Bleeding Control, Shock, and Wound Management
What the exam tests
This domain tests direct pressure, wound packing, tourniquet use, shock recognition, and safe dressing of wounds and impaled objects.
Core rules
- Control severe bleeding with firm direct pressure using a dressing or clean cloth. Add layers if blood soaks through; do not remove the first dressing.
- For life-threatening extremity bleeding not controlled by pressure, apply a manufactured tourniquet 5–7 cm above the wound, not over a joint, and record the time.
- Pack junctional wounds (neck, shoulder, groin) with gauze and apply pressure if trained.
- Shock signs include pale or cold skin, rapid weak pulse, thirst, anxiety, and altered consciousness. Lay the patient flat, keep warm, and do not give food or drink.
- Stabilize impaled objects in place; do not remove them. Cover open wounds with a sterile dressing.
Worked example
A worker sustains a deep thigh laceration from a metal sheet. Direct pressure with gauze does not stop the bleeding. The first aider applies a tourniquet high and tight above the wound, notes the application time, and calls EMS. The patient becomes pale and thirsty; the first aider keeps the patient flat and warm and gives nothing by mouth.
Traps that cost marks
- Loosening or removing a tourniquet once bleeding is controlled.
- Applying a tourniquet for minor bleeding that direct pressure can control.
- Removing an impaled object or pulling out blood-soaked dressings.
- Giving water to a shocked patient.
Key points
- Direct pressure is first-line bleeding control.
- Tourniquets are for life-threatening extremity bleeding; record the time.
- Pack junctional wounds if trained.
- Keep shock patients flat, warm, and NPO.
- Stabilize impaled objects; never remove them.