Accidents or illnesses can cause bleeding emergencies. When a child has a bad fall, is in a car accident or is injured by a knife or a piece of machinery, there may be serious bleeding. Children with certain illnesses, such as hemophilia and ulcers, can also lose a great deal of blood in a short period of time. Severe hemorrhaging requires prompt treatment with possible hospitalization, blood replacement and/or surgery.
• Bright red blood that comes out in spurts or a heavy, steady flow, indicating that an artery has been severed. This is the most serious type of external bleeding because blood flows through the arteries at a higher pressure than other blood vessels; thus, a large amount of blood can be lost rapidly.
• A steady flow or trickle of dark red blood, indicating that a vein has been severed. This type of bleeding is most common in deep cuts.
Signs of internal bleeding:
• Vomiting or coughing up blood, which may be bright red or resemble coffee grounds
• Passing blood in the stools or urine
• Bleeding from the ears, nose or mouth
• Abdominal swelling
• Pain and tenderness, especially in the abdomen
• Pale skin
• Excessive thirst
• Possible restlessness, apprehension and mental confusion. In addition, excessive blood loss can result in shock.
HOW TO GIVE FIRST AID FOR EXTERNAL BLEEDING
For minor cuts, scratches and wounds: 1. Control the bleeding by applying direct pressure to the wound. Press a sterile pad or clean cloth to the wound and hold it firmly until the bleeding stops.
2. If bleeding persists, hold an ice pack over the cloth or sterile pad. The cold constricts blood vessels and helps stop the bleeding.
3. After the bleeding has stopped, assess the severity of the wound. Seek medical advice for a long, gaping wound that may require suturing.
For more severe wounds:
As with any serious injury, start by assessing the ABCs of emergency care (an open airway, breathing and circulation), and take any needed action. If these are stable, proceed to stop the bleeding.
1. Lay the child down, with the head slightly lowered and the legs elevated (unless there is a fracture or there is bleeding from the nose or mouth). This position maintains blood flow to the brain and helps prevent fainting.
2. Apply direct pressure to the source of bleeding. If possible, use a thick sterile pad or clean cloth, towel, or similar material. Place the pad directly over the entire wound, and press firmly with the heel of your hand.
3. If the wound is in a limb, elevate it above the child's heart. This helps reduce blood flow.
After bleeding has stopped, maintain pressure over the wound while wrapping the bandage
4. Continue to apply the pressure until the bleeding stops. Take care not to disturb any clots that form under the pad. If it becomes soaked with blood, do not remove it; instead, apply another compress over it and apply firmer pressure over a wider area.
5. If bleeding slows or stops, apply a pressure bandage directly over the compresses, even if they are blood-soaked. Take care not to wrap the bandage so tightly that it cuts off circulation. You should be able to feel a pulse below the bandage. Continue to keep the child's limb elevated and seek medical attention if warranted.
6. If the bleeding persists despite using direct pressure and elevation, attempt to stop the flow by pressing against the appropriate arterial pressure point. The idea is to stop the flow of blood by cutting off the circulation to the affected blood vessel. This is done by compressing the artery that is supplying blood to the wound against the underlying bone.
If pressure pads were used to stop bleeding, apply bandage over pads
7. Use the accompanying illustration to find the appropriate pressure point. Make sure that the point is between the heart and the wound. For example, if the wound is near the wrist, apply pressure to the artery in the middle portion of the arm.
8. DO NOT continue pressing against a pressure point after the bleeding stops. Instead, slowly release the pressure point while applying direct pressure over the wound.
9. If severe bleeding recurs, repeat Step 7.
HOW TO GIVE FIRST AID FOR INTERNAL BLEEDING
Internal bleeding is not always obvious but should be suspected after any blunt trauma, head injury or other accident that may injure internal organs.
1. If internal bleeding is suspected, call for emergency help.
2. While waiting for the ambulance or EMS (emergency medical services) crew to arrive, keep the child quiet and lying flat or, if the child is having trouble breathing, prop up the head and shoulders with a pillow and also elevate the legs.
3. Cover the child with a light blanket or coat.
4. Look for signs of other injuries, such as a broken bone, and administer appropriate first aid.
5. Watch for signs of shock, and check the pulse and breathing. Administer CPR if needed.
6. If vomiting occurs, turn the child's head to one side to allow the vomit to exit the mouth.
