Module 3 Bleeding and Shock
Unit 1: The Circulatory System
Let’s start off this module by briefly looking at how blood moves around our
body through the circulatory system.
The heart is a muscular pump responsible for pushing blood around the
body. Blood travels in arteries, veins, and capillaries. Its purpose is
to transport Oxygen and nutrients around the body and to remove waste
products such as Carbon Dioxide.
An average adult has around 5 liters of blood in their body.
The Different Types of Blood Vessels
The three types of blood vessel will cause different types of bleeding from a
victim.
Arteries: Carry blood under high pressure away from the heart. Blood is
likely to spurt out of a wound.
Veins: Carry blood under low pressure back to the heart. Blood will flow
steadily from the wound
Capillaries: Carry blood to the individual cells and tissues, very small and
very low pressures. Blood will ooze from the wound.
Types of Wound
There are various types of wound that a victim may sustain.
Laceration: Tearing of the skin & tissue
Contusion: A bruise
Abrasion: Graze – loss of the superficial layer of skin
Incision: A straight clean wound
Puncture: Caused by a sharp object which may still be in the wound
(foreign / embedded object)
Unit 2: Dealing with Major Bleeding
Major bleeding is life-threatening and requires urgent first aid intervention
to prevent further blood loss and the development of shock.
First Aid Steps for Major Bleeding
1. Expose injury and elevate above level of the heart
2. If there are no foreign objects, apply firm direct pressure over the
wound
3. If there is an object, apply pressure around the foreign object
4. Call for emergency medical help
A useful mnemonic to help you remember the first aid steps for major
bleeding is ‘PEEP‘.
P: Position – position the victim in a safe / comfortable position
E: Elevate limbs
E: Expose & examine the injury. Check for any embedded or foreign
objects such as pieces of glass.
P: Pressure – apply direct pressure over the injury to control blood loss
Do not apply a tourniquet unless specifically trained to do so. Do not
attempt to wash out a major wound – your aim is to control the bleeding as
quickly as possible. Watch for signs and symptoms of shock (next unit)
Video: applying a bandage
If you have access to first aid materials, you may be able to apply a sterile
bandage to a wound. Applying a bandage provides direct pressure and
reduces the risk of infection. The following video demonstrates how to
apply a sterile bandage
[Link]
Unit 3: Puncture Wounds
A puncture wound occurs when an object pierces the skin and enters a
tissue of the body. This creates an open wound which is painful and may be
bleeding. Punctures may occur due to any sharp objects such as glass,
scissors, knives, pins, nails, wood splinters and sharp stones.
The object may remain embedded in the wound or may have passed clean
through the body part involved.
1. Do not remove the object unless it is very small (for example a small
splinter)
2. Stop the bleeding by applying pressure around the wound – take
care not to dislodge the object
3. If possible, elevate the limb to prevent further blood loss
4. Seek urgent medical attention
It is important to keep the object as still as possible to prevent further injury
to the deeper structures below the skin. Whilst it is tempting sometimes to
attempt to remove the object, this can worsen the situation by causing
further bleeding and tissue damage. Removal of embedded objects should
only be carried out by a medical professional.
Unit 4: Shock
What is shock?
A lack of oxygen and essential nutrients reaching the tissues
Shock is a medical emergency which can be caused by severe blood
loss. The casualty does not receive enough oxygen and other essential
nutrients due to the loss of blood.
Remember that blood is the major transport mechanism in the body for
oxygen and vital nutrients. If you have lost half your blood volume (on the
floor in a puddle) then that blood is not available to transport oxygen and
nutrients to your important organs.
Medical shock is not the same as emotional shock
Many people are confused about what shock means. The mass media use
the term ‘shock’ to refer to people who have been emotionally affected by a
traumatic incident.
However – this is not the same as medical shock.
Medical shock is a life-threatening medical emergency. There are various
causes of shock, major blood loss will cause hypovolemic shock.
Hypovolemic means low blood volume.
How to recognize shock
Signs & symptoms of shock include:
▪ Pale, cold and clammy skin
▪ Confusion
▪ Drowsiness (reducing level of consciousness)
▪ Fast, weak pulse
▪ Fast, shallow breathing
If a casualty has lost a lot of blood, you should be actively looking for signs
and symptoms of shock.
First aid treatment for shock
If you suspect a casualty is suffering from shock, then you should:
1. Control any external blood loss (think PEEP from the last unit)
2. Lie the casualty down and raise their legs if possible
3. Cover the casualty with a coat or blanket to keep them warm
4. Call for emergency medical help
Do not give the casualty anything to eat or drink! Stay with them until
medical help arrives. If the casualty becomes unconscious / unresponsive
then you should place them into the recovery position. If they stop
breathing normally then commence CPR.
The key skill for a first aider is being able to recognize shock developing
early and call for prompt medical assistance.
Video: First aid for shock
This video goes into a bit more depth about the different types of shock.
[Link]
Unit 5: Minor Wounds
Nearly all of us will have suffered a minor wound at some point in our lives.
There are some simple first aid steps you can take if someone has suffered
a minor wound:
1. Wash your hands and wear gloves
2. Clean the wound thoroughly with antiseptic wipes or clean running
water
3. Cover the wound using a clean dressing (plaster, non-adherent pad
etc.).
Caution: Do not remove any embedded objects (e.g: glass) – seek medical
advice if there are any objects in a wound.
Most minor wounds will heal with time and these simple first aid steps.
However, sometimes they can become infected. You should watch out for
signs and symptoms of an infected wound:
▪ Increasing pain
▪ Area around the wound become red, swollen, and warm to touch
▪ The wound starts producing discharge / pus
▪ The casualty develops a temperature / fever
Below is an example of an infected minor wound (click on the photo to
enlarge). You can clearly see the area around the wound has become red
and swollen. The wound is also producing a yellow discharge. If you
suspect a minor wound has become infected, then you should seek urgent
medical attention.
End of Module 3 Quiz
Module 3 quiz
Question #1: How much blood does the average adult have?
a) 10 pints
b) 8 pints
c) 12 pints
d) 13 pints
Question #2: What is a contusion?
a) A large wound
b) A tearing of the skin
c) A head injury
d) A bruise
Question #3: Elevating a limb can slow down bleeding
a) True
b) False
Question #4: You should remove an object from a wound to help stop the
bleeding
a) True
b) False
Question #5: Direct pressure is the best way to stop major external
bleeding
a) True
b) False