Bleeding

Bleeding occurs when any of the blood vessels are ruptured. Bleeding can be external, caused from wounds, or internal if it is caused by trauma, fractures or ruptured organs. Severe bleeding causes low blood pressure and the casualty will enter shock. Bleeding is categorised according to the type of blood vessel affected:

• Arterial Bleeding: Bright red colour blood spurting from a wound following a heart beat

• Venous Bleeding: Dark red colour blood oozing from the wound

• Capillary Bleeding: Blood will ooze from the blood vessel.

This is the most common type of bleeding

The following paragraph outlines some guidelines on the treatment of bleeding;

1) Examine the wound. If there is an object embedded, DO NOT attempt to remove it.

2) Apply direct pressure to the wound using a gauze to stop the bleeding. If there is an embedded object, apply pressure to either side of the wound.

3) If the bleeding is from a limb, raise it above the level of the head and support it in this position. For lower limb bleeding, lay down the victim and raise the affected limb.

4) Cover the wound with sterile dressing.

5) Check the casualty for shock and treat if necessary.

Whilst treating bleeding, the following precautions should be observed;

• Do not use a tourniquet unless bleeding is uncontrollable such as the case of a traumatic amputation of a limb. In this case, apply the tourniquet as near as possible to the point of amputation and make a note of the time when the tourniquet was applied.

• For cases of severe bleeding, apply pressure at the brachial artery (arm below biceps) or in the femoral artery (groin crease).

In both cases press the artery firmly against the bone. Pressure should not be applied for more than 10 minutes.

Burns

Burns may be caused by extreme hot or cold temperatures, extremely moist heat, chemicals, friction, radiation and electricity sources. Burns destroy the skin layers leading to infection and fluid loss.

Superficial burns involve only the outer layer of the skin. A partial thickness burn affects several layers of the skin. This type of burn requires medical treatment and, if affecting over 60% of the body’s skin, can cause death. A full-thickness burn destroys all layers of the skin and can extend to damage nerve, muscle and fat.

The risk of shock and fluid loss is proportional to the area affected by the burn. As a rule of thumb, the size of the casualty’s palm represents 1% of the body area. Extensive burns, 15% of skin surface in adults and 8% in children, can cause death. Another method to determine the extent of burns is the ‘rule of nines’ by which the body is divided in 9 equal parts. A guide to this method can be found in the ‘Ship’s Captains Medical Guide’ kept on board.

The following paragraphs outline some guidelines on the treatment of burns.

1) Cool the affected area with copious amounts of running water. This has the effect of preventing further tissue damage and minimizes swelling and shock. Do not overcool a burn as this may result in shock.

2) Cover the injury with a sterile gauze or a sterile dressing which is not fluffy. If no dressing is available, use cling film or a clear plastic to cover the area.

3) Treat the casualty for shock if necessary.

4) Non-alcoholic drinks may be given to casualties who are fully conscious to replace fluid loss.

Whilst treating burns, the following precautions should be observed

• Do not remove any clothing sticking to the skin

• Do not touch or interfere in any way with the injured area

• Do not burst any blisters

• Do not apply any ointments, adhesive tape or any other substance to the affected area

Burns to the airway may occur when the casualty has inhaled very hot gases. In this case, maintain the airway open and be prepared to give artificial ventilation if necessary. In the case of electrical burns, make sure that the contact with the electrical source is broken. Do not approach a casualty of a high voltage incident until you receive positive confirmation that the electrical source has been switched off and isolated. Failing to do so could result in electrocution when touching the casualty. For chemical burns, make sure that the chemical source is sealed. Ventilate the area of the accident and, if possible, remove the casualty from the area. Apply copious amounts of water to the affected area for at least 20 minutes. Remove any contaminated clothing.

Дата добавления: 2015-08-26