How to Deal with Severe Bleeding

Lucy Piper: Sometimes when babies and children have accidents you can see when there is an awful lot of blood around, normally is nothing too much to worry about but sometimes it can be more serious. So, what do we do if we suspect there is something more severe? With me now I have got Yvonne from St. John Ambulance and mum Palvi. So, first of all Yvonne, what do you call severe bleeding? Yvonne: Well, for an adult you would think about losing a point, but when you think of a child then relatively less is more significant problem to them. So, a child or a toddler, probably severe bleeding would be counted as about a cup full. It would be and then they start to show signs of blood loss and shock, so you may notice them going very pale, a bit tremble possibly even a little bit of blue tinge around the lips and that is a sign of losing too much blood. Palvi Karia: So what you do if the child goes into shock. Yvonne: Get him to lie down and treat the cause of the shock no matter what it is, it is obviously if the bleeding is severe you need to control that so that the shock doesn’t get any worse. Lay him down, elevate the bleeding part so that the blood loss is reduced, elevate their legs if you can and cover them with a blanket, keep them warm, but anybody who has gone into shock would need to be treated at a hospital. Palvi Karia: And when you say treat the bleeding what would I do? Yvonne: In the first instance, direct pressure. So, wherever the wound is press on it as long as you are sure there is nothing embedded, elevate the injury, get it above the level of the heart and then get the patient into the position that you need, which is basically laid down with legs raised. Lucy Piper: If there is something like grit or anything embedded in the wound, should I don’t take that out? Yvonne: If it’s a minor bruise and there is a grit or anything like that embedded in it and it will wash out easily then fine. You can rinse out them great. But if its something like a piece of glass or a large splinter or a piece of metal, then leave it where it is because first half its plugging the hole, it’s like the coke in the bottle. Secondly, you don’t know how far its gone in, you don’t know what it may have been punctured or been sticking into, and thirdly if it cut going in its going to cut coming out to make the wound worse. You still need to apply direct pressure but in this instance if there is a piece of glass here rather pressing down on top of it, you have to apply pressure on either side, gently but firmly. Palvi Karia: Okay, if I have used towels to protect the wound, to pressure on and if they get saturated by blood, do I remove the towels, replace them all or just leave them? Yvonne: You can get two layers on, so if the first layer it bleeds through, then you can apply second layer. If it bleeds through the second layer then that really is severe bleeding because the body should naturally act to control blood loss. In that case, you need to take the dressings off and go back to stage one which is the direct pressure and elevate. Do that for about ten minutes. Body should kick in and control it by then, and then you can redress it. Lucy Piper: Has bruise what to do if a child is impelled is having say like a fence post or something, should we try and remove the child in that situation? Yvonne: Similar to smaller embedded objects, it’s actually plugging the hole. So, it would be natural instinct to want to pick them off, because it’s hurting them but you can actually cause the problem to be worse by doing that. So, what you would need to do would be to actually support the weight so they didn’t fall on to that any further and impel themselves any deeper but support them where they are, don’t lift them off it. Phone 999 immediately and get the ambulance on the way. Just keep them as calm as you can till they arrive. Palvi Karia: Keeping a child still on a good day is hard enough, how do you do it if he is pain, any tips? Yvonne: If it was something like in impalement then quiet often they will go into shock and they actually may will become unconscious very quickly. If it is severe bleeding or a nasty injury then a bit of a distraction can often work. When we are out on duty dealing with children who are injured we always have a glove puppy or a soft toy on our vehicles in our first aid post. And its amazing how that would distraction can take their mind off it and then now you should treat them. Lucy Piper: Thank you very much Yvonne. Well we hope you wont have do deal with severe bleeding but if you do apply firm direct pressure for ten minutes and cover, apply dressing firmly but not too tight and do check their circulation. If anything is embedded please don’t try to remove it yourself and apply pressure around it.