How to Treat a Significantly Bleeding Injury

In this post, you’ll learn about CARE and how to bandage an injury that is bleeding significantly but does not have an impaled or embedded object in the wound.

Hi my name’s Tom from the First Aid Training Co-operative and in this video we’re going to show you how to bandage a casualty who is significantly bleeding. What we’re going to use for these bandaging exercises is some wound dressings. Wound dressings commonly come in packs like this and they are in a variety of different sizes. This one here is a medium.

Importantly with any bandage make sure you check that it’s still within its expiry date so that it’s still sterile.

We’ve got some that we’ve opened up already. I’ve already got my gloves on because there’s an obvious cross-contamination issue with dealing with somebody else’s blood and what we’re going to use is our acronym CARE to treat a significant bleed.

So the first letter is C and that stands for CLEAN and CHECK.

So to clean and check an injury what I’m going to use is any water that I would happily drink and I’m going to give the injury on his arm here a really good clean and check for any foreign objects.

If there was a foreign object I would not pull it out as it could be plugging a hole.

I may also need to cut away clothing so if he was wearing trousers I might need to cut around so I could see the injury properly before I clean and check it.

So let’s have a shot of doing some bandaging!

Cory: ”Tom I’ve cut my arm really badly”

Tom: ”Dear oh dear Cory!”

Tom: “So I’m just going to use a wound dressing here on your arm Cory. I see you’ve got your hand over it, do you think there’s anything in it?”

Cory: “Don’t think so!”

Ok so I’m going to give that a good clean and make sure there’s nothing inside it.

The first thing I’m going to do Cory with this wound dressing is I’m going to APPLY – so A from my acronym.

Tom: “So apply some pressure then I’m just going to lay that on. If you take your hand away please and then put it back on and keep squeezing that nice and tight.”

OK so we’ve got control, Cory is applying pressure to his own injury, so I’m just going to let this short end of the dressing hang down and then I’m going to unwrap this end using the bandage there to hold the pad in place.

I’m going to keep coming around, working my way up his limp.

Tom: “That’s good Cory, you are doing a fine job there”.

I’m trying to keep the bandage nice and wide as best as I can and also trying to cover up both ends of the pad.

And what’s happened there is I’ve slightly ran out of bandage there so I’m just going to tie this up on this end here, trying to close in the pad as much as possible, being careful that the knot doesn’t press directly down on the wound and make sure that it’s all nice and neat.

So I’ve CLEAN, I’ve APPLIED pressure to the wound, the next thing I’m going to do is RAISE the wound up.

I need it to be above his heart and while I’m checking it out, that’s a good place for it to be but in the longer term I probably would just place it up on his shoulder so it’s still above his heart.

The last of my letters in my acronym CARE is E and that stands for ENSURE.

Now there’s three things I want to ensure. I want to ensure that:

1) First of all the bandage isn’t going to fall off so I’m just going to rub my finger up and down and make sure that it’s not slipping and it’s not moving.

2) The other thing I want to make sure or ENSURE is that it’s not too tight so if I just squeeze a knuckle I can check the capillary refill in Cory’s hand and make sure that his circulation is maintained. I’m going to compare one hand against his other hand to ensure that they are both the same then I know that there’s good circulation being maintained.

3) For the last of my checks I need to ensure that my bandage has worked so I’m just checking for any bleeding that said that might still be happening. If indeed it was I would apply another bandage over the top and go through my checks again.

CHECK Summary

In summary, to address a significantly bleeding injury we’re going to:

  • C = CLEAN and CHECK the wound with any water that we’d be happy to drink
  • A = We’re going to APPLY indirect pressure using an absorbent pad and some form of bandaging
  • R = We’re going to RAISE the limb up above the casualties heart
  • E = We’re going to ENSURE that it’s been effective by doing that we’re going to make sure that the bandage isn’t too loose or too tight and that the casualty isn’t still bleeding.