Hemorrhaging or Bleeding

"Bleeders"

Methods of Controlling Bleeding

• Direct pressure with sterile bandage, if available
• Elevation
• Pressure Points (if trained)
• Cauterization (as a last resort only)
• Tourniquet (as a last resort only)

Minor Bleeding

• Make sure that all hands dealing with the injury are clean, washed and sterilized.
• Wash the injury.
• Wrap in a firm (but not too tight) bandage. This should stop the bleeding.
• Stitches might be necessary if the wound is more than an inch wide.
• Note that scalp wounds have a tendency to bleed a lot. This normal for even minor head wounds. However, if you are dealing with a head injury, keep an eye out for signs of trauma.

Major Bleeding

• Make sure that all hands dealing with the injury from this point on are clean, washed and sterilized in warm water, soap, and then covered in redwort.
• Lay the down to reduce the risk of fainting, and try to elevate the injured limb (if possible).
• Control the bleeding. Do not clean it the wound, or try to pull out any small objects that have become embedded inside of it (such as pebbles, dirt, splinters of wood). This could make the bleeding worse.
• Use a clean bandage or cloth and apply it to the wound with firm and steady pressure until the bleeding stops.
• Do not remove the bandage to see if the bleeding has halted. This could ruin the clotting that has occurred so far and make the bleeding worse. If the bleeding has soaked through the bandage, do not remove it. Take another sterile bandage and cover the first, keeping up the firm pressure.
• If the bleeding is still severe and cannot be controlled by pressure, there are two options:
  • Cauterization is the act of using extreme heat or cold to destroy tissue. This will seal off the blood vessels and reduce bleeding. The most common way to do this would be to use a brand or blade that is heated within a fire.
  • Tourniquet
    • (This should be used only as a last resort to a potentially fatal injury!) To make a tourniquet, tear cloth into strips that are between two and four inches wide, making them around thirty-six inches long. A tourniquet can also be improvised from a strap, belt, handkerchief, towel, or other suitable material. An improvised tourniquet should be at least two inches wide to distribute pressure over the tissues. NEVER use wire, cord, or anything that will cut into the flesh. A cravat bandage may be used as a tourniquet. The tourniquet must be applied on the limb between the wound and the heart, where its function will be to cut off the blood flow to the injury.
    • Take the strip of cloth and wrap around the limb several times, tying it in a half knot. It is necessary for the cloth to have loose ends left over, long enough to tie together into a second knot.
    • Place a stick between these two knots, twisting it until the bandage is tight enough around the limb to control the bleeding. Then it will be secures.
    • Tourniquets must be checked every ten to fifteen minutes. When the bleeding has slowed enough that it can be managed by direct pressure, release the tourniquet. Return to step four until the bleeding has halted.
• Once bleeding has halted, apply numbweed. Any stitching that needs to be performed can be done now.
• Wrap the injury in a clean bandage, making sure to keep the injured body part still.
• Treat the patient for shock.
• Keep watch for infection.
• Caution: If too much blood is lost, a transfusion might be necessary.

Internal Bleeding

• Pain, tenderness, swelling, or discoloration where injury is suspected.
• Abdominal rigidity or muscle spasms.
• Blood in stomach (visible from blood in vomit), lungs (visible from coughing), blood in stool and urine, bleeding from anus or vagina.
• Showing symptoms of shock:
• Dizziness, without other symptoms--dizziness when going from lying to standing may be the only early sign of internal bleeding.
• Cold and clammy skin.
• Eyes dull, vision clouded, and pupils enlarged.
• Weak and rapid pulse.
• Nausea and vomiting.
• Shallow and rapid breathing.
• Thirst.
• Weak and helpless feeling.

Nosebleeds

• Keep the victim quietly seated, leaning forward if possible. Do not have the patient lean their head back. This will cause the blood to go down the back of their throat, potentially interrupting their ability to breathe.
• Gently pinch the nostrils closed. Keep this up for five to ten minutes, holding firmly.
• Apply cold compresses to the victim's nose and face.
• If the person is conscious, it may be helpful to apply pressure beneath the nostril above the lip.
• Instruct the victim not to blow his or her nose for several hours after bleeding has stopped or clots could be dislodged and start the bleeding again.
• If the bleeding has not stopped after forty minutes, seek a Masterhealer.
• In the case of severe nosebleeds, pack the nostril with gauze. This will apply pressure to the vessel that has ruptured.
• Cauterization may be necessary if the bleeding will not stop.