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PREVENTING INJURY: CONTROLLING BLEEDING
External Bleeding
Control of external bleeding is an important part of emergency care. Survival is threatened by the loss of 1 quart of blood or more. There are three major procedures for the control of external bleeding.
1. Direct pressure. The best method is to apply firm pressure by covering the wound with a sterile dressing, bandage, or clean cloth. Wearing disposable latex gloves or an equally protective barrier, apply pressure for 5 to 10 minutes to stop bleeding.
2. Elevation. Elevate the wounded section of the body to slow bleeding. For example, a wounded arm or leg should be raised above the level of the victim\'s heart.
3. Pressure points. Pressure points are sites where an artery that is close to the body\'s surface lies directly over a bone. Pressing the artery against the bone can limit the flow of blood to the injury. This technique should be used only as a last resort when direct pressure and elevation have failed to stop bleeding.
Knowing where to apply pressure to stop bleeding is critical. For serious wounds, seek medical attention immediately.
Internal Bleeding
Although internal bleeding may not be immediately obvious, you should be aware of the following signs and symptoms:
• Symptoms of shock
• Coughing up or vomiting blood
• Bruises or contusions of the skin
• Bruises on chest or fractured ribs
• Black, tarlike stools
• Abdominal discomfort or pain (rigidity or spasms)
In some cases, a person who has suffered an injury (such as a blow to the head, chest, or abdomen) that does not cause external bleeding may experience internal bleeding. If you suspect that someone is suffering from internal bleeding, follow these steps:
1. Have the person lie on a flat surface with knees bent.
2. Treat for shock. Keep the victim warm. Cover the person with a blanket, if possible.
3. Expect vomiting. If vomiting occurs, keep the victim on his or her side for drainage, to prevent inhalation of vomit, and to prevent expulsion of vomit from the stomach.
4. Do not give the victim any medications or fluids.
5. Send someone to call for emergency medical help immediately.
Nosebleeds
To control a nosebleed, follow these steps:
1. Have the victim sit down and lean slightly forward to prevent blood from running into the throat. If you do not suspect a fracture, pinch the person\'s nose firmly closed using the thumb and forefinger. Keep the nose pinched for at least 5 minutes.
2. While the nose is pinched, apply a cold compress to the surrounding area.
3. If pinching does not work, gently pack the nostril with gauze or a clean strip of cloth. Do not use absorbent cotton, which will stick. Be sure that the ends of the gauze or cloth hang out so that it can be easily removed later. Once the nose is packed with gauze, pinch it closed again for another 5 minutes.
4. If the bleeding persists, seek medical attention.
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GENERAL HEALTH
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