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ANZCOR Guideline 9.1.1 - First Aid for Management of BleedingThis guideline applies to adults, children and infants. Who is the audience for this guideline?This guideline is for use by bystanders, first aiders and first aid training providers. RecommendationsThe Australian and New Zealand Committee on Resuscitation (ANZCOR) makes the following recommendations:
AbbreviationsANZCOR: Australian and New Zealand Committee on Resuscitation CoSTR: Consensus on Science with Treatment Recommendations (from International Liaison Committee on Resuscitation - ILCOR) CPR: Cardiopulmonary Resuscitation Guideline1 External BleedingThe use of pressure on or around the wound is usually the fastest, easiest and most effective way to stop external bleeding.1,2,3,4 [Good Practice Statement] Other methods should be used if direct pressure alone does not control severe bleeding. The aim is to stop further bleeding whilst waiting for help to arrive. There is no evidence that elevating a bleeding part will help control bleeding1,5 and there is the potential to cause more pain or injury. Bleeding should be managed as severe, life-threatening bleeding in the following situations:
1.1 Management
1.2 Direct Pressure MethodWhere the bleeding point is identified, the rescuer, a bystander or the injured person should control bleeding by:
To assist in controlling bleeding, where possible:
1.3 Embedded ObjectsIf there is an obvious embedded object causing bleeding, use pressure around the object. [ Good Practice Statement]
Pressure application methods may be insufficient to control bleeding. It may still be necessary to use other measures including an arterial tourniquet or haemostatic dressings. 1.4 Arterial tourniquet
Figure 1: Combat Application Tourniquet 1.5 Haemostatic dressings
The need to control the bleeding is paramount. The risks associated with the first aid use of tourniquets and haemostatic dressings are less than the risk of uncontrolled severe, life-threatening bleeding. These adjuncts provide temporary bleeding control and rapid transfer to hospital remains critically important. Figure 2: Kaolin impregnated gauze (an example of a haemostatic dressing) 1.6 Flow Chart for First Aid Control of External Bleeding2 Internal Bleeding2.1 RecognitionInternal bleeding may be difficult to recognise, but should always be suspected where there are symptoms and signs of shock. [Refer to ANZCOR Guideline 9.2.3] Internal bleeding includes bruising, locally contained bleeding (e.g. an 'egg on the head') and the bleeding associated with injury or disease of organs in the abdomen or chest, as well as fractures. Severe bleeding may also occur from complications of pregnancy. Symptoms and signs may include:
2.2 ManagementSevere internal bleeding is life-threatening and requires urgent treatment in hospital.
2.3 Closed Bleeding in a Limb
3 Nose Bleed (Epistaxis)For a nose bleed:
4 Management of All Severe Bleeding
References
Further Reading
About this Guideline
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