Premergency First Aid, CPR and AED Manual

7 Bleeding, Wound Care and Trauma

Impaired circulation to a limb is a serious concern and must be corrected. Advise medical personnel of any circulation problems. No matter the type of injury or the first aid required, the steps of PSM remain the same. Ensure the safety of yourself, the patient, and others as you gain control of the scene and gain consent. Determine the mechanism of injury or the nature of illness, and decide if you need help from 911. Bleeding and wounds that are a life threat are treated during the primary assessment. All other treatment is done during the secondary assessment.

Capillary Refill Test • Place your thumb on the patient’s fingernail with your fingers underneath the patient’s finger and gently squeeze until blood is forced from the capillaries and the nail bed turns white. • Release pressure. As the capillaries refill with blood, the colour will return to pink. • Capillary refill should be prompt. Less than two seconds in both children and adults. • Capillary refill is not used to assess overall quality of perfusion in adults and children.

Checking circulation with the capillary refill test may be delayed or inaccurate in the cold.

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