Bleeding and Shock

Pulse Points Locations on the body surface where arteries can be felt expanding and contracting

Head and Neck Pulse Points Temporal artery – slightly anterior of the eternal ear. Carotid artery – along the front margin of the sternocleidomastoid muscle

Arm Pulse Points Brachial artery – along the inner border of the biceps brachii Radial artery – on the thumb side of the wrist

Leg Pulse Points Femoral artery – in the groin (inguinal) area

Popliteal artery – behind the knee Dorsalis pedis artery – on the anterior surface of the foot, below the ankle joint

Wound Care Irrigate the wound with clean, cool water Remove all foreign particles Dry the wound Treat with first-aid cream Apply a dry sterile bandage

Bleeding There are three types of bleeding Arterial bleeding can be severe. Venous bleeding is less severe but can be profuse. Capillary bleeding is slow but may increase the risk of infection.

Arterial Bleeding This has the force of arterial pressure behind it; thus it will often spurt with each heartbeat. Typically from a deep laceration or puncture wound. Treat with firm pressure and immediate medical attention.

Venous and Capillary Bleeds Venous blood will be darker and will trickle out. Capillary bleeds will also trickle out but will have a brighter color. With both of these, usually light to moderate pressure will constrict bleeding enough for the body’s natural clotting mechanisms to work.

Shock Shock is a failure of the circulatory system to oxygenate vital organs. This is a medical emergency. Undetected shock can lead to death.

Recognition and Treatment for Shock Recognition of Shock Initially, a flow of adrenaline causes: A rapid pulse. Pale, grey skin, especially inside the lips. If pressure is applied to a fingernail or earlobe, it will not regain its colour immediately. Sweating, and cold, clammy skin (sweat does not evaporate).

Recognition and Treatment for Shock As shock develops, there may be: Weakness and giddiness. Nausea, and sometimes vomiting. Thirst. Rapid, shallow breathing. A weak, ‘thready’ pulse. When the pulse at the wrist disappears, fluid loss may equal half the blood volume.

Recognition and Treatment for Shock As the oxygen supply to the brain weakens: The casualty may become restless, anxious and aggressive. The casualty may yawn and gasp for air (‘air hunger’). The casualty will eventually become unconscious. Finally, the heart will stop.

Recognition and Treatment for Shock DO NOT let the casualty move unnecessarily, eat, drink, or smoke. DO NOT leave the casualty unattended. Reassure the casualty constantly.

Recognition and Treatment for Shock Treat any cause of shock which can be remedied (such as external bleeding). Lay the casualty down, keeping the head low. Raise and support the casualty’s legs (be careful if suspecting a fracture).

Recognition and Treatment for Shock Loosen tight clothing, braces, straps or belts, in order to reduce constriction at the neck, chest and waist. Insulate the casualty from cold, both above and below. Contact the emergency service.

Recognition and Treatment for Shock Check and record breathing, pulse and level of response. Be prepared to resuscitate the casualty if necessary.