Blood is normally contained within the circulatory
system: the heart, arteries, capillaries and veins.
When these are torn or damaged, bleeding occurs. This
can be on the outside of the body through a visible
wound or on the inside of the body (internal bleeding).Blood
carries oxygen from the lungs to the heart along the
arteries to the tissues and through the tissues in
the capillaries where the oxygen is made available
for use. Veins carry the deoxygenated blood back to
Bleeding is classified according to the blood vessel
that has been damaged. This may be identified by observing
the colour and flow of the blood.
Bright red blood that rhythmically spurts from the
body in time with the heart beating. This is very
serious bleeding and can rapidly lead to collapse
Dark red blood that may ooze from a wound. If a large
vein is damaged the oozing is copious and can rapidly
lead to collapse and death.
This is the trickling of blood seen with minor cuts
and wounds. It is not serious.
This is bleeding that is extremely profuse and may
be arterial (bright red blood) or venous (dark red
blood). You will notice large amounts of blood on
and around the casualty.
If the casualty is unconscious,
Put direct pressure with your hands on to the wound.
If it is possible, do this using a sterile or clean
pad- but do not waste time looking for first aid materials.:
If there is something sticking out of the wound, press
down firmly on either side of the protrusion without
dislodging it and bandage around.
Lay the casualty down.
Raise the injured part above the level of the casualty's
As soon as first aid kit is available, apply a sterile
Keep the limb elevated, using an elevation sling for
forearm and hand wounds.
Call for an ambulance.
Treat the casualty for shock
Check the dressing frequently to ensure that the bleeding
Serious bleeding that will not stop
Do not remove the original dressing.
Apply further sterile dressings over the original
Continue to apply direct pressure and maintain the
watery blood loss
of cerebro-spinal fluid
bright red bloodThat is coughed up
blood that isVomited up looks like Coffee grounds
in the lungs
in the upper gut/ stomach
tongue or lip
as a black, sticky stool with a strong offensive
be piles or a bleed from within the lower bowel
Bleeding from the upper
part of the gut
bleed when Period is not expected
injury to the womb or vagina
within the urinary system.Possible kidney injury/infection
if any of these symptoms occur, medical advice needs
to be sought. If the casualty has signs of an internal
bleed or shock, an ambulance should be called for
Where the bleeding is not profuse and life is not
endangered, the same principles still apply.
Apply direct pressure (the casualty may be able to
assist you in this respect).
Elevate the limb.
Lay the casualty down.
Apply a sterile dressing and an elevation sling if
dealing with forearm or hand wound.
Call for an ambulance if needed.
In some less serious instances you may decide that
an ambulance is not required. If you decide to transport
the casualty to hospital by car, It is sensible for
him/her to travel in the back of the vehicle in these
circumstances, preferably with a third person to give
support and assistance. Remember to take a bucket
(or similar) with you in case the casualty feels sick.
Do not transport a casualty in a private vehicle merely
because you feel that it will be quicker than waiting
for an ambulance.
Bleeding from certain parts of the body can cause
problems due to their shape and position. The principles
of direct pressure still apply but with variation
when it comes to applying a sterile dressing.
to the scalp and face
These tend to bleed profusely, but rarely endanger
the casualty's life. However, superficial scalp and
facial wounds can cause distress as the blood gets
into the casualty's eyes, nose, and mouth. If the
casualty is unconscious, you must ensure that the
airway is not obstructed by blood - putting the casualty
into the recovery position alleviates this problem.
If the bleeding is copious, apply a sterile dressing
as best as you can, being careful not to obstruct
the casualty's vision unless absolutely necessary,
and then provide plenty of explanation and reassurance.
If the bleeding is not profuse, use a dressing held
in place by a light bandage. Always ensure that the
casualty can breathe and the bandage is not too tight.
be aware when treating a casualty for scalp and facial
wounds that there may be an underlying fracture .
in the palm
This area will bleed profusely and other structures
(tendons and nerves) may be damaged. The basic principles
of direct pressure and elevation apply, then:
Using a sterile dressing, place the pad on the injured
palm and ask the casualty to grip on to this.
Bandage around the wrist once and then come up and
over the fingers so as to apply firm pressure on the
wound. Repeat this until the fingers are fully enclosed.
all the fingers in this way and secure the bandage
by trying it over the fingers.
Support the injured hand in an elevation sling.
Internal bleeding may be completely hidden, in which
case, the casualty will appear to be shocked without
any obvious cause. Such bleeding can occur as a result
of an accident or spontaneously and without any warning.
Cold clammy and pale skin.
Rapid, weakening pulse.
Discomfort or pain.
'Air hunger' (the casualty yawns frequently).
Restlessness and irritability.
Drowsiness,even lapsing into unconsciousness.
Lay the casualty down, and provided there are no lower
rib fractures, raise the legs.
Protect the casualty from the cold. Try to place a
blanket (or similar) underneath as well as on top.
Loosen tight clothing at the neck, chest and waist.
Call for an ambulance.
If the casualty becomes unconscious, perform Resuscitation
in the mouth
Mouth injuries can be serious. While not life-threatening,
they can cause considerable discomfort and have long-lasting
effects. Very often the injuries sustained are caused
by the casualty's teeth.
the casualty to sit down and to lean forward to allow
the blood to drain.
Place a piece of gauze over the wound and ask the
casualty to squeeze it from the outside and inside
with a pincer movement of his/her finger and thumb.
This should be done for 5-10 minutes.
If the bleeding persists, repeat.
the casualty not to swallow any blood as this is likely
to cause sickness.
the wound is minor and does not require medical attention,
advise the casualty to avoid hard, chewy foods and
hot drinks for 12 hours.
Seek medical aid if the wound is large or if bleeding
has not stopped after 20-30 minutes.
from the ear
If a casualty has bleeding from the ear, medical advice
will be need.
If the bleeding is part of a thin, watery loss then
you should suspect a head injury .
Do not plug the ear.
Sit the casualty with the head inclined to the injured
Cover the ear with a lightly secured sterile dressing
Arrange for the casualty to go to the hospital.
from the nose
This is very common following,or during, a cold or
as a result of a blow to the nose. If the bleeding
is part of a thin, watery loss you should suspect
a head injury .
not plug the nose.
Sit the casualty down with the head tipped well forward.
Ask the casualty to pinch the soft part of the nose
(just below the upper bony part) and to breathe through
Pressure should be applied for at least 10 minutes.
If bleeding continues, reapply pressure.
If available, an ice pad can be applied to the outside
of the nose in addition to the above.
Seek medical aid if bleeding continues for 20-30 minutes.
2. When bleeding stops, advise the casualty not to
blow the nose for 4-6 hours.
Bleeding from the vagina
A woman suffering unusual or heavy bleeding from her
vagina will feel embarrassed and may not seek first
aid for some considerable time. Bleeding, when not
associated with a normal period, may be due to miscarriage
or other gynaecological problems.
At all times respect the woman's feelings and arrange,
if possible, for privacy.
Provide a sanitary pad or a folded hand towel (or
the woman comfortable, sit her up with her knees propped
up on a couple of blankets ( or similar).
If the bleeding is severe,call for an ambulance.
If the woman has been sexually assaulted, you must
be most careful to preserve any evidence .
possible, a female should render first aid to a woman
with vaginal bleeding. If this is not possible, the
male first aider should try to arrange for a female
There will be bleeding but due to the nature of gunshot
wounds, underlying fractures and internal injuries
must always be expected.
Depending on the type of weapon involved, the wounds
can vary considerably. High-velocity weapons may cause
catastrophic internal damage while leaving only a
small entrance wound.
Low-velocity weapons cause less severe internal in
injuries. Air guns may inflict nasty injuries, particularly
if the eye is involved, but otherwise generally cause
only minor flesh wounds.
Approach the casualty only if
you are sure that it is safe to do so.
If the casualty is unconscious check whether to give
Resuscitation and act accordingly.
Stop any life-threatening bleeding by applying direct
pressure on the wound .
If an underlying fracture is suspected, immobilise
the part .
Protect the casualty from the cold.
Do not probe the wounds for the bullet.
Remember to check for exit wounds.
They can be more serious than the entry wound.
Call for an ambulance and police.
Blisters are thin 'bubbles' that form on the skin.
They occur when the skin is damaged by friction, such
as when wearing new shoes or as a consequence of a
Under the 'bubble' there is fluid called serum. During
the healing process a new skin layer forms. The serum
is absorbed before the dead skin peels off.
Do not burst the blister.Cover
the blister with a plaster or small dressing (p 44).
Ensure that the pad extends well beyond the edges
of the blister.
THE BLISTER HAS BURST
·Clean the area.
·Do not attempt to peel or cut away the loose skin.
-Cover the area with plaster or small dressing.