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Chapter 4 - Page 2

Control Bleeding

In a survival situation, you must control serious bleeding immediately because replacement fluids normally are not available and the victim can die within a matter of minutes. External bleeding falls into the following classifications (according to its source):

You can control external bleeding by direct pressure, indirect (pressure points) pressure, elevation, digital ligation, or tourniquet.

Direct Pressure

The most effective way to control external bleeding is by applying pressure directly over the wound. This pressure must not only be firm enough to stop the bleeding, but it must also be maintained long enough to "seal off" the damaged surface.

If bleeding continues after having applied direct pressure for 30 minutes, apply a pressure dressing. This dressing consists of a thick dressing of gauze or other suitable material applied directly over the wound and held in place with a tightly wrapped bandage (Figure 4-2). It should be tighter than an ordinary compression bandage but not so tight that it impairs circulation to the rest of the limb. Once you apply the dressing, do not remove it, even when the dressing becomes blood soaked.

Figure 4-2. Application of a pressure dressing

Leave the pressure dressing in place for 1 or 2 days, after which you can remove and replace it with a smaller dressing.

In the long-term survival environment, make fresh, daily dressing changes and inspect for signs of infection.

Elevation

Raising an injured extremity as high as possible above the heart's level slows blood loss by aiding the return of blood to the heart and lowering the blood pressure at the wound. However, elevation alone will not control bleeding entirely; you must also apply direct pressure over the wound. When treating a snakebite, however, keep the extremity lower than the heart.

Pressure Points

A pressure point is a location where the main artery to the wound lies near the surface of the skin or where the artery passes directly over a bony prominence (Figure 4-3). You can use digital pressure on a pressure point to slow arterial bleeding until the application of a pressure dressing. Pressure point control is not as effective for controlling bleeding as direct pressure exerted on the wound. It is rare when a single major compressible artery supplies a damaged vessel.

Figure 4-3.Pressure points

If you cannot remember the exact location of the pressure points, follow this rule: Apply pressure at the end of the joint just above the injured area. On hands, feet, and head, this will be the wrist, ankle, and neck, respectively.

WARNING
Use caution when applying pressure to the neck. Too much pressure for too long may cause unconsciousness or death. Never place a tourniquet around the neck.

Maintain pressure points by placing a round stick in the joint, bending the joint over the stick, and then keeping it tightly bent by lashing. By using this method to maintain pressure, it frees your hands to work in other areas.

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Updated: 12 January 2008
Born on 25 October 1999