5.1 Types of wounds and bleeding

Wounds come in various types, from minor scrapes to severe lacerations. Understanding these differences is crucial for proper first aid. Open wounds involve breaks in the skin, while closed wounds damage tissues beneath the surface. Recognizing wound types helps determine appropriate treatment.

Bleeding can be classified by source (arterial, venous, or capillary) and location (internal or external). Knowing how to control bleeding through hemostasis techniques is vital. In severe cases, hemorrhage can be life-threatening, requiring immediate intervention to prevent shock and organ failure.

Types of Wounds

Open Wounds

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• Abrasion occurs when skin is rubbed or scraped away (road rash)
• Laceration is a cut or tearing of skin caused by an object (knife wound)
• Puncture wound is a small hole caused by a long, pointy object such as a nail or needle
  • May be deceiving because external bleeding can be limited while causing extensive internal damage
• Avulsion involves tissue being partially or completely torn away (gunshot wound)
• Amputation is the complete removal of a body part (severed finger)

Closed Wounds

• Contusion (bruise) occurs when blood vessels are damaged or broken underneath the skin
  • Causes bleeding beneath the surface of the skin without breaking the skin
  • Blood leaks into tissues under the skin causing discoloration (black eye)

Bleeding Classifications

Bleeding Source

• Arterial bleeding is bright red and spurts with each heartbeat due to high pressure in the arteries
• Venous bleeding is dark red and flows steadily from the veins
• Capillary bleeding oozes slowly since capillaries are small blood vessels (scraped knee)

Bleeding Location

• Internal bleeding occurs inside the body when blood leaks from blood vessels or organs
  • Can be hard to recognize but can cause shock and be life-threatening (ruptured spleen)
• External bleeding occurs outside the body from a natural opening or break in the skin
  • Visible bleeding that can be easier to identify and control (nosebleed)

Bleeding Control

Hemostasis

• Hemostasis is the body's physiological process to stop bleeding
  • Involves three steps: vascular spasm, platelet plug formation, and coagulation (blood clotting)
• Vascular spasm is the first response as blood vessels constrict to restrict blood flow
• Platelets stick together and adhere to the vessel wall forming a plug to seal the hole
• Coagulation reinforces the platelet plug with threads of fibrin to form a stable clot

Hemorrhage

• Hemorrhage is the loss of a large amount of blood in a short time
  • Can lead to shock, organ failure, and death if not treated promptly
• Control hemorrhage by following steps: direct pressure, elevation, pressure points, and tourniquet
  • First apply direct pressure on the wound with a dressing
  • Elevate the wound above the level of the heart if possible
  • Apply pressure to an artery proximal to the wound to slow blood flow (brachial artery for arm wounds)
  • A tourniquet is a last resort that stops arterial blood flow to a limb (combat situations)