Blood and Open Wounds

firstaidPeople react to the sight of blood in different ways. Some may wonder if it’s serious, does it need stitches, or is it dangerous to me as the rescuer? Others feel that it is just disgusting. But that’s because they don’t understand blood.

Before we can answer any of the above fears or questions, we must understand the differences of each type of bleeding. There are three types of bleeding: capillary, venous and arterial, and they have their own distinct characteristics.

Capillary bleeding, the least serious, is dark red in color, and the blood usually flows slowly from the wound. Venous bleeding, where a vein has been severed or damaged, is characterized by a dark red, steady flow of blood. Arterial bleeding, the most severe of the three, is bright red in color, and the blood spurts out of the body, indicating that an artery has been severed or damaged.

Now that we know some traits of bleeding, let’s look at how bleeding occurs, and ways to control it.

There are generally four types of open wounds that resulting bleeding: an abrasion, an avulsion, a laceration and a puncture wound. All four have their own distinct characteristics.

An abrasion is generally created by the scraping of the skin against a rough, firm object. It’s usually a minor wound in the form of capillary bleeding, and doesn’t need more advanced medical help. However, if the abrasion covers an extensive area of the body surface, blood loss may be severe. An avulsion is a tearing of the skin, where bleeding flows steadily from the wound. A laceration is a cut of the skin that may be straight of jagged, resulting in venous or arterial bleeding. And a puncture wound, which bleeds the least, is the result of an impaled object.

No matter what type of open wound there is, my first concern for myself as the rescuer is to protect against disease transmission. As I cited in previous columns, if the victim doesn’t live in your house, assume that his/her bodily fluids are infectious. Always use personal-protection items, such as gloves, goggles and a mask to cover your hands, eyes, mouth and nose.

After I have protected myself, I can now begin to help the injured person. My first concern is to control the bleeding and to prevent infection. The number-one step to accomplish both of these results is to use direct pressure over the wound. To apply direct pressure, use a sterile gauze pad, or, if not available, a clean towel or napkin. You may avoid contact with victims’ blood by having them apply the direct pressure themselves, if they are able to.

The next two steps can be interchangeable. We can elevate the wound to slow down the flow of bleeding, and then apply a pressure bandage, or vice versa. It depends if the wound is against the ground or raised. The best product to use as a pressure bandage is an ace bandage, because it’s flexible, pliable and absorbent.

If the blood continues to soak through the first dressing, leave it on and apply another right on top. If the extra dressing doesn’t control the bleeding, then my last step is to apply a pressure point, located in the upper arm at the brachial artery, or upper leg at the femoral artery. Apply enough pressure at these points to slow the flow of bleeding, not stop it.

If the wound is minor, such as an abrasion, calling 911 is not necessary. The first step is to wash the wound with soap and water. After you wash it, apply pressure if needed to slow bleeding, apply an antibiotic cream, and apply a bandage, most often a ban-aid is sufficient. Remember to check and clean the wound several times a day. If it becomes discolored or infected, seek medical attention.

If the wound is bleeding heavily, first call 911. After you have put on your protective devices, perform the four steps of controlling bleeding: direct pressure, pressure bandage, elevation, and, if necessary, a pressure point. Monitor the victim’s breathing and circulation, because heavy blood loss can result in shock, and possibly cardiac arrest.