First aid for cuts, scrapes, or puncture wounds differs depending on the location and severity of the wound.
Bleeding can be divided into three main categories; capillary, venous, and arterial.
Capillaries are the smallest of the body’s blood vessels and are found just underneath the skin. Capillary bleeding is caused by minor cuts and scrapes and is characterized by a slow, steady ‘ooze’.
It is the most common type of bleeding and the easiest to treat. Apply hard, direct pressure to the injury with a bandage, gauze pad or clean cloth and hold for at least 10 minutes without removing. Elevate the injured area above the heart if possible.
If the bandage becomes blood soaked leave it in place and apply another one on top.
The main concern with this type of injury is infection so when the bleeding stops apply a topical antibiotic such as Polysporin and cover with an adhesive Band-Aid or other type of bandage. For straight cuts a ‘butterfly closure’ can also be used to speed healing and reduce scarring.
Venous bleeding occurs when the veins, the blood vessels that return blood to the heart, are damaged. It is characterized by a rapid, steady flow of dark (almost maroon) blood.
First aid for this type of bleeding is the same as for capillary bleeding however the risk of hypovolemia (low blood volume) and hypotension (low blood pressure) is greater so it is important to act quickly to stop the flow of blood.
A patient with this type of injury should see a physician as soon as possible.
Arterial bleeding is the most serious type. Arteries are the blood vessels that carry oxygenated blood from the heart to the rest of the body. Injures resulting in arterial bleeding should be considered a medical emergency.
When an artery is cut blood will ‘spurt’ from the wound with each beat of the heart and it will be bright red in color (although blood darkens when it meets the air). As always, monitor the ABCD’S of the patients ‘lifeline’. Assess the scene for hazards, alert EMS, and ensure the patient has an open airway.
If the patient is not breathing and/or has no circulation perform rescue breathing and CPR as necessary.
Once you know the patient is breathing and has circulation immediately apply hard, direct pressure to the injury with a bandage or clean cloth and hold for ten minutes without removing. Elevate the injured area above the heart if possible.
If the bandage becomes blood soaked leave it in place and apply another one on top. After 10 minutes, check to see if the bleeding has stopped. If the bleeding continues and the injury is on an extremity (arm or leg) you can use ‘pressure points’ to help stem the flow of blood.
Pressure points are areas where arteries pass close to a bone. Apply pressure to the brachial artery on the upper arm (between the bicep and tricep) for an arm injury, and the femoral artery on the upper leg (near the groin area) for a leg injury. Do not compress the carotid artery in the neck to stop bleeding from a head injury.
For areas of the body other than the extremities, maintain direct pressure and monitor the patient’s lifeline until EMS arrives or the patient is transported to medical help.
When treating an injury that exposes you to blood or other body fluids it is important to remember to use barriers such as gloves and a face shield to protect you from infectious diseases.
This weekly column is only an introduction to emergency care skills and is designed to increase interest in First-Aid/CPR training. For information on courses please contact the Red Cross, a medical professional, or a local dive shop.