Doctor's Notes on Bleeding
Bleeding may be caused by any number of injuries such as cuts, lacerations, or puncture wounds from sharp objects. Minor bleeding is very common, easy to treat, and usually has no long-term consequence. Extensive bleeding can be very dangerous. It may cause a drop in blood pressure and decreased organ blood flow, which could lead to shock. For any bleeding that is difficult to control with pressure or requires a tourniquet, call 911 immediately. If a person is bleeding, always check for other injuries such as a significant head injury, fractures, or dislocations.
Symptoms that may result from bleeding include
- clammy skin; fast heart rate,
- low blood pressure,
- unconsciousness, and
- in very severe cases, death within seconds to minutes.
What Is the Treatment for Bleeding?
Bleeding can range from minimal to severe.
Minimal or mild bleeding that can be controlled by the patient or a caretaker can usually be treated at home (for example: small abrasions or cuts, or minor nosebleeds)
For more substantial bleeding, use these guidelines to help with treatment:
- For any bleeding that is difficult to control with pressure or that requires a tourniquet, call 911 as soon as possible
- A trained health care professional may place permanent or temporary sutures (stitches) or dermal glue to control the bleeding
- For severe bleeding:
- Apply immediate direct pressure to the wound
- Continue pressure until the bleeding is controlled
- Elevate the wound above the affected individual's heart
- The person should be lying down with the legs elevated
- Apply a tourniquet only if other means to control life-threatening bleeding do not work
- Tighten the tourniquet enough to stop the bleeding
- Note the time the tourniquet was applied and do not remove unless medical professionals have assessed the patient
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Cuts or LacerationsCuts and lacerations are both terms that apply to a tear in the skin, though a laceration implies a more jagged tear. These terms do not include abrasions where the skin is scraped away, or avulsions where the skin is torn from the flesh. Cuts and lacerations must be disinfected and sutured in more serious cases. Basic first aid may be all that is necessary for more minor wounds. Infection is the biggest medical concern when it comes to cuts or lacerations. Signs of infection include severe pain, draining pus, redness beyond the wound edges, fever and chills, and excessive wound swelling.
Fractures or DislocationsFractures are breaks in bone and are classified according to several different categories. Compound fractures are the most dangerous; the bone is broken into fragments that come through the skin. Treatment includes setting the broken bone and splinting the injury, among other steps. Steps are taken to prevent infection if the skin is broken.
Marine Animal BiteMany animals in the ocean can bite or cause scrapes and puncture wounds, and some are even venomous. The first step in treatment is to identify the animal, the time of injury and nature of the attack. Then, first aid should be applied as appropriate.
Pressure ImmobilizationThe pressure immobilization technique is the application of a pressure device and immobilization of an affected arm or leg following a venomous bite. After a pressure immobilization application has been applied to an injured person, medical care should be sought emergently at a medical care facility.
Puncture WoundA puncture wound is caused by an object piercing the skin such as nails, glass, pins, or other sharp objects. A puncture wound can become infected if not treated properly. A tetanus booster may be necessary for some puncture wounds.
SplintingA suspected broken bone or dislocation should be immobilized, splinted, or both. Splinting helps to prevent further injury and can provide pain relief.
Wound CareWounds are lacerations, cuts, or punctures in the skin. Wounds can be superficial, deep, punctures, or pressure sores. The amount of pain, inflammation, and bleeding depend on the type of wound. Most superficial wounds can be treated at home. Deep wounds, or complicated wounds generally need medical care. Sutures, staples, or surgical glue for a wound depend on the depth of the wound and the time lapse between the injury and when medical care is sought.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.