Premergency First Aid, CPR and AED Manual

7 Bleeding, Wound Care and Trauma

• Compression – Apply mild pressure over the site to slow bleeding and decrease swelling. • Elevation – Raise the injured part slightly higher than the heart to decrease swelling. Do not use RICE on open wounds or if the skin is being pushed up from a broken bone. In addition to RICE, splinting or immobilizing a wound decreases bleeding and reduces pain (See Chapter 8, Muscle, Bone, and Joint Injury). While using these measures to control bleeding and swelling, be aware of signs and symptoms of developing shock, including agitation, anxiety, changes in mental status, increased breathing rate, increased heart rate, and cool, clammy skin. Any or all of these may indicate internal bleeding from injury to internal organs. If the patient shows signs and symptoms of shock, treat accordingly. (See Chapter 4, Circulation and Shock).

Closed soft tissue injuries Small contusions, bumps, and bruises, require little first aid. More extensive closed injuries can have significant swelling and bleeding under the skin. This can lead to shock. Before treating a closed injury, take standard precautions and ensure safety. Although soft tissue injury can look very dramatic, you must still focus on maintaining the airway and breathing and be ready to provide CPR if needed. Treat soft tissue injury with RICE: • Rest – Keep the patient as quiet and comfortable as possible. • Ice – Use ice, a cold pack, or cold compresses to slow bleeding, swelling, and pain.

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