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Excessive blood loss does not just happen when the skin's broken, a bone can be fractured and the blood can be lost inside the body. For example, if the thigh bone is broken and the skin is not broken, you can lose half to 1 litre of blood. If the skin is broken and there's a bleed, this can be increased to 1 to 2 litres. Fractures in the pelvis can cause minor blood loss of about half a litre to major injuries where you can lose all of the blood. The main femoral artery runs over the pelvis, which is a major artery. Injuries to the spleen, liver, or chest can cause very minimal blood loss to total blood loss. The big problem is recognizing that severe blood loss is actually possible or is actually happening. It's best to assume the worst and treat it as if there is a severe blood loss. It's very hard to work out how much blood has been lost with an external bleed and even harder if it's an internal bleed. It's also difficult to assess blood loss as different people react in different ways which can cover up the signs and symptoms until it gets very serious. Things can affect the way that the signs and symptoms show, things like age, size, weight, underlying medical conditions, their fitness and any medications they're taking. You need to get as much information as possible about the history of what's happened and the mechanism of injury. Things to look out for are pale, cold, and sweaty skin, thirst, a pulse of over 100 beats a minute, altered mental state, anxious, confused, drowsy, restless, and finally unconsciousness. The treatment is to first activate the emergency services, treat external bleeding, and try to identify if there is internal bleeding. Lay them down and elevate their legs if possible. Finally, keep them warm and monitor their consciousness and vital signs.
Recognizing and Treating Blood Loss: First Aid Guide
Understanding Blood Loss
Hidden Threat: Excessive blood loss doesn't always involve visible skin injuries; it can occur internally with fractures or organ damage.
Impact of Fractures: Even when the skin remains intact, a broken thigh bone can lead to blood loss of up to one litre; if there's an external bleed, this can escalate to one to two litres.
Pelvic Fractures: Pelvic fractures can range from minor blood loss to severe cases where a person can lose all their blood, as the main femoral artery passes over the pelvis.
Organ Injuries: Injuries to organs such as the spleen, liver, or chest can result in varying levels of blood loss, from minimal to total.
Recognizing Blood Loss
Challenging Recognition: Identifying severe blood loss can be difficult. It's wise to assume the worst and treat accordingly due to the challenges of assessing both external and internal bleeding.
Factors Affecting Recognition: Various factors like age, size, weight, medical conditions, fitness, and medications can influence how signs and symptoms manifest, potentially masking them until the situation becomes critical.
Assessment and Response
Collect Information: Gather details about the incident history and assess the injury mechanism.
Watch for Signs: Keep an eye out for these signs:
- Pale, Cold, Sweaty Skin
- Rapid Breathing (Over 20 breaths per minute)
- Thirst
- Rapid Pulse (Over 100 beats per minute)
- Altered Mental State
- Anxiety, Confusion, Drowsiness, Restlessness
- Unconsciousness
Emergency Treatment
Immediate Actions:
- Activate Emergency Services: Call for professional help.
- Treat External Bleeding: Address any visible external bleeding.
- Identify Internal Bleeding: Attempt to determine if there is internal bleeding.
Position and Monitor:
- Lay Down: Place the individual on their back.
- Raise Legs (If Possible): Elevate their legs if feasible.
- Keep Warm: Ensure they stay warm.
- Monitor Consciousness and Vital Signs: Continuously assess their consciousness and vital signs.