Stopping of an external bleeding with a direct manual compression and a compressive bandage

Authors: Simulation and Certification Center

Editor: Rednenko V.V.

Equipment for the practical skill:

• simulator;
• vehicle first aid kit.

Clinical situation:      

• While driving your car, you saw an accident on the road. A victim is sitting next to a broken car standing on the side of the road, calling for help. The victim has a wound to his right shin with bleeding from it. A car first aid kit is available for your use. Stop the bleeding.

The procedure for performing a practical skill

• Call for help:
  • ask an eyewitness to call an ambulance and report an accident with a victim;
  • ask the bystander to assist you in providing first aid.
• Make sure the scene is safe. If necessary,
  • stop driving by setting the "Emergency stop" sign and

• • turn off the car engine with the key or ignition switch button.
• Since the victim is conscious, obtain informed consent to the procedure:
  • give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure;
  • explain what you are going to do;
  • ask the patient to consent to procedure.
• Take from the first aid kit protective gloves and put on it.
• Identify a type of the external bleeding:
  • visualize the wound;
  • verify the bleeding;
  • choose a way to stop the bleeding.
• Stop bleeding with a direct manual compression:
  • Take a comfortable position for this manipulation, if it’s possible, use the help of an assistant.
  • Take from the first aid kit an individual sterile medical dressing package and open it. If there is no package, take 2-5 sterile  gauze pads 10x10 cm and stack them on top of each other to form a multi-layer gauze pad.
  • Сover the wound with this pad and apply direct pressure until the bleeding stops. It may take several minutes for the bleeding to stop.

• • If blood soaks through the cotton-gauze pad, put another one on top and apply additional direct pressure (press harder than you did before, if possible). 
  • When the bleeding stops, check for circulation (feeling, warmth and color) beyond the injury.
• Place a compressive bandage:
  • Take a sterile bandage of the individual sterile medical dressing package or a  sterile bandage from the first aid kit.
  • Hold the head of the bandage with your dominant hand and the tail with your non-dominant one.
  • Place a strip of bandage below the wound and make an anchor wrap.

• • Apply the wraps of the bandage in a spiral upward, completely covering the pad. Wrap the bandage around the wound several times to hold the pad(s) in place. Tie ends of the bandage to secure it.

• Check for circulation (feeling, warmth and color) beyond the injury. If there is a change in feeling, warmth or color (indicating that the bandage is too tight), gently loosen it.
• Remove your gloves and wash your hands.
• In the cold season, protect the damaged limb from cold.