Module
Bleeding & Shock
Adult blood volume
~5 litres = roughly 7% of body weight. Major loss → shock → organ failure → death without treatment.
Bleeding types
- Arterial — bright red, pulsating, fast loss
- Venous — dark red, steady flow
- Combined — both
1. Direct pressure
- Wear gloves
- Expose the wound (cut clothing if needed)
- Sterile gauze or clean cloth, press hard with palm or fingers
- Elevate the limb if possible
- For groin or neck arterial bleed — direct pressure is often the only option
2. Compression bandage
- Sterile gauze on the wound
- A few wraps of base bandage to fix it
- Place a tightly-rolled second bandage ON TOP of the wound
- Wrap firmly with the rest of the base bandage
- Check distal limb: if pale, tingling, or restricted — too tight
- If it bleeds through: add another rolled pad on top and wrap again
3. Esmarch tourniquet — last resort
- Use for amputations or uncontrolled limb bleeds
- Place 5–8 cm above the wound (above the joint if a joint is between)
- Tighten with a stick-like windlass until bleeding stops
- Fix the windlass with a triangular cloth so it doesn't unwind
- WRITE DOWN the time of application
- Never loosen it yourself — only EMS
- Sometimes two tourniquets stacked are needed
After-care for major bleeding
- Comfortable position; severe → flat on back
- Loosen tight clothing
- Amputation: care for both stump and amputated part
- Immobilise the limb
- Re-check the dressing every 5–10 min
- Cover with metallised foil (warmth)
- No food or drink — only moisten lips
- SAMPLE
Signs of shock
- Pale, sweaty, cold skin
- Rapid weak pulse
- Rapid shallow breathing
- Anxiety, restlessness, then drowsiness
- Thirst
- Decreasing consciousness