Massive external bleeding
Tereza Prokopová
First Aid practice (aVLPO011c)
First Aid - practice (aVLPO011c)
Learning outcomes
̶ Student knows how to secure his safety during the massive
bleeding management.
̶ Student knows direct pressure as the first step in the massive
bleeding management.
̶ Student knows the pressure bandage indication.
Bleeding
̶ Divided by:
̶ Localization
̶ Internal
̶ External
̶ Type of vessel
̶ Arterial
̶ Venous
̶ Capillary
̶ Intensity
̶ Massive
̶ Minor
̶ Adult blood volume: 4.5 – 6 L
First Aid - practice (aVLPO011c)
First Aid – practice (aVLPO011c)
S-S-S
̶ Safety
̶ Stimulate
̶ Shout
̶ Shake
• The patient is responsive
➢ Continue with communication
➢ Apply direct pressure
➢ Apply tourniquet
• The patient is not responsive
➢ Apply tourniquet
➢ Open the airway
➢ Check for breathing
➢ Call the ambulance
➢ Start CPR if needed
̶ Shout for help
First Aid (aVLPO011c)
Massive bleeding management
Direct pressure
Hemostatic
dressing
+
direct pressure
Tourniquet
First Aid - practice (aVLPO011c)
Direct pressure
First Aid - practice (VLPO011c)
Hemostatic dressing
̶ Apply directly into the wound
̶ Apply direct pressure on the dressing
̶ Fixate
Obr.: https://www.amesa.cz/amesa/CELOX-G-gaza-7-6x-3m-d321.htm
First Aid - practice (VLPO011c)
Turniquet
̶ At least 5 cm width
̶ Apply proximally to the wound
̶ Apply over a thin layer of clothes
̶ Use on thigh and arm
̶ Do not apply over the joints
̶ !CAVE: never apply on neck!
Obr.: https://www.bexamed.cz/p/skrtidlo-pryzove-martinovo
First Aid - practice (VLPO011c)
Pressure bandage
̶ Sterile wound dressing
̶ Pressure layer
̶ Fixation layer
First Aid – practice (aVLPO011c)
Pressure bandage
̶ Use for not massive bleeding
̶ Additional in massive bleeding algorithm
̶ Over hemostatic dressing
̶ Cover still leaking wound distally to turniquet
Take home message
̶ Firstly secure your and the victim´s safety.
̶ Direct pressure is the first step in the massive bleeding algorithm.
̶ Turniquet should not be eased at the scene.
First Aid - practice (aVLPO011c)
Faculty of Medicine, Masaryk University
2022