency help arrives, tell them how long the tourniquet has been in place.
- ##### **Keep the person still.** If you're waiting for emergency help to arrive, try to keep the injured person from moving.
    
    ##### If you haven't called for emergency help, get the injured person to an emergency room as soon as possible.
- ##### **Wash your hands.** After helping the injured person, wash your hands, even if it doesn't look like any blood got on your hands.

# External Bleeding

#### <span style="color: rgb(224, 62, 45);">**What is it?**</span>

##### <span style="color: rgb(0, 0, 0);">Bleeding due to breaking of the skin from cuts, scrapes, etc.</span>

##### **<span style="color: rgb(0, 0, 0);">With all bleeding injuries, first identify:</span>**

- ##### <span style="color: rgb(0, 0, 0);">The amount of bleeding</span>
- ##### <span style="color: rgb(0, 0, 0);">The location of bleeding</span>

##### <span style="color: rgb(0, 0, 0);">If the flow of blood is continuous, steady, and heavy, consider the wound to be life-threatening.</span>

#### <span style="color: rgb(224, 62, 45);">**Plan of Action:**</span>

##### **<span style="color: rgb(0, 0, 0);">For non-life-threatening bleeding:</span>**

- ##### <span style="color: rgb(0, 0, 0);">Apply dressings over the bleeding area, and put direct pressure on the dressings using the heel of your hand</span>
- ##### <span style="color: rgb(0, 0, 0);">Direct pressure should be firm, steady, and constant</span>
- ##### <span style="color: rgb(0, 0, 0);">Do not remove pressure from the wound to add more dressings</span>
- ##### <span style="color: rgb(0, 0, 0);">Do not remove a dressing once it's placed because it could cause the wound to bleed more</span>
- ##### <span style="color: rgb(0, 0, 0);">Do not remove pressure until help arrives or the bleeding stops</span>
- ##### <span style="color: rgb(0, 0, 0);">If the bleeding is not stopping, press harder</span>
- ##### <span style="color: rgb(0, 0, 0);">Once the bleeding stops or you cannot keep pressure on the wound, wrap a bandage firmly over the dressings to hold them in place</span>
- ##### <span style="color: rgb(0, 0, 0);">A person who is bleeding should be seen by a healthcare provider ASAP because they may need stitches or a tetanus shot</span>

##### <span style="color: rgb(224, 62, 45);">**When to Seek Emergency Care:**</span>

- ##### <span style="color: #000000;">There is a lot of bleeding</span>
- ##### <span style="color: #000000;">You cannot stop the bleeding</span>
- ##### <span style="color: #000000;">You see signs of shock</span>
- ##### <span style="color: #000000;">You suspect a head, neck, or spine injury</span>
- ##### <span style="color: #000000;">You are not sure what to do</span>

# Internal Bleeding

#### <span style="color: rgb(224, 62, 45);">**What is it?**</span>

##### <span style="color: rgb(0, 0, 0);">Bleeding inside the body.</span>

##### <span style="color: rgb(0, 0, 0);">When bleeding occurs inside the body, you may be able to see a bruise under the skin or you may not be able to see anything.</span>

##### **<span style="color: rgb(0, 0, 0);">You should suspect internal bleeding if someone:</span>**

- ##### <span style="color: rgb(0, 0, 0);">Was injured in a car crash or was hit by a car</span>
- ##### <span style="color: rgb(0, 0, 0);">Fell from a height</span>
- ##### <span style="color: rgb(0, 0, 0);">Was injured in the abdomen or chest (including bruises such as seat belt marks)</span>
- ##### <span style="color: rgb(0, 0, 0);">Was injured in a sporting event, such as slamming into other people or being hit with a ball</span>
- ##### <span style="color: rgb(0, 0, 0);">Has pain in the abdomen or chest after an injury</span>
- ##### <span style="color: rgb(0, 0, 0);">Has shortness of breath after an injury</span>
- ##### <span style="color: rgb(0, 0, 0);">Is coughing up or vomiting blood after an injury</span>
- ##### <span style="color: rgb(0, 0, 0);">Shows signs of shock without external bleeding</span>
- ##### <span style="color: rgb(0, 0, 0);">Was stabbed or shot</span>

#### <span style="color: rgb(224, 62, 45);">**Plan of Action:**</span>

- ##### <span style="color: rgb(0, 0, 0);">Call 911, and get a first aid kit and AED</span>
- ##### <span style="color: rgb(0, 0, 0);">If the person is responsive, have them lie down and keep still while you treat any external injuries</span>
- ##### <span style="color: rgb(0, 0, 0);">Check for signs of shock and provide first aid as needed</span>
- ##### <span style="color: rgb(0, 0, 0);">Be prepared to provide CPR if they become unresponsive and stops breathing normally</span>