Emergency First Aid for Children

7. Wounds and Bleeding

Types of Wound

ABRASION

PUNCTURE

LACERATION INCISION

DOG BITE HUMAN BITE

GRITTY GUNSHOT

Protect Yourself

Where possible avoid direct contact with blood or other body fluids such as vomit.

External Bleeding

Reduce blood loss by applying direct pressure and elevating the injured part To prevent shock Cover any open wound with a dressing, to

protect it from infection and promote natural healing

Minimise the risk of infection, between the casualty and yourself, pay scrupulous attention to hygiene.

AIMS

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Major External Bleeding

Apply direct pressure over the wound

Raise and support injured limb.

It may help to lay casualty down. Apply a sterile dressing

Dial 999 for an ambulance.

Treat the casualty for shock.

Check the dressing for seepage, and check the circulation beyond the bandage.

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Embedded Object Wounds

Do not remove object.

Apply pressure to surrounding

area.

Place padding around object. Build padding up as high as

embedded object.

Bandage over padding or on either side of it if object still

protrudes.

Nose Bleeds

Aim:• To control blood loss, and maintain an open airway

Treatment• Sit the casualty down with head well forward• Casualty should breath through the mouth and pinch the

nose just below the bridge.• After 10 minutes release the pressure.• If nosebleed persists, reapply pressure for further

periods of 10 minutes• If nosebleed persists beyond 30 minutes, casualty

should go to hospital in the treatment position.

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Bleeding from the Mouth

Aims

• To control bleeding

• Safeguard airway by preventing inhalation of blood

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Bleeding from the Mouth

Possible causes

• Cuts to tongue, lips or lining of the mouth

• Tooth socket bleeding may be the result of loss of tooth

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Bleeding from the Mouth

Treatment

• Lean casualty forward• Place a gauze dressing pad over the wound and

ask casualty to apply pressure• If bleeding has not stopped after 30 minutes, the

casualty should go to hospital

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Knocked Out Tooth

An “Adult” tooth may be replanted. Do not clean it. Put the tooth in milk.

Place a pad over the tooth socket, making sure that it is higher than the adjacent teeth so that the casualty can bite on it.

Ask the casualty to sit down with their hand supporting their jaw. Tell them to bite hard on the pad.

A younger child may need you to hold the pad in place.

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Crush Injuries

• Ensure it is safe to approach the scene.

• Monitor and maintain airway and breathing.

• Treat major bleeding and cover smaller wounds.

• Keep casualty still and reassure them while waiting

for help.

• Treat for shock.. Keep them warm.

IF THE INJURED PERSON IS STILL TRAPPED ?

Crush InjuriesCasualty Still Trapped

• Additional risks to casualty if still trapped, releasing the body may bring on severe shock.

• Even greater concern is “crush syndrome”

IF THE CASUALTY HAS BEEN TRAPPED FOR LESS THAN 15 MINUTES

Crush syndrome takes some time to develop. If you can do so, safely remove the object. Treat as for crush injuries.

IF THE CASUALTY HAS BEEN TRAPPED FOR LONGER THAN 15 MINUTES

Make an early call for help. Treat as for crush injuries.

DO NOT RELEASE THE CASUALTY

Recognising Internal Bleeding

• Casualty show signs of shock (cold, clammy, pale skin, loss of consciousness , thirst, general weakness, a fast weak pulse)

• Casualty coughs up blood

• Passing blood from rectum

• Casualty has been in an accident where they fell from height, stopped suddenly etc

• Casualty has bruising and/or swelling – may be “pattern bruising” at site of injury

• Blood coming from nose or mouth after head injury

Internal Bleeding

Aims

• Arrange urgent removal to hospital

• Minimise shock

Internal Bleeding

Treatment• If injury is cause by penetrating object do not try

to take it out• Lie casualty flat and raise their legs• Do not let casualty eat or drink• Keep casualty warm, loosen tight clothing• Watch their ABC• It they become unconscious, place them in

recovery position (but still keep legs elevated)

Palm Wounds

AIMS• Control blood loss• Arrange transport to hospital

The palm is richly supplied with blood and a wound may bleed profusely.

A deep wound may sever tendons and nerves.

Palm WoundsTreatment – Fist Bandage

• Press a sterile dressing firmly into the palm and ask casualty to clench fist over it

• Bandage the fingers so that they are clenched over the pad

• Support the arm in an elevation sling• Ensure casualty receives treatment in hospital

Bandage fingers over pad, leaving thumb exposed

Amputation

Aims• To minimise blood loss and shock• To preserve the amputated part

Treatment• Control blood loss by applying direct pressure and

raising the injured part. (Do NOT use tourniquet).• Apply a sterile dressing or non-fluffy clean pad

secured with a bandage.• Treat the casualty for shock. Dial 999 for an

ambulance.

Care of the Amputated Part

• Wrap the severed part in kitchen film or a plastic bag.

• Wrap the bag in soft fabric.

• Put a bag filled with ice cubes around the fabric.

• Put the whole package in another container. Mark with the time of injury and the casualty’s name. Give it to the ambulance attendant.

Chest Wound

• A chest wound may cause sever internal damage.

• The lungs are particularly vulnerable, and breathing problems, shock, and collapsed lung may follow an injury.

• It is important to make an airtight seal over the wound to prevent air entering the cavity.

Chest Wound

Cover the wound with the palm of your hand and support the casualty in a semi-upright position.

With the casualty supported over the wound with a sterile dressing or clean pad and tape it in place.

TREATMENT

Chest WoundTREATMENT cont’d

Create a seal over the wound with a kitchen film. Secure on 3 sides with tape.

Incline the casualty towards the injured side, supported on cushions.

Continue to monitor ABC and be prepared to resuscitate if necessary

Emergency First Aid for Children

End of Section