by:
© John Fiorentino
Abrasions, Lacerations, Avulsions,
Punctures, Hematomas and Amputations are all common Motor Sports injuries.
These injuries have one thing in Common. They all bleed, sometimes
causing severe blood loss. Severe bleeding can quickly
lead to shock (Hypovolemia) that can result in organ failure and death.
It is critical to control severe
bleeding to prevent the onset of shock. Bleeding can be either Internal or
External, and usually results from damage to blood vessels. There are
three major vessel groups inside our bodies (Arteries, Veins, and Capillary
vessels).
Bleeding may come
from arteries, veins and capillaries. Arteries carry oxygen-rich blood
from the heart throughout the body. Veins carry blood back to the heart
and lungs to be oxygenated. Capillaries are the smallest type of blood
vessel. They serve as conduits for the exchange of Oxygen, Nutrients, Carbon
Dioxide and Waste.. Major bleeding is a life-threatening condition needing
immediate attention.
Arterial Bleeding:
Arteries carry oxygen rich blood away from the heart to muscles and organs.
Arterial bleeding is characterized by spurting blood flow. Blood from an
arterial bleed is typically bright red in color, severe and difficult to
control. This type of bleeding requires immediate attention (Call
911).
Venus Bleeding:
Veins carry oxygen-depleted blood from muscles and organs back to the heart and
lungs. Venous bleeding is characterized by steady flowing blood. You
may notice that the blood is a much darker shade due to the lack of oxygen.
This type of bleeding can be as dangerous as arterial bleeds.
Capillary Bleeding:
Capillary vessels are tiny structures located just below the skin.
Capillary bleeding is characterized by slow, oozing blood (As seen in a scrape
or road rash).
There are three primary
methods for controlling bleeding: 1) Direct Pressure, 2)
Elevation, and 3) Pressure Points.
Important: Blood
may carry dangerous pathogens. It's very important that you take
precautions against direct contact with someone else's blood. Latex
or vinyl gloves should be worn as a barrier to prevent blood born pathogens from
entering your body through breaks in your skin. It is also a good idea to
wear eye protection, a mask and protective clothing.
Direct Pressure:
Is the most common and effective field method to control bleeding. Direct
pressure may be applied with your gloved fingertips or hand for larger wounds.
If available, a sterile dressing should be placed over the wound. If a
sterile dressing is not available, a rag or piece of clothing may be used.
Note:
Do Not remove Blood Soaked Dressings! Instead add more dressings
over the old. Removing a blood soaked dressing will disturb the wound and
will likely cause more bleeding.
Elevation:
If direct pressure does
not stop the bleeding, consider Elevating the injured body part.
Elevate the wound above the heart while continuing to apply direct pressure.
Elevation should only be used if there are no broken bones suspected.
Pressure Points:
Should direct pressure
and elevation fail to stop the bleeding, locate and apply pressure to the
nearest arterial pressure point. Pressure points are found wherever an
artery passes over a bone. For Arm and Hand injuries, apply pressure to
the (Brachial Artery) located in the upper inside arm. The Femoral
Artery is located in the crease of the groin area. Pressure placed
here will stop bleeding in leg wounds. Direct Pressure and
Elevation should be continued while applying pressure to pressure points.
Finally, A pressure bandage should be placed over the dressing and wound. Check for circulation before and after applying bandage. If the fingers or toes become cold, pale or bluish, the bandage may be to tight. Once you have loosened the bandage recheck circulation. You may also attempt to locate a pulse in the extremity below the injured area. (For example, for a forearm injury, place your bandage over the injury site and check for pulse at the inside of the wrist also known as Radial Pulse).
Tourniquets should be avoided
without prior medical direction from a 911 Operator or Emergency Room
Director. Once applied, a tourniquet should not be removed in the
field. Doing so will allow clotting blood to travel back to the
heart and can result in death. Tourniquets
should be used as a last resort when all else has failed and death is imminent.
Once a Tourniquet is set, it is likely that the limb will be lost.
Be sure to log and communicate the exact time when a tourniquet is applied (it's
common practice to write the time on the victim's forehead).
Internal Bleeding:
Field treatment for Internal
Bleeding is limited to calling 911, keeping the victim warm, comfortable and
calm. The patient should be closely monitored and treated for signs of
shock. Signs of internal bleeding may include:
by:
© John Fiorentino