Hemorrhage Control | Paramedic Level CME

This chapter focuses on Hemorrhage Control , including focus on the essentials, the latest protocols and inventions. It discusses soft tissue trauma and the different techniques of Hemorrhage control

The lessons covered are

• 1: Soft Tissue Trauma
• 2: Hemorrhage Control
• 3: Special Considerations

Excerpt from Hemorrhage Control

Blood loss often accompanies soft-tissue injuries and can result from damage to arteries, veins, capillaries, or a combination of these vessels. Arterial bleeding is bright red and spurting, venous bleeding appears dark red-blue and flowing, and capillary bleeding is bright red and oozing. However, differentiating between these types of vessel hemorrhage can be challenging.

In the prehospital setting, the primary focus when dealing with a patient experiencing hemorrhage, irrespective of its source, is to control the bleeding. Methods for hemorrhage control include direct pressure and the application of tourniquets. Additionally, in cases involving fractures, immobilization using splints can be beneficial in reducing bleeding.

Direct Pressure

The paramedic effectively manages external hemorrhage by initially applying direct pressure over the injury site, which usually controls most types of bleeding within 4 to 6 minutes. To sustain this control, a pressure dressing is placed over the site and secured with an elastic bandage. It’s crucial to maintain direct pressure even after the dressing is applied. Removing the dressing could disrupt the freshly formed blood clot.

If bleeding resumes and saturates the dressing, a second dressing should be applied over the first, and direct pressure should be maintained until bleeding is once again controlled. If multiple dressings prove insufficient, more aggressive or alternative hemostasis measures must be considered.