Stop the Bleeding Baby, Stop the Bleeding!

Those were the words my Daughter said when I told my kids I was writing a article on controlling bleeding. I have a hard time writing this article. It is very hard to be humorous and educational at the same time at the best of times; it is even more so when you are writing about something so unfunny as bleeding. You also have to take into account that bleeding varies so much and is often dependent on where you are bleeding from and what caused it. I mean you don’t want to put a tourniquet on someone’s neck if they have a Head wound (just so you know it will stop the bleeding…. forever!). So, if you want to learn a little bit about how to control bleeding and what constitutes dangerous bleeding, I want to encourage you to stick with it and hopefully you will learn something…

There are Four ways to control bleeding, and they are:

1. Direct Pressure. The simplest and easiest way to stop bleeding. With most small wounds, this is all you will need to do. In it’s simplest form, you just grab onto the wound and hold on with a firm grip. If the bleeding isn’t bad, you can take a minute or two to put a sterile dressing on the wound first. Most small wounds will stop bleeding in 5 to 10 minutes, and you can put a dressing and a bandage on. No need to remove the dressing for awhile.

First of all 2. Elevation. Raise the wound above the level of the heart and let gravity help you keep full pressure away from the wound. This tends to work best with wounds on the extremities (arms and legs), and it is usually best if you have the patient sitting or lying down.

3. Pressure points. Where the arteries leave the main trunk of the body there are places where you can apply pressure and decrease the blood flow to the extremity. For the legs, in the crease of the leg where you can feel a pulse is where you apply pressure. For the arms, the armpit works. In fact, roll up a towel and put it in the armpit; keep the arm against the body, and it will do wonders. And, for those who have figured out that the head is a extremity, you do have pressure points for the head. However, you don’t want to put pressure on these. The least you will do is cause unconsciousness and the worst you can do is kill the patient. So pressure points for head wounds are out!

4. Constricting Bands. These used to be called Tourniquets, and the idea is to completely stop the blood flowing to the limb. This is to be used only in case of a last resort. A simple and effective way to do it is to put an elastic bandage around the limb. Some authorities say you should release the pressure every 10 to 15 minutes for about half a minute. In my experience, you may want to wait for 30 to 40 minutes, then leave the pressure off for about a minute. And if your transport time is less than a hour, you may not want to release the pressure at all, at least if you think there is some circulation to the limb. Your mileage may vary as they say and different “experts” will have different ideas. Do some research on the internet and make your own decisions.

Now, some of the things I want you to know so that you are more effective in controlling bleeding. First of all, if you put a dressing on a wound, don’t remove it; it can pull the clots that are forming loose. Just put more dressings on top of the first one. However, if you put a bare hand on a wound, wait a few minutes to put a dressing on if you don’t have one right away — 5 minutes should be good. (Also, let me note that in today’s world you may want to be careful about touching someone else’s blood — you known what I am talking about, HIV, Hepatitis and other blood borne diseases.). If you want to keep some pressure on wounds and don’t want to tie up your hands, you can use sand bags, bags of sugar, anything that is heavy for its sized and can conform to the area.

Also, what is serious bleeding? Anytime you have blood spurting under pressure (anyone remember the Julia Childs skit on Saturday night?… ). Well, that is arterial bleeding, and it is very serious. Then, there are wounds to the trunk of the body. Anytime you can see as my kids say the “guts” or any other internal structures, you have a serious wound and usually serious bleeding and serious danger of infection.  Serious Bleeding needs rapid transport to the hospital, which should go without saying, but I will anyway!

Lastly, how much blood you lose is important — anytime a person loses a liter or more of blood it is very, very serious. The Adult has about 6 liters of blood in it. So, a liter is serious, 2 liters can cause shock and kill, and, if you lose 3 or more liters, the outlook is bad.

So, stop the bleeding, and, if it is serious, get the person to proper medical care as soon as you can. In the end, just remember (quoting a very dark joke we have in EMS ) . . . All bleeding stops eventually!

Your Obedient Servant,

Gary Smith, Jr.