Title: Bleeding
Course: Level 3 - First Aid > Section: Provision of First Aid service and referral

Depending on the degree of damage of the body part in an injury, there could be massive or heavy bleeding from the vascular system that can cause life in threatening. This massive bleeding can be external (bleeding is an external body part) or internal (bleeding is from the internal body part).

First aid for severe external bleeding (Figures 28-35):

- Use gloves or other barriers to prevent cross infection like, HIV, syphilis which can be transmitted by direct contact with body fluids.
- Application of direct pressure using a thick pad.
- Elevation of the part.
- Pressure on the supplying artery (Pressure point technique) for a short duration of time. Usually, this pressure is applied on the brachial artery (upper arm ) and femoral artery (lower extremity)
- The application of a Tourniquet is dangerous so it should be used only for severe, life-threatening haemorrhages that can't be controlled by other means.

Fig. 28: External blood loss.

Fig. 29: Internal bleeding.

Fig. 30: Finger tip pressure.

Fig. 31: Elevated extremity.

Fig. 32: Direct pressure.

Fig.33. Pressure dressing.

Fig. 34. Pressure point, brachial.

Fig.35. Pressure point, femoral.

Bleeding From the Nose (Epistaxis)

Epitasis or nose bleeding is a common emergency problem. The blood you see may be only a small part of the total blood that may pass down through the throat into the stomach as the patient swallows. Then patient may become nauseated and start vomiting. Possible causes of bleeding from the nose are facial injuries, sinusitis, infections, dried or cracked nasal mucosa, or other abnormalities such as high blood pressure

Most non-traumatic nasal bleeding may occur from sites in the septum, and this type of bleeding can be effectively handled by pinching the nostrils together:

- Have patient sit and lean forward with head tilted forward.
- Apply direct pressure for at least 15 minutes by pinching nostrils together.
- Keep the patient calm and quiet.
- Apply ice over the nose.
- Maintain pressure until bleeding is controlled.
- Provide transport.

Fig. 36. Pinching of the nostril.