Premergency First Aid, CPR and AED Manual

7 Bleeding, Wound Care and Trauma

Improving Circulation Once bandages are applied, reassess circulation. If circulation is impaired after bandaging, then you must take steps to improve it. Maintain pressure on the dressing while loosening and reapplying the bandages. Reassess circulation again below the injury. If circulation does not improve after reapplying the bandages, it may be due to the position of the limb. Blood vessels can be compressed or pinched when an arm or leg is in certain positions. Gently reposition the limb, keeping it in a natural position. This may allow circulation to resume. Never move a limb more than patient comfort allows. If any resistance is felt, do not attempt to force a limb into position as this can cause further damage to the tissue, bones, and joints. Reassess circulation frequently.

Checking circulation Some injuries to limbs may impair circulation and cut off perfusion to tissue below the injury. This is more common in joint injuries and fractures. Impaired circulation below an injury can also be caused by bandages that are applied too tightly. Sometimes a bandage may be applied correctly but later becomes too tight as the injury swells. Once bleeding is controlled, assess the circulation below the injury before applying a bandage. Circulation is assessed by comparing results from the injured side to the uninjured side. Signs of impaired circulation include: • Skin colour – paler skin on the injured side • Pulse – absent or weaker on injured side • Capillary refill test – slower on injured side

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