References:
- Lecturer (Coprade)
Hemorrhaging may be internal or external. For identification, patients may be checked for signs and symptoms:
- Shock triad (hypotension, tachycardia, tachypnea). Hypotension is a result of blood loss, while tachycardia and tachypnea are compensatory mechanisms in order to attempt to maintain perfusion.
- Discoloration: pallor occurs from decreased blood volume.
- Lowered level of consciousness from decreased cerebral perfusion.
- Weak thready pulse from decreased blood volume.
For first aid,
- Locate the sites of bleeding. Assess all areas of the body that may be bleeding.
- Apply direct pressure. This is the gold standard as the initial action or bleeding. If bleeding persists, apply pressure on the proximal arteries.
- Place the patient on a modified trendelenburg position (Shock position). This shifts blood flow from the legs to the vital organs, and the modification used to reduce pressure on the diaphragm. It is a position where the patient lies flat on the bed with the legs elevated.
- Monitor for hypovolemic shock. Transport the patient to the nearest hospital once bleeding has been managed.
Epistaxis
In case of nose bleeding, the principle still applies: apply direct pressure on the nose bridge. The patient is positioned upright with the neck flexed, or leaning forward. A cold compress can be used for vasoconstriction to reduce bleeding.
In The Emergency Room
The patient in the hospital will:
- Receive Oxygen Therapy
- Receive Fluid Resuscitation/Fluid Volume Replacement with IV Fluids, best with NSS.
- Receive Blood Transfusion. Blood type O is used in emergency cases as the universal donor.
- Blood vessel repairs are performed by surgeons once managed.