external bleeding first-aid
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Traumatic Injuries
This section of the course covers the most common types of injuries you’re likely to encounter. They include:
  • ● External bleeding
  • ● Wounds
  • ● Internal bleeding
  • ● Head, neck and spinal injuries
  • ● Broken bones and sprains
  • ● Burns and electrical injuries
In some cases, these injuries may not seem urgent, but it’s important to remember that they can become serious if they’re left untreated.

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​external bleeding

Bleeding can be internal or external. If left uncontrolled, it can be a serious threat to a person’s life. It’s important to know what you’re looking at when you’re trying to help someone who is bleeding.
Minor Bleeding is usually the result of small scrapes and cuts. In most cases, it can be stopped by applying pressure. Be sure to stay calm. A lot of the time, bleeding will look worse than it actually is.
Severe Bleeding occurs when a large blood vessel is torn or cut, resulting in rapid blood loss.
Dressing vs Bandaging
Many people confuse the terms dressing and bandage. They are actually two different things.
  • ● A dressing is a material, such as a clean cloth or gauze, that is used directly on a wound to stop bleeding.
  • ● A bandage is a material used to protect or cover up an injured body part. It may also help pressure a wound.
You may use dressings and bandages together. A bandage can be placed over a gauze dressing to hold it in place on top of the wound.

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​when to call 911 for bleeding

You should call, or ask someone to call 9-1-1 if:
  • ● The person is bleeding excessively
  • ● You cannot stop the bleeding
  • ● They show signs of shock
  • ● You suspect they may have a head, neck or spinal injury
  • ● You aren’t sure what to do

tourniquets, pressure & bandaging

Controlling Bleeding by Direct Pressure and Bandaging
​Follow these steps to help someone who is bleeding:
  • ● Make sure the scene is safe
  • ● Get the first aid kit, or have someone else get it if they are available
  • ● Put on personal protective equipment (PPE)
  • ● If they can, ask the injured person to apply pressure to the wound, while you put on your PPE. Apply dressings from your first aid kit. Put pressure on the dressings over the bleeding area. Use the flat part of your fingers, or the palm of your hand
  • ● If the bleeding does not stop, add a second dressing and press harder. Do not remove a dressing once in place. You may cause the wound to bleed more. Instead, keep pressure on the wound until it stops
  • ● Once the bleeding has stopped, or if you can’t keep pressure on the wound, firmly wrap a bandage over the dressings to hold them in place
  • ● If the cut is minor, wash the area with soap and water before applying a dressing to it
Using a Tourniquet
When an arm or leg won’t stop bleeding, you can use a tourniquet. Make sure to call 9-1-1 and get an AED if possible, uncontrolled bleeding can lead to more complications.
Your first aid kit should contain a pre-made tourniquet. It should have two main components: One is a strap that is wrapped around the injured person’s arm or leg. The other is a straight, stick-like object called a windlass, which is used to tighten it. If used correctly, a tourniquet should stem the flow of blood. It is also likely to cause pain as the bleeding stops.
Once the tourniquet is in place, note the time and leave it alone.

​applying pre-made tourniquet

Follow these 7 steps when using a pre-made tourniquet on an injured person.
  • 1: Make sure the scene is safe
  • 2: Call 9-1-1 and get your first aid kit, and an AED if available
  • 3: Put on your PPE
  • 4: Place the tourniquet approximately 2 inches above the injury
  • 5: Tighten it until the bleeding stops
  • 6: Note what time the tourniquet was placed
  • 7: Once it’s in-place, and the bleeding has stopped, leave it alone until someone with more advanced training arrives and takes over

making & applying tourniquet​

If you don’t have a pre-made tourniquet, you can make one. Follow steps 1-3 as normal.
  • 1: Make sure the scene is safe
  • 2: Call 9-1-1 and get your first aid kit, and an AED
  • 3: Put on your PPE
After doing all of this, it’s time to make the tourniquet.
  • 4: Fold a cloth or bandage so that it’s long and at least 1 inch wide
  • 5: Wrap the bandage about 2 inches above the injury
  • 6: Tie the ends of the bandage to a stick-like item. It can be a small hand tool, a stick, or something similar. This will work as a windlass.
  • 7: Turn it until the bleeding stops
  • 8: Secure the makeshift windlass so that the tourniquet stays tight
  • 9: Note the time that it was placed
  • 10: Leave it alone until someone with more advanced training arrives and takes over

severe trauma, amputation, internal bleeding

Penetrating and Puncturing InjuriesPenetrating and puncturing injuries require special care. When a sharp object, such as a knife or a nail, has penetrated the body or punctured the skin, you don’t treat it as if it’s a normal bleeding injury.
When trying to help someone with a penetrating or puncturing injury, you should take the precautions you normally would.
  • ● Make sure the scene is safe
  • ● Call 9-1-1
  • ● Put on your PPE
  • ● When providing aid, try to stop any visible bleeding
If the object is still stuck inside their body, do NOT remove it. Leave that to a professional healthcare provider. You doing so may cause more bleeding and damage.

amputation

Traumatic amputation is when any part of an arm or leg is cut or torn off. Certain body parts, such as toes and fingers, may be reattached in some cases. It is important to know the steps you must take to stop bleeding and protect the amputated part.
  • ● Make sure that the scene is safe
  • ● Call, or have someone else call 9-1-1
  • ● Put on PPE
  • ● Try to stop the bleeding of the injured area with very firm pressure. This may take a long time
If you have found the amputated part:
  • ● Rinse it with clean water
  • ● Cover it with a clean dressing
  • ● Place it in a watertight plastic bag
  • ● Place the plastic bag in another container with ice, or water and ice
  • ● Label the container with the person’s name, and the current date/time
  • ● Send the part to the hospital with the victim
Important: The amputated body part should not directly touch ice. Extreme cold can damage it.

​internal bleeding

Internal bleeding, or bleeding inside the body, isn’t always obvious. You might be able to see a bruise under the skin, or you might not see any signs at all. You also won’t be able to determine just how much bleeding has occurred.
You should suspect internal bleeding if a person:
  • ● Has been injured in a car crash, hit by a car, or has fallen from a great height
  • ● Has sustained an injury to the chest or abdomen, including bruises
  • ● Has sustained a sports-related injury, such as being hit with a ball or colliding with another person
  • ● Has abdominal pain or chest pain after an injury
  • ● Is short of breath after an injury
  • ● Is vomiting or coughing up blood after an injury
  • ● Shows signs of shock, but not external bleeding
  • ● Has a knife or gunshot wound
If you suspect internal bleeding:
  • ● Make sure the scene is safe
  • ● Call 9-1-1
  • ● Get the first aid kit and AED
  • ● Put on PPE
  • ● Have the person lie down, and ask them to keep still
  • ● Check for signs of shock
  • ● Give CPR if you need to

​shock

A person may go into shock when they lose a large amount of blood, have a heart attack, or a severe infection or allergic reaction. It's important to recognize the Signs of Shock.
Symptoms of a shock include:
  • ● Feeling weak, dizzy or faint
  • ● Feeling nauseated or thirsty
  • ● Pale or grayish skin
  • ● Skin that is clammy or cold to the touch
  • ● Being agitated, restless or confused
Helping a Person in Shock
  • ● Make sure the scene is safe
  • ● Call 9-1-1 and get the first aid kit and AED
  • ● Help the person lie down on their back
  • ● Cover them with a blanket to keep them warm
  • ● Check to see if CPR is needed

​bleeding from nose

To stop a nosebleed, follow these steps:
  • ● Make sure the scene is safe
  • ● Put on your PPE
  • ● Have the person sit and lean forward
  • ● Pinch the soft part of the nose on both sides with a clean dressing
  • ● Place constant pressure on the nostrils. If bleeding doesn’t stop within a few minutes, press harder
Call 9-9-1 if:
  • ● You can’t stop the bleeding after 15 minutes
  • ● The bleeding is very heavy
  • ● The person is having trouble breathing
A person with a nosebleed should always lean forward. If they lean backward, you will see less blood, but only because it’s draining down that person’s throat, which can result in vomiting.

bleeding from mouth

A mouth injury can become serious if blood or broken teeth end up blocking the airway. Like with nosebleeds, the bleeding may be stopped by applying pressure.
When someone is bleeding from their mouth:
  • ● Make sure the scene is safe
  • ● Get the first aid kit
  • ● Put on PPE
  • ● If bleeding is coming from the lip, cheek, or tongue, and you can easily reach it, apply pressure with a gauze or cloth
  • ● If you can’t stop the bleeding yourself, or the person is having trouble breathing, call 9-1-1 if you haven’t already done so

tooth injuries

Teeth that are broken, loose, or knocked out can become choking hazards. When someone suffers a tooth injury, follow these steps:
  • ● Make sure that the scene is safe
  • ● Get the first aid kit
  • ● Put on PPE
  • ● Check their mouths for missing, loose or broken teeth
  • ● If a tooth is chipped, carefully clean it and contact a dentist
  • ● If a tooth has been knocked loose, have them bite down on a piece of gauze to hold it in place, while you call a dentist
  • ● If a tooth has fallen out, there’s a chance that a dentist will be able to reattach it. Hold the tooth by the crown (the top) instead of the root
    • ● Use a gauze and apply pressure to stop bleeding in the empty tooth socket
    • ● Clean the area with water or saline
    • ● Store the tooth in coconut water, whole milk or egg white. If none of these things are available, store it in a container with the person’s saliva
    • ● Take the person to an emergency department or dentist as soon as possible

​eye injuries

Eye injuries are common first aid emergencies that can potentially lead to big problems, especially if left untreated. Common signs of an eye injury include pain, bruising, bleeding, swelling, and difficulty seeing. If a person’s eye has been hit hard, or punctured, call 9-1-1 immediately.
When helping someone who has sustained an eye injury:
  • ● Determine that the scene is safe
  • ● Get the first aid kit
  • ● Put on PPE
  • ● If something small, like dirt or sand has gotten into the person’s eye, help them rinse with running water
  • ● Call 9-1-1 if this doesn’t help, if they are in extreme pain, or if they still can’t see
  • ● Tell the person to keep their eyes shut until advanced help arrives.​

​additional resources
Soft Tissue Injuries
File Size: 90 kb
File Type: pptx
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Keep the Blood Flowing
File Size: 145 kb
File Type: pptx
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Wounds
File Size: 354 kb
File Type: pptx
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