How to Control Bleeding

Photo by quinn.anya

A bleeding wound is no joke.  Depending on the severity, it can leave its victim in shock or even dead.   Before a wound can mend and heal, the blood must stop flowing so it can clot.  Knowing how to stop severe bleeding while waiting for help to arrive could greatly increase a bleeding victim's chances of survival.

Here are some general rules to stop major bleeding:

1. If time and circumstances allow, wash and sanitize before helping a bleeding victim to prevent spreading infection.  Wear gloves if they are available and take precautions to prevent the spread of HIV including covering any open wounds you may have and putting on protective clothing for your face and body.
2. Apply direct pressure to the wound.  For mild wounds, this may take as little as 2-5 minutes, or 20+ minutes for serious wounds.  Sterile gauze is perfect to use if you have it on hand, or terry cloth.  If not, look for a clean towel, rag, clothes, or any material you can fold and cover the wound with.  Small foreign objects within the wound may quickly be removed, but a large object within the wound should be left in case it is stopping some of the blood flow.  Your immediate need is to stop the blood, so just bandage around it.  Don't start out too thick (because it could interfere with good pressure), and once the cloth is on, don't take it off.  This could reopen the wound and undo any clotting that began.  If your material becomes soaked with blood, add another layer on top.  Keep your pressure constant.    
3. Along with applying pressure directly to the wound, you can also apply pressure to specific pressure points where arteries are close to the surface to help slow the flow of blood.  These pressure points should be found between the wound and the heart.  Common pressure points are found in the middle of the upper arm (brachial artery), the back of the knee (popliteal artery), and the groin area where the thigh meets the pelvis (femoral artery).  Be sure to apply pressure nearer the heart rather than the wound.
4. Raise the wound above the level of the heart.  It is easier for blood to flow down rather than up against gravity, so raising the wound will help slow the flow.  Continue to apply direct pressure.

Applying a tourniquet should only be used as a last resort when someone is willing to lose a limb to save their life.  Limbs are often lost with tourniquets because the blood flow is so completely restricted. Use with caution.

For minor bleeding, direct pressure is still important.  Other ideas that have been "reported" to stop minor cuts from bleeding (like when you nick yourself shaving) are ice, hot water, salt water (sting!), lip balm, flour, cornstarch, deodorant, witch hazel, sugar, white vinegar, a tea bag, duct tape, and spider webs (really?), though I've tested very few of them myself (ice and cornstarch work) and can't verify the truth of the others.  Yarrow is supposed to be great for healing and a natural remedy with antiseptic properties.  Crush cleaned yarrow leaves and hold to the wound to stop bleeding.

How to Treat a Bee Sting

The sting from one of these tiny insects is painful and even possibly fatal.  If you are stung, follow these steps quickly to reduce your body's reaction:

1. Get to a safe area quickly.  When bees feel threatened, they release a scent that attracts other bees to come help.  You should also be aware that hornets, yellow jackets, and wasps produce similar reactions to their stings but their stingers don't come out like bees, and they can sting many times.  Avoid multiple stings if possible.
2. Get the stinger out as quickly as possible.  Scrape it off, pull it out, or brush it away.  The longer it sits in your skin, the stronger your reaction will be to the bee's venom.  Some sources say you should avoid squeezing the stinger since it can release more venom, but others say to use whatever method you need to get it out as fast as you can.
3. Elevate an arm or leg that has been stung.  Remove any nearby jewelry (rings, bracelets, etc.).  Pad the affected area with a towel and cool with an ice pack to slow the venom's spread and numb the area.  
4. Itching at the sting site can be treated with an antihistamine, calamine lotion with an analgesic, hydrocortisone cream, or even toothpaste.  You can also create a soothing paste for your sting using baking soda and water.  If you have meat tenderizer, you can add some to your paste to help break down toxins in the sting.  Reapply any of the previous treatments if symptoms return.
5. Pain relievers can be used for lingering pain.
6. The area may take several days to heal so you should keep it clean to prevent infection.  Wash the area with soap and water.

Some people may have a severe allergic reaction to bee stings called anaphylaxis.  Anaphylaxis can occur when an affected person has contact with various allergens: latex, pollen, animal fur, nuts, bee stings, etc.  The outcome may be fatal, so if you suspect anaphylaxis you should call for emergency help immediately.  Look for:

• Redness, itching, or hives that spread beyond the sting
• Dry mouth or itchy throat
• Hoarseness or difficulty speaking

And especially look for:

• Difficulty breathing, swallowing, or tightness in the throat
• Swollen face, mouth, or tongue
• Dizziness or rapid drop in blood pressure
• Feeling weak
• Nausea or vomiting
• Diarrhea
• Quickened pulse
• Unconsciousness

If the allergy is previously known and you have an EpiPen, use it!  This could save your life.  An antihistamine could also slow the reaction but ultimately will not stop anaphylaxis.

You should also seek medical help if you are stung more than 10 times, or have stings inside your mouth, throat, or nose.  Swellings from these stings may block your breathing and be deadly even in people who are not allergic.

Identifying a Heart Attack or Stroke

I used to think a heart attack and a stroke were the same thing.  Well, they're not.  A heart attack generally occurs when a blood clot has formed in one of the arteries sending blood to the heart.  With the blood flow blocked, the heart begins to die.  A stroke is similar in that typically a blood clot has once again formed in an artery, but this time to the brain.  As blood to the brain is blocked, that section of the brain begins to die.  The signs of both are different, but the faster you act the less damage will be done and the higher the chance of survival.

Every minute, 52 people in the USA die from a heart attack.  Half of those who experience a heart attack wait 2 hours or more to go get help.  Time is critical!  If someone is experiencing multiple of the following symptoms, it may be a heart attack.  Call 911 immediately.  Many people suffer extreme exhaustion and sleeplessness the month before their attack.  You don't need to have all of the symptoms for it to really be a heart attack, and no two attacks are exactly alike. 

Heart Attack Symptoms:

1. Pain in the chest (though some sources say women feel less chest pain)
2. Heaviness or pressure in the chest in the chest (like an elephant sitting on your heart)
3. Pressure or pain in the jaw or neck
4. Pressure or pain in one or both arms, (usually a dull ache in the left arm that grows and then radiates to the chest)
5. Nausea
6. Sweating
7. Shortness of breath
8. Feeling faint or dizzy
9. Throbbing pain between the shoulder blades
10. Nervousness or anxiety

Even before a heart attack is confirmed, medical professionals often give treatments of oxygen, aspirin (to thin the blood and prevent more clotting), or nitroglycerin.  The person should rest to not strain the heart more.

A stroke occurs every 40 seconds in the United States.  Strokes don't often have accompanying pain as in a heart attack, but some symptoms are similar.  Symptoms often come suddenly, but not always 

Stroke Symptoms:

1. Sudden tingling, numbness, or loss of movement in the leg, arm, or face, especially on one side
2. A severe headache that comes on suddenly and is different from ones in the past
3. Sudden difficulty of balance, walking, and coordination 
4. Difficulty in speaking and understanding simple statements 
5. Sudden changes in vision from one or both eyes

If you suspect someone may be suffering a stroke, use this "F-A-S-T" test:

1. F = Face - Ask the person to smile and look to see if one side of the face is drooping.
2. A = Arms - Ask the person to raise both arms and watch to see if one starts to drift downward.
3. S = Speech - Ask the person to repeat a simple phrase and listen to see if their speech is slurred and difficult to understand.
4. T = Time - Get help immediately if you see any of these signs.  

While waiting for help to arrive, lay the person down to help get blood to the brain.  If the person feels nauseous, is drowsy, or unresponsive, lay them on their side to prevent vomiting and choking.  Don't give aspirin unless a doctor approves; some strokes are caused by internal hemorrhages and a blood thinner could make the situation worse.

Adult CPR

Along the same lines as my Child CPR post, this is meant to review CPR for adults.  The steps are nearly the same and as mentioned before, the acronym A-B-C has now been changed to C-A-B by the American Heart Association, meaning we first start with "Compressions," followed by "Airway" and then "Breathing."  Here are the guidelines:

1. Check the Scene  Make sure it is safe so you don't become the second victim.
2. Check the Victim for injuries and consciousness.  You don't want to perform CPR on someone who's just sleeping.
3. Call for Help by directing someone specific on the scene to call 911.  If you are alone, do 2 minutes of C-A-B before calling for help.  Not delaying may mean the difference between life and death for the victim.
4. Compressions  Place the heel of one hand slightly lower than the nipple line in the center of the victim's chest.  Your other hand goes on top with the fingers interlaced.  Lock your elbows and compress down 2 inches, hard and fast.  You should give 30 compressions in about 18 seconds (almost 2 each second).  This alone may save someone's life.  Sing a song if needed to keep up a steady beat; I've seen "Staying Alive" recommended since the beat is nearly the right tempo, though the lyrics may be a bit sardonic.
5. Airway  If trained in CPR, you may now open the airway.  Lift the chin and tilt the victim's head back.  Watch for the chest to rise and listen for any breathing.  Look for any object that might be blocking the airway, but be careful not to push it further in by trying to get it out.
6. Breathing  If the victim is still not breathing, pinch the victim's nose and give two short breaths (1 second each).  Make sure your mouth makes a tight seal over the victim's mouth, and watch for the chest to rise and fall.  
7. Continue C-A-B until help arrives.

Remember: even if you are untrained, doing compressions alone may help save someone's life.  Compressions help circulate an emergency reserve of oxygen in the victim's lungs and bloodstream from the last breath.  The American Heart Association changed to the C-A-B method so as not to delay this step.  Don't worry about making things worse (if the person is dying, that would be difficult to do);  Just keep calm and do your best.  

These guidelines are no replacement for official CPR training.  My recommendation to anyone reading is to take a CPR certification class so you are well-prepared.  It would also be handy to keep a reference guide available just in case you want to double check some things.

Child CPR

     As you may or may not know, the CPR guidelines for both adults and children were changed by the American Heart Association in October of 2010.  Prior to that, the handy acronym A-B-C indicated the order of operations as "Airway - Breathing - Compressions."  That has now changed to C-A-B, meaning compressions come first.
     Why the change?  With the earlier method, medical professionals were concerned that chest compressions were being delayed too long.  Chest compressions are more important than breathing.  What?!?  Yes, it's true: chest compressions are more important than giving mouth-to-mouth breaths.  In fact, if you are untrained in CPR, you can still give someone only chest compressions until help arrives and may still save their life.  The reason for that is that a reserve supply of oxygen remains in the blood and lungs after a person takes their last breath.  Chest compressions help circulate that vital oxygen through the body, so don't delay!
     Because this post deals with child CPR, here are the new guidelines for children and infants.  This is NOT a replacement for official CPR training.  I recommend taking a class to become certified.  It's also nice to keep a first aid guide on hand in case you have questions in the moment.

1. Check the Scene and make sure everything is safe.
2. Check the Victim, tapping him or her and shouting to make sure he/she is not just sleeping.  Look for injuries.
3. Call for Help, or better yet, send someone else to call while you start CPR.  If you are alone, do five rounds of C-A-B and then call for help.
4. C = Compressions  Roll the victim to his or her back.  For infants (under 1 year), place two fingers in the center of the chest just below the nipple line.  Press down only 1 1/2 inches (you don't need to push hard).  For children, you can place the heel of one hand in the center of their sternum (central rib cage bone) and the other hand on the child's forehead to stabilize, or use two hands.  Lock your elbows and use your body to compress 2 inches, or 1/3 of the depth of the chest.  Do 30 quick compressions in 18 seconds, or almost 2 per second.
5. A = Airway  If trained in CPR, you can now tilt back the head while lifting the chin.  If you have a towel available you can roll it up to help align and support the victim's head.  Look in the mouth for any object that may be blocking the airway, but don't reach in to get it unless you can turn the head and swipe it out.  Otherwise, you may push the object in further.
6. B = Breathing  For an infant, cover the nose and mouth with your mouth and give a light puff.  For children, pinch the nose, make a tight seal over their mouth with yours, and give one breath.  Watch for the chest to rise and fall.  Give a second breath.  If you don't see the chest rise, realign the head and try again.
7. Repeat C-A-B until help arrives or the victim shows signs of life.