Controlling External Bleeding
TYPES OF WOUNDS
Incision is the type of wound made by 'slicing' with a sharp knife or sharp piece of metal. 
Laceration is a deep wound with associated loss of tissue — the type of wound barbed wire would cause. 
Abrasion is a wound where the skin layers have been scraped off. 
Puncture wounds are perforations, and may be due to anything from a corkscrew to a bullet. 
Amputation is the loss of a digit or limb by trauma. 

CARE AND TREATMENT

LIFE THREATENING BLEEDING
- DRABC 
- quickly check the wound for foreign matter 
- immediately apply pressure over the wound to stop any bleeding 
-call 000 [911] for an ambulance 
- apply a non-adherent dressing 
- apply a pad 
- lay the casualty down 
- raise and support the injured part above the level of the heart if possible 
- apply a firm roller bandage 
-treat for shock if required 

INCISIONS and LACERATIONS.
- DRABC 
- quickly check the wound for foreign matter 
- immediately apply pressure to stop any bleeding 
- apply a non-adherent dressing 
- apply a firm roller bandage 
- immobilise and elevate the injured limb if injuries permit 

ABRASIONS
- DRABC 
- check the wound for foreign matter 
- swab with a diluted antiseptic solution 
- apply a non-adherent dressing or a light, dry dressing if necessary  

PUNCTURE WOUND
- DRABC 
- check the wound — do not remove any penetrating object 
- apply pressure to stop any bleeding 
- stabilise with a ring pad and non-adherent dressing 
- apply a firm roller bandage 
- rest and elevate injured limb if injuries permit 

AMPUTATION
- DRABC 
- apply immediate pressure to stop any bleeding 
- apply a large pad or dressing to the wound 
- treat for shock 
- rest and elevate injured limb if possible 
- collect amputated part — keep dry, do not wash or clean 
- seal the amputated part in plastic bag or wrap in similar waterproof material 
- place in iced water — do not allow the part to come in direct contact with ice.  - Freezing will kill tissue. 
- ensure the amputated part travels to the hospital with the casualty 

 
Shock
CAUSES OF SHOCK
- Loss of blood and body fluids — may be due to haemorrhage, burns, 
  dehydration and severe vomiting and diarrhoea 
- Heart attack — this is a very serious condition 
- Sepsis or toxicity — such as severe blood poisoning 
- Spinal injuries — due to the injury and the reaction of the nervous system 

SIGNS AND SYMPTOMS
- pale, cool, clammy skin      - thirst       - rapid, shallow breathing 
- rapid, weak pulse      - nausea and/or vomiting 
- evidence of loss of body fluids, or high temperature if sepsis present 
- collapse and unconsciousness 
- progressive 'shut-down' of body's vital functions

CARE AND TREATMENT
- DRABC 
- control any bleeding 
- call 000 [911] for an ambulance 
- if conscious, position supine, with legs elevated 
- if unconscious, stable side position with support under the legs to elevate them 
- reassurance 
- maintain body temperature, but do not overheat 
- treat any other injuries  
 

 
 
Slings
The Arm Sling
- Support the injured forearm approximately parallel to the ground with the wrist 
  slightly higher than the elbow. 
- Place an open triangular bandage between the body and the arm, with its apex 
  towards the elbow. 
- Extend the upper point of the bandage over the shoulder on the uninjured side. 
- Bring the lower point up over the arm, across the shoulder on the injured side to 
  join the upper point and tie firmly with a reef knot. 
- Ensure the elbow is secured by folding the excess bandage over the elbow and 
  securing with a safety pin. 

Elevated Sling
- Support the casualty’s arm with the elbow beside the body and the hand extended 
  towards the uninjured shoulder. 
- Place an opened triangular bandage over the forearm and hand, with the apex 
  towards the elbow. 
- Extend the upper point of the bandage over the uninjured shoulder. 
- Tuck the lower part of the bandage under the injured arm, bring it under the elbow 
  and around the back and extend the lower point up to meet the upper point at the 
  shoulder. 
- Tie firmly with a reef knot. 
- Secure the elbow by folding the excess material and applying a safety pin, then 
  ensure that the sling is tucked under the arm giving firm support. 
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