Bleeding Control

Soft Tissue Injuries / Bleeding Control

Some common types of soft tissue injuries and bleeding control, and their treatments:

Let’s begin with a simple contusion.  A contusion is another name for a bruise.  It is usually caused by blunt trauma; as in the case of a baseball bat striking an arm, or pressure; like a hickey or “love bite” on your neck.  The purple discoloration is caused by crushed blood vessels leaking blood into the surrounding tissues.  Often these areas will swell with other body fluids and cause lingering pain or discomfort.  If we begin by analyzing any potential life threatening situations, it would be safe to make a few initial assumptions: A person suffering only from a contusion will likely have:

1. Breathing,
2. Pulse
3. No severe bleeding.

Having eliminated some potential life threatening situations, we can proceed with the proper treatment, which is the careful application of ice.  An ice pack will constrict the injured blood vessels to help control bleeding, reduce swelling in the area, and eliminate some of the pain.  A special warning about ice: Never apply ice directly to the skin as prolonged contact may result in frostbite.



Other common soft tissue injuries & treatment:

• Nosebleed / Epistaxis
• Scrapes & Abrasions
• Cuts, Incisions and Lacerations
• Direct Pressure-Elevation-Pressure Points

A puncture wound occurs when a long, sharp object, like a nail, enters and exits the body, leaving a deep hole.  Of all the wounds listed so far, puncture wounds are the most likely to become seriously infected.  Infection occurs when bacteria from the nail are embedded deep into the body, and cleaning efforts are insufficient to remove them.  Puncture wounds often heal from the outside in, sealing off the open wound and creating an abscess, breeding bacteria in an anaerobic environment.  Gangrene and tetanus are two examples of this type of infection.  Both are extremely dangerous and can be prevented by early treatment by a physician.

An impalement occurs when an object becomes lodged in the tissue or bones of an individual.  An example might be a fishhook or a shaft of rebar from a construction site.  Consider the possibility of patient shock anytime an object is visibly embedded in the body.  Generally, treatment for impalement involves immobilization of the embedded object to prevent further damage, and treating the patient for shock.  An object that pierces through a section of the body may have damaged organs, muscles, or punctured major arteries.  Any motion of the object (including removal) may result in more damage, or massive internal bleeding.  Bulky dressings like rolls of bandage or a paper cup placed over the impaling object are recommended to reduce the likelihood of accidental motion while awaiting EMS.  (Remember to punch the hole in the cup before placing it over the object if this method is used)

An avulsion is the forcible removal of a section of soft tissue.  An example might be an earlobe or fingertip.  It is important to remember the life threatening situations we mentioned earlier in the presentation, as avulsions tend to have several priorities at once.  First, control the bleeding.  Second, treat for shock.  And third, locate and isolate the body part.  Be very careful not to come into contact with the blood.  Place the body part in a plastic bag, wrap in a towel, and keep it cool with ice.  Make sure the body part accompanies the victim to the hospital, as they will usually want it back.