Bleeding (also known as hemorrhaging) often occurs after an injury. Additionally, it can be the result of a disease. Bleeding occurs when blood vessels become damaged. Bleeding injuries can happen on the outside of the body (external bleeding) or inside the body (internal bleeding).
Minor bleeding injuries can heal on their own, when the body produces clots to stop the bleeding. However, when the bleeding is more severe and wont stop on its own, first aid becomes necessary. Treatment will depend on the type, severity, and cause of the injury.
3 Types of Bleeding.
In general, there are 3 types of bleeding: arterial, venous, and capillary. As you might expect, they are named after the three different types of blood vessels: the arteries, veins, and capillaries. The 3 types of bleeding injuries have different characteristics.
Arterial bleeding is usually the most severe. Blood may ‘spurt’ from a damaged artery in rhythm with the victim’s heartbeat. This is because the blood is under direct pressure from the heart’s pumping action. Arterial bleeding is an emergency and typically results in the most blood volume lost out of the 3 types of bleeding. Healthy arterial blood is often a bright red color, due to its high oxygen content.
Venous bleeding can also be serious, as the veins also carry a high volume of blood. Unlike arterial bleeding, blood will not usually ‘spurt’ from a damaged vein. Instead, blood will flow out consistently. This is because the veins are not under direct pressure from the heart’s action. Despite this, venous injuries can still result in rapid blood loss. Since venous blood doesn’t have as much oxygen, it has a dark red appearance.
Capillary bleeding occurs in all wounds. It is the least serious of the 3 types of bleeding, since it is the easiest to control and results in the least blood loss. Blood ‘trickles’ out of capillaries for a short while before the bleeding stops.
External Bleeding vs Internal Bleeding
External bleeding and internal bleeding are similar in principle: a blood vessel becomes damaged and leaks blood out. However, they will present differently.
A common example of external bleeding is a cut or puncture on the skin that blood will leak out of. The wounded area is clearly visible in this type of external injury.
On the other hand, a common example of internal bleeding would be a bruise. Small blood vessels inside the body are leaking into the tissue. The normally dark red blood presents as a dark blue color through the translucent skin.
However, internal bleeding is not always as easy to identify as a bump or bruise. Internal bleeding can be very serious. Depending on the type of internal injury, there may different signs to look for. Be aware of the signs of shock. Internal bleeding can show:
- dizziness
- nausea
- pain
- swelling
- paleness, graying skin
- clammy, sweaty skin
- shortness of breath
- extreme thirst
If the injured person has sustained a brain injury then the symptoms can be similar to a stroke. These include:
- headache
- vision problems
- loss of coordination
- difficulty speaking and understanding speech
- seizures
How to Treat Bleeding
All wounds should be treated carefully. Different wounds will require different treatments, but you can follow these general guidelines.
External bleeding First Aid
Before you attempt to treat someone who is bleeding, be sure to take the necessary safety precautions:
- Make sure the scene is safe.
- Call 911 or an ambulance if the bleeding is severe.
- Wear personal protective equipment (PPE)
Minor bleeding First Aid
Treating minor external bleeding is straightforward: clean the affected area with soap and water if possible. If soap and water are not available and the victim is still bleeding, clean the wound with a sterile gauze or similar item. Do not use a fabric that will leave lint or debris in the wound. Keep direct pressure on the wound, and dress it carefully. In most cases, minor bleeding can usually be stopped by keeping direct pressure on the wound. Since high-volume blood loss isn’t a risk, the top priority in this situation is to clean the wound to prevent infection, then stop the bleeding.
Severe bleeding First Aid
When dealing with a severe bleeding injury the top priority is to bring the bleeding under control. As always, call 911, get your first aid kit, and wear your PPE. If the bleeding victim is conscious, have them keep pressure on their wound. Apply the dressing to the site firmly. Keep pressure on the area with the flat part of your fingers, or your palm.
If the bleeding does not stop after dressing the wound, apply a second dressing over the first and add more pressure. Do not attempt to remove the first dressing, since that can result in more bleeding.
In very severe cases, a tourniquet may be needed to stop bleeding. A tourniquet is a device that is placed on a bleeding limb, applying pressure to stop blood flow. Commercial tourniquets can be purchased, but you can make your own in an emergency if you don’t have one. To apply a tourniquet:
- Find the source of the bleeding.
- Apply pressure.
- Position the tourniquet material (whether it is a cloth, bandage, T-shirt) several inches over the injury, but NOT over a joint. If the injury is below the knee, the material should be applied above the knee.
- Tie the material in a simple knot.
- Insert a windlass into the knot. A windlass is a straight, sturdy item like a stick or bar.
- Twist the windlass to further tighten the tourniquet.
- Wrap the windlass to keep it secure, so that pressure stays on the wound.
- Take note of the time. A tourniquet that has been on for more than 2 hours may cause damage to muscles and blood vessels.
Keep in mind, a tourniquet is only a temporary solution for severe bleeding. A tourniquet should only be removed by a professional.
Internal bleeding First Aid
Internal bleeding is a medical emergency. The best thing you can do to help someone with internal bleeding is to make sure the scene is safe, and that they are not at risk of further injury while waiting for an ambulance to arrive.
Be prepared to help the victim if they go into shock. Keep the victim lying down on their back. Cover them to keep them warm, and be prepared to perform CPR if it is needed.