Bleeding

Most adults can donate a pint of blood without harmful side effects. Losing a quart of blood, quickly, though, can lead to shock and even death. In a child, losing a pint (or less depending on the child’s size) can put the child in extreme danger.

For External Bleeding

• A skin wound.

• Dark red blood gushes or flows from veins.

• Bright red blood spurts from arteries.

• Blood oozes from capillaries. The bleeding usually clots off by itself.

For Internal Bleeding

• Vomiting or coughing up true, red blood. This includes blood-tinged sputum.

• A bruise on the skin of the chest or abdomen, especially if it is in a place where no blow was struck.

• Fractured ribs.

• Dizziness. Fainting. Weakness.

• Lethargy. Excessive sleepiness. Mental status changes. These can occur with trauma to the head, even if it is mild.

• Fast pulse. Cold, moist skin.

• Stools contain bright red blood or are black (not due to taking iron).

For External Bleeding

• Abrasions (scraped skin). Lacerations (cut skin with jagged edges). Punctures. (See Skin Injuries / Wounds.)

• Knife, gunshot, or other wounds can graze or penetrate the skin. These can damage internal blood vessels and body organs.

• Injury wounds.

For Internal Bleeding

• A bruise. This is bleeding from and damage to tissues beneath the skin.

• Damage to blood vessels and/or internal structures. This includes a blunt injury that does not break the skin, a bleeding ulcer, and an aneurysm.

• Bleeding disorders.

Taking blood-thinning drugs can result in both internal and external bleeding.

Treatment

When bleeding occurs, the goal is to find the source, stop or lessen the bleeding, and help the body cope with the loss of blood.

• For severe bleeding, treatment includes first aid measures and emergency medical care.

• For minor bleeding, treatment depends on the cause and other medical conditions present.

• Bleeding disorders need to be treated by a doctor.

Are any of these problems present?

• A body part has been amputated.

• Bleeding from a wound is severe.

• Blood spurts from the wound and it is not controlled with direct pressure.

• Signs of shock.

Are any of these problems present?

• Bleeding comes from a deep wound (it appears to go down to the muscle or bone) and/or a bone is exposed.

• The skin on or around the wound site hangs open.

• A deformity is at the injury site.

• Bleeding from what appears to be a minor wound continues after 20 minutes of applied pressure.

Are any of these problems present?

• Frequent nosebleeds.

• Small red dots or clusters of small, pinpoint-sized red specks under the skin.

• Easy bruising.

• Excessive bleeding from cuts.

• In females, excessive or prolonged menstrual bleeding or vaginal bleeding after menopause.

• Blood in the urine or stools.

For Severe Bleeding

Stay calm. Call 9-1-1 or take the person to nearest hospital emergency department. In the meantime,

• Monitor for signs of shock.

• Control bleeding.

• Apply direct pressure to the wound using a clean cloth or sterile bandage.

• Put pressure on the wound for at least 10 minutes. {Note: If the cut is large and the edges of it gape open, pinch the edges of the wound while you apply pressure.}

• If bleeding continues before medical help arrives, put extra cloths or bandages on top of existing ones and reapply pressure.

• Elevate the wounded area higher than heart level while applying pressure. Do this if no bone is broken.

• Do not remove an object that is stuck in a wound. Pack it in place with padding. Put tape around the padding so it doesn’t move.

• If bleeding still continues after 15 to 20 minutes of direct pressure, apply pressure to a “pressure point.” Use the pressure point closest to the bleeding site that is between the wound and the heart. (See Pressure Points.)

• Keep applying pressure to the bleeding site. Use flat fingers to put pressure on the pressure point until the bleeding stops. Don’t apply a tourniquet except to save a life.

• Keep looking for signs of shock.

For Amputation

• Control bleeding. See First Aid for Severe Bleeding.

• Wrap the severed part in a clean, dry (not wet) cloth or sterile gauze. Place the wrapped part in a plastic bag or other waterproof container. Put these on a bed of ice. Do not submerge the severed part in cold water or ice.

For Bleeding from the Scalp

• Use a ring pad to apply pressure around the edges of the wound, not on the wound. Make a ring pad (shaped like a doughnut) with a bandage of narrow, long strips of cloth. Start with one end of the narrow bandage and wrap it around all four fingers on one hand until you form a loop. Leave a long strip of the bandage material to weave in and around the loop so it doesn’t unravel.

{See also Self-Care / First Aid in Skin Injuries / Wounds.}

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