Severe Bleeding from a Kitchen Accident
You are visiting a friend's house when you hear a crash and a scream from the kitchen. You find your friend's 40-year-old spouse on the floor, holding their forearm. There is a deep laceration on the inner forearm, and blood is spurting out in rhythmic pulses. The wound is bleeding heavily, and blood is pooling on the floor. The person is pale, sweaty, and says they feel dizzy. You have a first aid kit with gloves, gauze pads, roller bandage, and a tourniquet. The person is conscious and breathing. You are the only one with first aid training. Another person is calling 911.
1. What is your immediate priority and how do you control the bleeding?
Read the worked answer
The spurting blood indicates arterial bleeding, which is life-threatening. Put on gloves. Apply direct pressure to the wound with a sterile gauze pad or clean cloth. Press firmly and continuously. If blood soaks through, do not remove the pad; add more pads on top and continue pressure. If bleeding is not controlled with direct pressure, and the wound is on an extremity, apply a tourniquet above the wound (proximal to the bleeding) and tighten until bleeding stops. Note the time. Do not loosen the tourniquet. Keep the person lying down and calm; monitor for signs of shock (pale, sweaty, dizzy). Do not give anything to eat or drink.
2. After applying a tourniquet, the bleeding stops. The person becomes more pale and drowsy. What do you do?
Read the worked answer
The person is showing signs of shock (pale, drowsy, dizzy). Keep them lying flat, elevate the legs if possible (unless there is an injury that prevents it), and keep them warm with a blanket. Monitor breathing and consciousness. Do not remove the tourniquet. Continue to reassure the person and wait for EMS. If the person becomes unresponsive and stops breathing, begin CPR. If they become unresponsive but are breathing, place them in a recovery position. Record the time the tourniquet was applied and report it to EMS.