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Arterial Bleeding (optional)

Video 37 of 41
5 minutes
English
English
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Speaker 2: Ah! Speaker 1: Now we're gonna cover arterial bleeding in the workplace. In this setup, what we saw is a person who knew he probably should have used something to help put the wood through. But the problem was it was inconvenient, which is so common, puts it down, uses his hand, but slips, and cuts his radial artery. We know that it's an arterial bleed because it's pulsating and bright red in color. Venous bleeding is more oozing and is darker in color. Now, when we come across this, most people automatically, they grab their bleeding part of their body. They put a hand over it. That's natural. It's normal but they may not even have a bandage. So when we respond, we're gonna make sure that our scene is safe, the machinery is off, our gloves are on, and we're ready to rescue. I like to come with at least a 4X4 or a 5X9 immediately. Sir, I'm gonna go ahead and replace your hand with this 4X4. Ready? Go ahead and change it out. Now we saw that it was obviously pulsating. Go ahead and put pressure on that right there. There you go. He puts direct pressure himself. He can assist as long as he's conscious and not losing responsiveness. I can see that it's already leaking through so I don't take the first one away. Go ahead and cover that now. And I put a second one on there. He puts firm pressure. It, you know, getting it above the heart was something that we used to teach, but again, if they're not comfortable doing that, it's more important to put the direct pressure instead of worrying about elevating it, all right? We're sitting the person down so that if they do get a little light headed, they're in a sitting position. Eventually, maybe a chair and if it gets real bad we'll lower them all the way down to the ground. Now once we have controlled the bleeding, and it's not like arterial bleeding cannot be controlled with direct pressure. It's something that we need to keep an eye on, every time we see it starting to leak through, we put another fresh bandage. Here's a 5X9, go ahead and put direct pressure there. And now we see that it's not leaking through this 5X9 bandage. If we could not control this arterial bleeding, we might move to a proper tourniquet device. This is for delayed emergency response of greater than 10-15 minutes, major arterial bleeding that cannot be controlled, and life-threatening bleeding that if we don't stop the bleeding, the person's gonna lose their life. That's the proper use of tourniquets and when to use them. In most cases, direct pressure and pressure bandages are going to work just fine. You can also make a make-shift tourniquet if you don't have a proper tourniquet device. In this case we're controlling it with direct pressure. Now it's not leaking through, the person's consciousness is fine. He's responding to me well. He's still helping. And now I'm gonna go ahead and wrap this, sir. I wrap it from the distal end which means all the way to the end. I start at the end of the extremity. I'm using an Ace wrap to hold pressure with this so it could actually work like a tourniquet by accident. Not my point, and I'm gonna show you how to check to make sure we're not causing a tourniquet in just a minute. But I'm able to wrap that pad in place. Look it, if I need a little extra pressure once I get over the wound itself, I do a little twist. Then I come back around, another little twist straight over it, and now I can finish out that bandage. And now I just tuck the end into the actual Ace wrap to hold it there. Now I wanna check nail beds. I squeeze the nail bed and look at this. You can see that when I pinch the nail bed and it blanches white and then I let it go, it only takes like one, maybe two seconds to refill with blood. That's what tells me this is not so tight that it's cutting off circulation, but it's tight enough that it's holding direct pressure and it's keeping the arterial bleeding from still losing a certain amount of blood. So this is a great bandage. Now we can decide whether we're going to transport this patient to the emergency room by private vehicle or whether we need to activate EMS. At the point that this person started to lose consciousness, or show signs of shock like cool, pale, sweaty skin, decreased level of consciousness or I could not get this bleeding to stop and they were losing a large amount, that's when I activate EMS by calling 911 and get help on the way and treat the patient for shock or any other life-threatening conditions.

Arterial bleeding is the most severe and urgent type of bleeding. It can occur due to a penetrating injury, blunt trauma, or from damage to organs or blood vessels.

As arterial bleeding is pumped directly from the heart to the rest of the body, this type of bleeding has a few distinctions:

  • The blood is bright red in color due to its high oxygen concentration
  • The blood tends to spurt due to the heart pumping it to the wound
  • The pressure is higher than other types of bleeding, so it will not clot or stop as easily

Warning: The pressure will only subside as blood volume decreases. This is a life-threatening situation and tissue will quickly begin to die due to lack of oxygen.

How to Provide Care

A person who is the victim of arterial bleeding will instinctively grab and cover the wound to reduce the amount of blood flow, if that person is conscious and able to. To best assist in treating the wound, you should:

  • Make sure the scene is safe.
  • Put on latex-free gloves if available. If you don't have gloves, wash your hands or use an alcohol-based hand sanitizer.
  • Find the source of the bleeding; you may have to remove clothing over the wound.
  • Make the switch from the victim's hand to a dressing pad or a clean cloth.
  • Apply pressure.

The wound will be pulsating, and it will likely take several dressing pads to control the bleeding. If the victim is conscious and can assist, this will help.

Ask the victim to maintain pressure over the dressing pad or cloth. The blood will probably soak through, so apply a second pad on top of the first, rather than removing it. Continue to apply firm, direct pressure over the wound.

If the victim is becoming light-headed from the blood loss, have them sit or lie down. The goal is to control the bleeding to the point where the wound is not leaking through each new dressing pad. If blood continues to leak through, continue to apply another pad or piece of cloth until it stops.

Consider using a tourniquet if – you cannot control the bleeding with dressing pads and the blood loss is extreme. This is a life-threatening situation and last resort.

In most cases, even arterial bleeding can be controlled using pressure plus dressing and bandages.

Once you have the bleeding controlled, it's time to wrap the wound. Using an ACE roller bandage like you find in most first aid kits, start from the end of the extremity where the injury is located. If the wound is on the wrist, began wrapping from the hand.

Pro Tip #1: it's important to extend the bandage several inches beyond the wound on both sides. This will help keep the wound clean and limit the chances of infection.

When wrapping the wound, if extra pressure is required, twist the bandage once over the wound and continue wrapping. Repeat as often as necessary. To finish, tuck the end of the bandage into the wrap to hold it in place.

Pro Tip #2: While pressure is important to control the bleeding, you don't want to cut off circulation to the extremity on which the wound occurred. Pinch a nail and the fleshy underside between two of your fingers (if the wound occurred on an arm or a leg). The nail should turn pale and then return to a pink color a couple seconds later. If it doesn't, the bandage is too tight.

It's important to try and not cover fingers and toes with the bandage if possible, so that this test can be performed.

At this point, you'll want to decide whether to call 911 for EMS services or transport the victim to the emergency room by private vehicle.

Call 911 if:

  • The victim has lost consciousness or is showing signs of losing consciousness
  • The victim is exhibiting signs of shock – pale, cold, sweaty skin
  • You cannot stop the bleeding

A Word About Dressings and Bandages

Dressings are sterile pads used to absorb blood and other fluids, help promote clotting, and prevent infection. Gauze pads are most common.

Most dressing pads are porous, which allows air to circulate to the wound and promote healing. Common sizes range from 2-4-inch squares.

Universal or trauma dressings are larger in size and used for larger wounds. Occlusive dressings are not porous, which means no air or fluids can pass through, and typically used for abdominal wounds.

Bandages are strips of material used to hold the dressing in place, maintain pressure over the wound, control bleeding, and protect from dirt and infection.

The most common type of bandage is the roller bandage that is usually made of gauze and comes in assorted widths and lengths. These are the type of bandages you find in most first aid kits. However, there are other types of bandages including:

  • Pressure bandage – for more pressure and a snugger fit
  • Bandage compress – thick gauze dressing attached to a gauze bandage
  • Elastic bandage – type of roller bandage typically used for muscles, bones, and joints
  • Triangular bandage – large bandage that can folded and used as a sling

As arterial bleeding is the most severe type of bleeding, it's important to properly assess the situation quickly as a rapid response is vital for a positive outcome. If you feel like the situation is too serious to handle yourself, it's important that you or someone else at the scene call 911 immediately.