                                       SECTION IV
                                        BLEEDING

Major bleeding may be a life-threatening condition requiring
immediate attention. Bleeding may be external or internal. Bleeding
may be from an ARTERY, a major blood vessel which carries
oxygen-rich blood from the heart throughout the body. It may be
from a VEIN, which carries blood back to the heart to be oxygenated
or bleeding may be from a CAPILLARY, the smallest of our body's
blood vessels.

ARTERIAL bleeding is characterized by spurts with each beat of the
heart, is bright red in color (although blood darkens when it meets
the air) and is usually severe and hard to control. ARTERIAL
bleeding requires immediate attention!

VENUS bleeding is characterized by a steady flow and the blood is
dark, almost maroon in shade. Venus bleeding is easier to control
than Arterial bleeding.

CAPILLARY bleeding is usually slow, oozing in nature and this type
of bleeding usually has a higher risk of infection than other types
of bleeding.




                                 

FIRST AID FOR BLEEDING IS INTENDED TO:

                     l. STOP THE BLEEDING

                     2. PREVENT INFECTION

                     3. PREVENT SHOCK


HOW TO CONTROL BLEEDING:

       1. APPLY DIRECT PRESSURE ON THE WOUND. USE A DRESSING, IF  
          AVAILABLE. IF A DRESSING IS NOT AVAILABLE, USE A RAG,   
          TOWEL, PIECE OF CLOTHING OR YOUR HAND ALONE. 

          ONCE PRESSURE IS APPLIED, KEEP IT IN PLACE. IF DRESSINGS 
          BECOME SOAKED WITH BLOOD, APPLY NEW DRESSINGS OVER THE  
          OLD DRESSINGS. THE LESS A BLEEDING WOUND IS DISTURBED,
          THE EASIER IT WILL BE TO STOP THE BLEEDING!

       2. IF BLEEDING CONTINUES, AND YOU DO NOT SUSPECT A FRACTURE, 
          ELEVATE THE WOUND ABOVE THE LEVEL OF THE HEART AND      
          CONTINUE TO APPLY DIRECT PRESSURE.

       3. IF THE BLEEDING STILL CANNOT BE CONTROLLED, THE NEXT STEP 
          IS TO APPLY PRESSURE AT A PRESSURE POINT. FOR WOUNDS OF 
          THE ARMS OR HANDS, PRESSURE POINTS ARE LOCATED 
          ON THE INSIDE OF THE WRIST ( RADIAL ARTERY-WHERE A PULSE 
          IS CHECKED) OR ON THE INSIDE OF THE UPPER ARM (BRACHIAL 
          ARTERY). FOR WOUNDS OF THE LEGS, THE PRESSURE POINT IS AT 
          THE CREASE IN THE GROIN (FEMORAL ARTERY). STEPS 1 AND 2 
          SHOULD BE CONTINUED WITH USE OF THE PRESSURE POINTS.

       4. THE FINAL STEP TO CONTROL BLEEDING IS TO APPLY A        
          PRESSURE BANDAGE OVER THE WOUND. NOTE THE 
          DISTINCTION BETWEEN A DRESSING AND A BANDAGE. A DRESSING 
          MAY BE A GAUZE SQUARE APPLIED  DIRECTLY TO A WOUND, WHILE
          A BANDAGE, SUCH AS ROLL GAUZE, IS USED TO HOLD A DRESSING 
          IN PLACE. PRESSURE SHOULD BE USED IN APPLYING THE       
          BANDAGE. AFTER THE BANDAGE IS IN PLACE, IT 
          IS IMPORTANT TO CHECK THE PULSE TO MAKE SURE CIRCULATION 
          IS NOT INTERRUPTED.  

          A SLOW PULSE RATE, OR BLUISH FINGERTIPS OR TOES, SIGNAL 
          A BANDAGE MAY BE IMPEDING CIRCULATION.     

SIGNS AND SYMPTOMS OF INTERNAL BLEEDING ARE:

       * BRUISED,SWOLLEN, TENDER OR RIGID ABDOMEN

       * BRUISES ON CHEST OR SIGNS OF FRACTURED RIBS

       * BLOOD IN VOMIT

       * WOUNDS THAT HAVE PENETRATED THE CHEST OR ABDOMEN

       * BLEEDING FROM THE RECTUM OR VAGINA



                                    

       * FRACTURES OF THE PELVIS

       * ABNORMAL PULSE AND DIFFICULTY BREATHING

       * COOL, MOIST SKIN

FIRST AID IN THE FIELD FOR INTERNAL BLEEDING IS LIMITED. IF THE
INJURY APPEARS TO BE A SIMPLE BRUISE,APPLY COLD PACKS TO SLOW
BLEEDING, RELIEVE PAIN AND REDUCE SWELLING. IF YOU SUSPECT MORE
SEVERE INTERNAL BLEEDING, CAREFULLY MONITOR THE PATIENT AND BE
PREPARED TO ADMINISTER CPR IF REQUIRED (AND YOU ARE TRAINED TO
DO
SO). YOU SHOULD ALSO REASSURE THE VICTIM, CONTROL EXTERNAL
BLEEDING,CARE FOR SHOCK (COVERED IN NEXT SECTION), LOOSEN
TIGHT-FITTING CLOTHING AND PLACE VICTIM ON SIDE SO FLUIDS
CAN DRAIN FROM THE MOUTH. 




