Veterinary Nursing Journal

ISSN: 1741-5349 (Print) 2045-0648 (Online) Journal homepage: http://www.tandfonline.com/loi/tvnj20

First Aid Management of Haemorrhage

Gareth Ford VN

To cite this article: Gareth Ford VN (1999) First Aid Management of Haemorrhage, Veterinary
Nursing Journal, 14:2, 49-50, DOI: 10.1080/17415349.1999.11012992

To link to this article: http://dx.doi.org/10.1080/17415349.1999.11012992

Published online: 21 Nov 2014.

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Download by: [Orta Dogu Teknik Universitesi] Date: 20 April 2016, At: 18:04
 TECHNICAL PAPERS

FIRST AID
MANAGEMENT OF
HAEMORRHAGE
Haemorrhage is potentially life threatening. The
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aim ofthis fact sheet is to present a training guide

Gareth Ford, VN to help in the management ofhaemorrhage cases

H
aemorrhage in any form can be life threatening. The
quicker bleeding is stopped or slowed the better the out-
come in likely to be.

When haemorrhage occurs

Primary haemorrhage
Primary haemorrhage occurs immediately following an injury.

Reactionary haemorrhage
Reactionary haemorrhage takes place within 24 to 48 hours of injury.
It occurs when the patient's blood pressure rises (sometimes after fluid
therapy) and dislodges the blood clot.

Secondary haemorrhage
Secondary haemorrhage can take place up to 10 days after injury. It
occurs when bacteria invade the wound site and destroy the clot and
A pressure bandage in place
any new tissue which has formed. This causes bleeding to start again.

Where the blood goes

Bleeding occurs either externally, in which case
blood loss is readily apparent, or internally, where
blood is lost inside the body; for example, into the
abdomen following a splenic rupture.

Natural control of haemorrhage

The body has its own mechanisms to control
bleeding, namely: retraction of the cut ends of
blood vessels; falling blood pressure; back pressure;
and the formation of fibrin clots.
Retraction of cut ends
Retraction of the cut ends of blood vessels comes
about due to the ability of blood vessels to recoil
and seal their own ends. By virtue of their elastic
Gareth Ford,VN, trained at
Myerscough College and qualified
in August 1997. He is senior
surgical nurse at Summerhill
Avenue Veterinary Clinic, Newport
nature, if blood vessels are pulled apart they recoil
and reduce the size of the aperture through which
blood is flowing, thereby helping to prevent
haemorrhage. This is why traumatic injuries
bleed less than a neat surgical incision.
Falling blood pressure
When blood is lost, blood pressure drops, leading
to a reduction in the pressure at which blood is

VETERINARY NURSING Volume 14 No 2 March 1999 49

 Methods of arresting haemorrhage
e Direct pressure Use a gauze dressing or even your hand to apply
pressure directly to the bleeding site.
e Indirect pressure Pressure is applied to the main artery supplying the
bleeding area. The arteries commonly used are the femoral and brachial
arteries (illustrated below).
e Pressure bandage Apply a gauze dressing to the wound and place a pad
of cotton wool on top.This allows the blood to be absorbed and
pressure to be applied safely to maintain firm but even pressure. A
conventional dressing is then placed. The use of such a dressing can also
help prevent bacteria getting to the wound site.
NB.If blood seeps through the ~rst dressing apply a second on top
of the ~rst
e Tourniquets The use of a tourniquet is no longer recommended
because the entire limb distal to the tourniquet will be deprived of
blood.lf a tourniquet is used, the patient must not be left unattended
and the pressure should be released for a few seconds every I 5
minutes.
e Artery forceps These clamp tightly shut and maintain a closed position.
Equipment that may be used
They are used to occlude blood vessels and should only be applied if in arresting haemorrhage
the bleeding artery is clearly visible, the patient is cooperative and the
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nurse is capable of clamping the artery effectively.

The location of the arteries to which Indirect pressure is most

commonly applied in an effort to curb haemorrhage is shown
here. (left) Femoral arteries. (above) Brachial artery

pushed our of the injured blood vessel. This helps to allow a clot ro Types of blood vessel damage
form.
Arterial Venous Capillary Mixed
Back pressure
Back pressure occurs when blood is lost into a body cavity such as the Bright red Darker than Capillary bleeding Mixed
abdomen. When the lowered blood pressure in the damaged vessel is blood that arterial blood. occurs in all haemorrhage
equal ro the pressure of the fluid surrounding it, the bleeding will spurts out Oozes out wounds. No occurs from
srop. with each rapidly definite bleeding both artery
heart beat point and vein
Blood clotting
The formation of a clot acts as a plug ro seal the cut ends of the blood
vessel. However, this may not occur if the body's blood clotting ability
Further reading
has been compromised in some way. For example, the patient may
BRAUNTON. H. ( 1998) Fact sheet Fluid therapy. Veterinary Nursing 13,201-202
have a clotting defect, or may have received an anticoagulation drug HOTSTON-MOORE, P. ( 1998) Coping alone in the event of an emergency.
such as warfarin. Veterinary Nursing 13, 161-163

so VETERINARY NURSING Volume 14 No 2 March 1999