St John Ambulance Young Life Saver Award First Aid SESSION THREE Welcome St John Ambulance Young Life Saver Award First Aid SESSION THREE

Connector… What does DRAB stand for? What does AVPU stand for? When do you carry out CPR? What type of patient do you put in the recovery position? What do you say when you call ambulance? Explain the chain of survival?

Big Picture… You are going to be working in pairs. You are going to be working in small groups. You can going to be practicing using first aid equipment. You are going to have to deal effective with scared patients. (acting skills)

Learning Outcomes Know the difference between wound types. State key recognition features of severe bleeding. Demonstrate control of bleeding using direct pressure and elevation. Demonstrate control of bleeding by the use of appropriate dressings and bandages. Explain the action to take if dressings are ineffective. Discuss complications which may arise.

Respond to the needs of a casualty with severe bleeding Aim Respond to the needs of a casualty with severe bleeding

Types of wounds (1) Superficial and often caused by friction. Can contain foreign bodies which may result in infection. A blunt blow or punch, cause rupture capillaries under the skin to leak blood into tissues. Crushing or ripping forces results in tearing the skin. These wounds may bleed less than incised. Tissue damage and high risk of infection.

Types of wounds (2) Caused by clean cut (knife). Blood vessels cut straight across, bleeding profuse. Tendons, nerves and arteries may be damaged. Causes serious internal injury. The entry wound may be small and neat, any exit wound may be large and ragged. Caused by standing on nail, pricked with needle. Small entry site but a deep track of internal damage.

G Graze (Abrasion) C Contusion (Bruise) L Laceration I Incised wound P Puncture wound S Shot (Gun shot)

Severe Bleeding When bleeding is severe, it can be dramatic and distressing. Shock is likely to develop, and the casualty may lose consciousness. If bleeding is not controlled, the casualty’s heart could stop.

Severe Bleeding Bleeding at the face or neck may impede the air flow to the lungs. When treating severe bleeding, check first whether there is an object embedded in the wound; take care not to press on the object.

Your Aims If no object is embedded in wound:- To control bleeding. To prevent and minimise the effects of shock. To minimise infection. To arrange urgent removal to hospital.

Watch video… Watch and learn… 13minutes on….

Severe Bleeding – Step 1 Put on disposable gloves if available. Remove or cut clothing as necessary to expose the wound.

Severe Bleeding – Step 2 Apply direct pressure over the wound with your fingers or palm. Preferably over a sterile dressing or non-fluffy, clean pad. Don’t waste time looking for a dressing. You can ask the casualty to apply direct pressure themselves.

Severe Bleeding – Step 3 Raise and support the injured limb above the level of the casualty’s heart to reduce blood loss. Handle the limb very gently if you suspect that there is a fracture.

Severe Bleeding – Step 4 Help the casualty to lie down on a blanket, if available, to protect them from the cold. If you suspect that shock may develop, raise and support their legs so that they are above the level of their heart.

Severe Bleeding – Step 5 Secure the dressing with a bandage that is tight enough to maintain pressure, but not so tight that it impairs the circulation.

Severe Bleeding – Step 6 If further bleeding occurs, apply a second dressing on top of the first. If blood seeps through this dressing, remove both dressings and apply a fresh one. Ensure that pressure is applied accurately to the point of bleeding.

Support the injured part in a raised position with a elevated sling. Severe Bleeding – Step 7 Support the injured part in a raised position with a elevated sling.

Severe Bleeding – Step 8 DIAL 999 for an ambulance. Monitor and record vital signs: Level of response Pulse Breathing Watch for signs of shock. Check dressing for seepage. Check circulation beyond the bandage.

Do not allow the casualty to eat, drink or smoke. Caution……… Do not allow the casualty to eat, drink or smoke.

Quiz! Name these type of wounds……. A B C

Minor bleeding… What would you do?

Objects embedded… What would you do?

Review… Ask the person beside you… What are the differences between wound types? How can you recognise the features of severe bleeding? How do you control bleeding using direct pressure and elevation? How do you control bleeding by the use of appropriate dressings and bandages? What would you do if dressings are ineffective? What complications which may arise?

Any QUESTIONS?? Thanks for Listening!