- Prompt control of bleeding is a life-saving skill.
- You need to look systematically for sources of bleeding.
- The first clot is the best clot.
- Direct pressure, keeping the casualty warm and reassurance are the main treatments.
In an extreme sports accident, internal and external bleeding are the most immediate threats to the casualty.
When assessing the casualty, you need to look carefully and systematically for sources of bleeding.
When bleeding, the body uses components of the blood (‘clotting factors’) to form a plug to stem the loss of blood. The clotting factors are in finite supply, so the first blood clot made will be the strongest. To make sure the first clot stays in place, minimise movement of the casualty and avoid repeated removal-reapplication of pressure ie. don’t keep taking the bandages off to see if the bleeding has stopped!
Keep the casualty warm, as that assists blood clotting. Pain relief and reassurance also reduce blood loss.
The best way to stop external bleeding is with direct pressure onto the wound with a trauma bandage. Once the pressure is on, do not remove it until help arrives.
Casualties can also bleed internally, into their chest, abdomen, pelvis and thighs. Signs can include skin bruising or deformity, but sometimes it is only the mechanism of injury that will give you a clue. It is difficult to treat bleeding into the chest and abdomen in the field without special skills, however you can treat pelvic bleeding by binding the pelvis and bleeding into the thighs by splinting broken femurs. Keeping the casualty warm, reassured and minimising movement will help in almost all instances though.