Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version
Severe Bleeding
DESCRIPTION
This guideline covers arterial bleeding (from an artery) or
major venous bleeding (from a vein). In arterial bleeding,
the blood pumps or spurts from the wound with each
heartbeat. In major venous bleeding, the blood just runs
out of the wound at a steady rate. The arterial bleeding is
bright red compared to the dark red of venous bleeding.
Minor bleeding (from capillaries), however, can also be
bright red.
FIRST AID FOR ARTERIAL BLEEDING
- Prevent shock
Have your child lie down with the feet elevated 10 to
12 inches to prevent symptoms of shock (low blood
pressure). If your child is pale and the hands and feet
are cold, shock is imminent.
- Apply direct pressure
If you know the arterial pressure points, apply strong,
direct pressure to the artery between the wound and the
heart until help arrives. If you do not know the
arterial pressure points, place several sterile
dressings or the first clean cloth at hand (towels,
sheets, shirts, or handkerchiefs) over the wound and
apply direct pressure. The pressure must be forceful
and continuous. You can often apply this pressure with
the palm of your hand. Act quickly because the ongoing
blood loss can cause shock. Continue the pressure until
help arrives.
- Rescue squad (911)
Have someone call a rescue squad immediately while you
tend to the bleeding.
- Arterial tourniquet
A tourniquet is needed only if arterial bleeding cannot
be controlled by direct pressure (for example, in the
case of an amputated or mangled limb). Once applied, it
should be released for 15 minutes of every hour
(according to the American College of Emergency
Physicians, 1985). During this time, direct pressure
must be used to prevent excessive blood loss.
FIRST AID FOR VENOUS BLEEDING
- Prevent shock
Have your child lie down with the feet elevated 10 to
12 inches to prevent symptoms of shock.
- Apply direct pressure
- Place two or three sterile dressings (or a clean
towel or sheet) over the wound.
- Apply direct pressure to the wound for 8 to
10 minutes, using your entire hand. Direct pressure
can always stop venous bleeding if it is applied to
the right spot.
- Bandage the dressings tightly in place (elastic wrap
gives excellent compression) and leave them there
until arrival at the emergency room.
- Seek emergency care
Drive to the nearest emergency room. EXCEPTION: Call
the rescue squad (911) if your child is clearly in
shock.
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