however, the bleeding will appear to be a steadystream.In actual practice, you might find it difficult todecide whether bleeding is venous or arterial, but thedistinction is not usually important. The importantthing to know is that all bleeding must be controlled asquickly as possible.External hemorrhage is of greatest importance tothe Corpsman because it is the most frequentlyencountered and the easiest to control. It ischaracterized by a break in the skin and visiblebleeding. Internal hemorrhage (which will bediscussed later) is far more difficult to recognize and tocontrol.Control of HemorrhageThe best way to control external bleeding is byapplying a compress to the wound and exertingpressure directly to the wound. If direct pressure doesnot stop the bleeding, pressure can also be applied at anappropriate pressure point. At times, elevation of anextremity is also helpful in controlling hemorrhage.The use of splints in conjunction with direct pressurecan be beneficial. In those rare cases where bleedingcannot be controlled by any of these methods, youmust use a tourniquet.If bleeding does not stop after a short period, tryplacing another compress or dressing over the first andsecuring it firmly in place. If bleeding still will notstop, try applying direct pressure with your hand overthe compress or dressing.Remember that in cases of severe hemorrhage, it isless important to worry too much about findingappropriate materials or about the dangers of infection.The most important problem is to stop rapidexsanguination. If no material is available, simplythrust your hand into the wound. In most situations,direct pressure is the first and best method to use in thecontrol of hemorrhage.Pressure PointsBleeding can often be temporarily controlled byapplying hand pressure to the appropriate pressurepoint. A pressure point is the spot where the mainartery to an injured part lies near the skin surface andover a bone. Apply pressure at this point with thefingers (digital pressure) or with the heel of the hand.No first aid materials are required. The object of thepressure is to compress the artery against the bone, thusshutting off the flow of blood from the heart to thewound.There are 11 principal points on each side of thebody where hand or finger pressure can be used to stophemorrhage. These points are shown in figure 4-27. Ifbleeding occurs on the face below the level of the eyes,apply pressure to the point on the mandible. This isshown in figure 4-27A. To find this pressure point,start at the angle of the jaw and run your finger forwardalong the lower edge of the mandible until you feel asmall notch. The pressure point is in this notch.If bleeding is in the shoulder or in the upper part ofthe arm, apply pressure with the fingers behind theclavicle. You can press down against the first rib orforward against the clavicle; either kind of pressurewill stop the bleeding. This pressure point is shown infigure 4-27B.Bleeding between the middle of the upper arm andthe elbow should be controlled by applying digitalpressure to the inner (body) side of the arm, abouthalfway between the shoulder and the elbow. Thiscompresses the artery against the bone of the arm. Theapplication of pressure at this point is shown in figure4-27C. Bleeding from the hand can be controlled bypressure at the wrist, as shown in figure 4-27D. If it ispossible to hold the arm up in the air, the bleeding willbe relatively easy to stop.Figure 4-27E shows how to apply digital pressurein the middle of the groin to control bleeding from thethigh. The artery at this point lies over a bone and quiteclose to the surface, so pressure with your fingers maybe sufficient to stop the bleeding.Figure 4-27F shows the proper position forcontrolling bleeding from the foot. As in the case ofbleeding from the hand, elevation is helpful incontrolling the bleeding.If bleeding is in the region of the temple or thescalp, use your finger to compress the main artery tothe temple against the skull bone at the pressure pointjust in front of the ear. Figure 4-27G shows the properposition.If the neck is bleeding, apply pressure below thewound, just in front of the prominent neck muscle.Press inward and slightly backward, compressing themain artery of that side of the neck against the bones ofthe spinal column. The application of pressure at thispoint is shown in figure 4-27H. Do not apply pressureat this point unless it is absolutely essential, since there4-31
Integrated Publishing, Inc. - A (SDVOSB) Service Disabled Veteran Owned Small Business