CPR + First Aid + BBP Certification Manual: Trauma Emergencies

Wounds & Bleeding Injuries

Trauma emergencies are injuries caused by physical force or impact. Common examples include wounds, bleeding, falls, cuts, and other accidents.

Types of Open Wounds

Abrasion: A scrape involving damage to the surface of the skin.

Laceration: A cut or tear in the skin or underlying tissue.

Puncture: A wound caused by an object penetrating the skin.

Avulsion: An injury in which skin or tissue is partially or completely torn away.

The severity of a wound depends on factors such as depth, location, and blood loss — not on wound type alone. An avulsion is not automatically more serious than a puncture; a puncture that penetrates deep into the body (such as the chest or abdomen) can be more dangerous than a minor avulsion. The appearance of a wound does not always indicate the full extent of the injury.

Minor External Bleeding

For a minor wound:

1. Ensure scene safety
2. Use gloves or other PPE when available
3. Apply direct pressure until bleeding is controlled
4. Rinse the wound with clean running water
5. Remove only loose surface debris that can be easily cleared
6. Protect the wound with a clean dressing or bandage when appropriate
7. Monitor for redness, swelling, drainage, worsening pain, or other signs of infection

Avoid pouring hydrogen peroxide, alcohol, or other harsh chemicals into a wound.

Special Note:  If the bleeding is from the nose (Epistaxis):  pinch the nose, tilt the head forward and apply an ice pack to the bridge of the nose.

Severe External Bleeding

Life-threatening bleeding may involve:

• Rapid or continuous blood loss
• Blood pooling on the ground
• Blood soaking through clothing or dressings
• Spurting blood
• Partial or complete amputation
• Bleeding that is difficult to control

First Aid Steps:

1. Ensure scene safety
2. Call 911
3. Use PPE when available
4. Apply firm direct pressure to the wound
5. Maintain continuous pressure
6. If blood soaks through, add additional material over the original dressing
7. For life-threatening bleeding from an arm or leg, apply a commercial tourniquet when appropriate
8. Tighten the tourniquet until bleeding stops
9. Record the time of application
10. Do not loosen or remove the tourniquet while awaiting professional care

Current first-aid guidance places direct pressure first and supports tourniquet use for life-threatening extremity bleeding.

Internal Bleeding

Internal bleeding may not be visible.

Possible signs include:

• Pale, cool, or clammy skin
• Weakness
• Dizziness
• Rapid breathing
• Abdominal swelling or pain
• Bruising after significant trauma
• Confusion or reduced responsiveness

Suspected serious internal bleeding requires emergency medical care. Keep the person calm, limit unnecessary movement, and monitor breathing and responsiveness.

Nosebleed

For a typical nosebleed:

1. Have the person sit upright
2. Lean slightly forward
3. Pinch the soft portion of the nose
4. Maintain continuous pressure

Do not tilt the person's head backward. Seek medical attention for heavy, prolonged, recurrent, or trauma-related bleeding.