Australian Ski Patrol Association

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Australian Ski Patrol Association

• Advanced First Aid
• Lesson 3
• BLEEDING, SHOCK, WOUNDS

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Lesson 3

• Bleeding
• Shock
• Wounds

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BLEEDING

• Basic Anatomy
• External Bleeding
• Uncontrolled bleeding
• Internal Bleeding

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Basic Circulatory Anatomy

• The Pump - The Heart
• Right - Pulmonary, Left - Systemic
• The Pipes - Arteries, Veins, Capillaries
• Muscular lining, valves in veins
• The Fluid - Blood
• Plasma, white cells, red cells, platelets, fibrin

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EXTERNAL BLEEDING

• Remember protection
• Arterial
• Venous
• Capillary

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BLEEDING MANAGEMENT

• R - Rest
• I - Ice
• C - Compression
• E - Elevation

D R A B C
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DRESSINGS

• Remember protection
• Apply a pad and bandage
• Immobilise the injured part
• Elevate if possible
• If insufficient - bandage may be removed and
  re-applied, but not the pad

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Other Measures

• Pressure Points - Brachial and Femoral
• Constrictive bandage
• only in emergency situation
• remove after 10 - 15 mins and check if bleeding
  has stopped
• ensure bandage is visible and time of application
  is noted
• inform medical aid of location and time

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THE BODYS RESPONSE

• Reduction of BP to bleeding area
• provides O2 to vital organs
• Ends of damaged vessel constrict
• Clot creation begins - using platelets and fibrin

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SHOCK

• As effective blood volume falls, blood supply
  (perfusion) to the vital organs is compromised
  and more actions are taken to overcome the
  shortage. In this situation the casualty is
  suffering from shock. This occurs with most major
  injuries or illnesses.

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SHOCK

• Restriction of peripheral circulation
• hence pale, cool, clammy skin
• Increase of heart rate (initially) but less
  volume being circulated
• hence rapid, weak pulse
• Attempts to increase blood O2 levels
• hence rapid, shallow respirations (later)

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PROGRESS OF SHOCK

• Progress
• to LOC

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Shock - Recognition

• rapid weak pulse
• pale, cool, clammy skin
• rapid, shallow breathing
• anxious or restless
• may develop nausea/vomiting
• may complain of thirst, giddiness
• lowered LOC as shock progresses

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SHOCK - Management

• Control external bleeding
• Lie the casualty down and elevate the legs
• Treat other injuries
• Cover patient but do not overheat (consider
  protecting under casualty)
• GIVE NOTHING TO EAT OR DRINK (if remote small
  frequent sips of water permissible)
• Seek Urgent Medical Aid

D R A B C
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INTERNAL BLEEDINGRecognition

• History
• Blood escaping from body by mouth, etc
• Pain
• Tenderness
• Rigidity of abdominal muscles
• PLUS THE SIGNS OF SHOCK

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Internal Bleeding Management

• Lay the casualty down and raise the legs or bend
  the knees
• Loosen clothing
• SMA urgently
• No food or drink
• Reassurance is essential

D R A B C
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WOUNDS

• Abrasion
• Open wounds
• Penetrating wounds
• Crater wounds
• Foreign objects in wounds
• Fish-hooks

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Internal Bleeding Management

• Lay the casualty down and raise the legs or bend
  the knees
• Loosen clothing
• SMA urgently
• No food or drink
• Reassurance is essential

D R A B C
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Special cases of bleeding

• Ear
• Scalp
• Varicose veins
• Amputated parts

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Amputated Parts

• Do not wash or soak the part
• Wrap in gauze or other clean material and place
  in watertight container
• Pack container in a larger container containing
  ice and water
• Part should not be in contact with ice
• Send to the hospital with the casualty

D R A B C
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Practical Exercises

• Bandage various parts of the body
• Practise approach, CPR, lateral position