however, the bleeding will appear to be a steady
stream.
In actual practice, you might find it difficult to
decide whether bleeding is venous or arterial, but the
distinction is not usually important. The important
thing to know is that all bleeding must be controlled as
quickly as possible.
External hemorrhage is of greatest importance to
the Corpsman because it is the most frequently
encountered and the easiest to control.
It is
characterized by a break in the skin and visible
bleeding. Internal hemorrhage (which will be
discussed later) is far more difficult to recognize and to
control.
Control of Hemorrhage
The best way to control external bleeding is by
applying a compress to the wound and exerting
pressure directly to the wound. If direct pressure does
not stop the bleeding, pressure can also be applied at an
appropriate pressure point. At times, elevation of an
extremity is also helpful in controlling hemorrhage.
The use of splints in conjunction with direct pressure
can be beneficial. In those rare cases where bleeding
cannot be controlled by any of these methods, you
must use a tourniquet.
If bleeding does not stop after a short period, try
placing another compress or dressing over the first and
securing it firmly in place. If bleeding still will not
stop, try applying direct pressure with your hand over
the compress or dressing.
Remember that in cases of severe hemorrhage, it is
less important to worry too much about finding
appropriate materials or about the dangers of infection.
The most important problem is to stop rapid
exsanguination. If no material is available, simply
thrust your hand into the wound. In most situations,
direct pressure is the first and best method to use in the
control of hemorrhage.
Pressure Points
Bleeding can often be temporarily controlled by
applying hand pressure to the appropriate pressure
point. A pressure point is the spot where the main
artery to an injured part lies near the skin surface and
over a bone. Apply pressure at this point with the
fingers (digital pressure) or with the heel of the hand.
No first aid materials are required. The object of the
pressure is to compress the artery against the bone, thus
shutting off the flow of blood from the heart to the
wound.
There are 11 principal points on each side of the
body where hand or finger pressure can be used to stop
hemorrhage. These points are shown in figure 4-27. If
bleeding occurs on the face below the level of the eyes,
apply pressure to the point on the mandible. This is
shown in figure 4-27A. To find this pressure point,
start at the angle of the jaw and run your finger forward
along the lower edge of the mandible until you feel a
small notch. The pressure point is in this notch.
If bleeding is in the shoulder or in the upper part of
the arm, apply pressure with the fingers behind the
clavicle. You can press down against the first rib or
forward against the clavicle; either kind of pressure
will stop the bleeding. This pressure point is shown in
figure 4-27B.
Bleeding between the middle of the upper arm and
the elbow should be controlled by applying digital
pressure to the inner (body) side of the arm, about
halfway between the shoulder and the elbow. This
compresses the artery against the bone of the arm. The
application of pressure at this point is shown in figure
4-27C. Bleeding from the hand can be controlled by
pressure at the wrist, as shown in figure 4-27D. If it is
possible to hold the arm up in the air, the bleeding will
be relatively easy to stop.
Figure 4-27E shows how to apply digital pressure
in the middle of the groin to control bleeding from the
thigh. The artery at this point lies over a bone and quite
close to the surface, so pressure with your fingers may
be sufficient to stop the bleeding.
Figure 4-27F shows the proper position for
controlling bleeding from the foot. As in the case of
bleeding from the hand, elevation is helpful in
controlling the bleeding.
If bleeding is in the region of the temple or the
scalp, use your finger to compress the main artery to
the temple against the skull bone at the pressure point
just in front of the ear. Figure 4-27G shows the proper
position.
If the neck is bleeding, apply pressure below the
wound, just in front of the prominent neck muscle.
Press inward and slightly backward, compressing the
main artery of that side of the neck against the bones of
the spinal column. The application of pressure at this
point is shown in figure 4-27H. Do not apply pressure
at this point unless it is absolutely essential, since there
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