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# Bleeding
## Direct pressure
Direct, firm pressure will stop almost all bleeding, even large,
heavily bleeding wounds. If the person is bleeding from the head,
apply pressure.
* Raise the injured part so it is above the level of the person's
heart.
* Grab the cleanest piece of cloth you can find nearby, fold it to
about the size of the wound, and press it directly and firmly on
the wound.
* Show the injured person how to put pressure on himself, if he is
able.
* If the wound is large, put the gauze or cloth into the wound.
* Keep pressing until the bleeding stops.
* Do not remove the cloth if it becomes soaked with blood.
Instead, add another cloth on top.
* For a large wound, do not lift your hand off until at least 15
minutes has passed, even to check if it has stopped bleeding.
Bleeding
When bleeding has slowed or stopped, you may be able to wrap a
dressing firmly around the bleeding part. Put a folded gauze or
cloth in or on top of the wound and then firmly wrap a bandage around
it. Be sure the bandage is firm enough to create pressure on the
wound, but not so tight that it cuts off the blood flow to the rest
of the arm or leg.
> Applying pressure to stop bleeding is hard work. Do not give up!
Never use dirt, kerosene, lime, or used coffee grounds to stop
bleeding.
Blood can make a big mess and look like the person lost more than he
did. Watch the person closely for these signs of losing too much
blood:
Danger signs
* Confusion or losing consciousness
* Very fast heart rate
* Cold, moist, pale skin
If you see these signs, raise both the person's feet onto something
so they are above the heart, and get help for shock.
shock
Even if you do not see these signs, stay with the person or check in
on him every 10 to 15 minutes to make sure he is OK and reassure him.
Keep checking until he is acting and feeling normal.
## Tourniquets
Use a tourniquet *only as a last resort*, when you are willing to
risk the loss of an arm or leg in order to save a person's life.
Use tourniquets only when:
* A limb is cut off or is so mangled that it clearly cannot be
saved.
* Heavy bleeding that does not slow down from an arm or leg with
direct pressure. (Have you tried pressing harder first?)
* There is a large, deep wound in the thigh, like when a bullet,
shrapnel, or something else has penetrated deep into the muscle,
and the person is showing signs of blood loss like weakness,
confusion, or pale skin. (It can be impossible to use enough
pressure on a large thigh to stop heavy bleeding.)
Use a wide belt, a piece of cloth folded into a flat strip, or a
blood pressure cuff inflated all the way to tie off the bleeding
part. Do not use thin string or wire. It will cut right through the
skin.
Get to a hospital as fast as you can. You have 2 or 3 hours before
the limb is likely to be lost.
* Place the tourniquet above but close to the wound, between the
wound and the body. (A common mistake is putting the tourniquet
too far from the wound.)
* Wrap the tourniquet tightly around the limb twice. Then tie a
knot.
* Put a short, strong stick on top of the knot. Tie two more knots
on top of the stick.
* Twist the stick to tighten the tourniquet until bleeding stops.
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Tourniquet
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