First aid is the immediate temporary care given to a victim of accident or illness before the availability of a physician is acquired. It is imperative that people should have proper training in first aid since an emergency may happen anytime.

A well-stocked first aid kit is a handy thing to have. To be prepared for emergencies, the Red Cross recommends keeping a first aid kit in your home, in your car and at the workplace.

If possible, the Mayo Clinic recommends that before you try to stop severe bleeding, wash your hands to avoid infection and put on synthetic gloves. Don’t reposition displaced organs. If the wound is abdominal and organs have been displaced, don’t try to push them back into place. Cover the wound with a dressing.

For other cases of severe bleeding, follow these steps:

Have the injured person lie down. If possible, position the person’s head slightly lower than the trunk or elevate the legs. This position reduces the risk of fainting by increasing blood flow to the brain. If possible, elevate the site of bleeding.

While wearing gloves, remove any obvious dirt or debris from the wound. Don’t remove any large or more deeply embedded objects. Don’t probe the wound or attempt to clean it at this point. Your principal concern is to stop the bleeding.

Apply pressure directly on the wound. Use a sterile bandage, clean cloth or even a piece of clothing. If nothing else is available, use your hand.

Maintain pressure until the bleeding stops. Hold continuous pressure for at least 20 minutes without looking to see if the bleeding has stopped. You can maintain pressure by binding the wound tightly with a bandage (or even a piece of clean clothing) and adhesive tape.

Don’t remove the gauze or bandage. If the bleeding continues and seeps through the gauze or other material you are holding on the wound, don’t remove it. Instead, add more absorbent material on top of it.

Squeeze a main artery if necessary. If the bleeding doesn’t stop with direct pressure, apply pressure to the artery delivering blood to the area of the wound. Pressure points of the arm are on the inside of the arm just above the elbow and just below the armpit.

Pressure points of the leg are just behind the knee and in the groin. Squeeze the main artery in these areas against the bone. Keep your fingers flat. With your other hand, continue to exert pressure on the wound itself.

Immobilize the injured body part once the bleeding has stopped. Leave the bandages in place and get the injured person to the emergency room as soon as possible.

If you suspect internal bleeding, call 911 or your local emergency number. Signs of internal bleeding may include:
• Bleeding from body cavities (such as the ears, nose, rectum or vagina);
• Vomiting or coughing up blood;
• Bruising on neck, chest, abdomen or side (between ribs and hip);
• Wounds that have penetrated the skull, chest or abdomen;
• Abdominal tenderness, possibly accompanied by rigidity or spasm of abdominal muscles;
• Fractures. Shock, indicated by weakness, anxiety, thirst or skin that’s cool to the touch.

For exterior bleeding, it’s important to know the various types of dressing and bandage materials available. A dressing is administered to cover an open wound. Since this material comes in direct contact with the wound there are several dos and don’ts to take into consideration when applying a dressing. The purpose of a dressing is to control bleeding, prevent infection, absorb blood and wound drainage and to protect the wound from further injury.

 Whenever possible a dressing should be:
• Sterile to lessen the likelihood of infection. If a sterile dressing is not available, using a clean cloth, such as a handkerchief, towel or washcloth would be appropriate.
• Larger than the wound to offer full protection.
• The material used should be soft, thick and compressible so pressure can be evenly distributed over the wound.
• Lint free in order to protect the wound from foreign particles.

Adhesive strips or band-aids, are primarily used for small cuts and abrasions. They are individually wrapped to ensure sterilization and can be used both as a bandage or a dressing.

Gauze pads are a good sterile dressing to be used on small wounds. They come in various sizes and are covered with a protective coating which keep them from sticking to a wound that is secreting fluid or a burn. Each pad comes individually wrapped to remain sterile until opened. For larger wounds, trauma dressings are available. They are large, absorbent, sterile and thick. In an emergency, individually wrapped sanitary napkins can also be used to dress a larger wound. Though these products are not sterile they serve well, for they are both absorbent and bulky.

When applying a sterile dressing do:
• Wash your hands before administering a dressing whenever possible.
• Use a dressing that is larger than the wound, covering the wound completely. • Hold the dressing by one corner and place the dressing directly over the wound. Never slide the dressing across the wound.
• Cover the dressing with one of the types of bandages described below. When applying a dressing to a wound do not:
• Touch any part on the wound or the dressing that comes in direct contact with the wound.
• Breath, talk or cough on the wound or the dressing.
• Use a fluffy cotton type of material or cotton balls. Cotton contains fibers that can get inside a wound, making it difficult to remove.
• Remove a blood-soaked dressing until the bleeding has completely stopped. Instead simply cover the dressing with a second dressing.
• Pull off a dressing that has adhered to a wound. Rather soak the dressing in warm water in order to remove the dressing without causing further injury.

 Bandages are used for a variety of reasons. A bandage can be used to hold a dressing in place over an open wound. It can be used to apply direct pressure over a dressing to assist in controlling bleeding. Bandages can also be used to prevent or reduce swelling and they can provide support for a joint or extremity.

 A bandage should be clean, but it does not need to be sterile since it does not come in direct contact with an open wound.

There are four basic types of bandages.

1) Roller bandages come in a variety of lengths and widths to accommodate various parts of the body. You would want to apply a 1-inch width bandage on a finger or toe wound, while a four or 6- inch width bandage would be more appropriate to wrap an ankle or knee injury.

Some roller bandages are made of self-adhering material, which is slightly elastic and gauzelike to conform to the body. They are easier to apply and can be used for a variety of injuries. Gauze rollers are more rigid as they are made of cotton and contain no elasticity. Also available are elastic roller bandages.

This type of roller bandage is not usually applied to a wound dressing. Rather, they are to be used for injuries requiring compression such as a sprain or contusion. In an emergency situation that calls for a roller bandage when none are available, strips of torn cloth, sheet or other like material can be used.

2) Triangular bandages are normally made of cotton and cut in the shape of a triangle. This type of bandage can be applied in two ways. Fully opened this type of bandage can be used as an arm sling. The triangular can also be used as a cravat. A binder placed around a victim’s body to stabilize an injured arm in a sling, or to hold splints in place. It may be applied evenly over a dressing to supply pressure to a wound as well.

3) Adhesive tape is available in various lengths and widths. Adhesive tape is primarily used to secure roller bandages or small dressings in place. Some people are allergic to adhesive. In these instances using paper tape or special hypoallergenic tape would be required.

4) Adhesive strips come in handy for small cuts and abrasions. This item can be used as a combination dressing and bandage. As you can see, dressings and bandages are very different in purpose. Having the correct items on hand can make a difference in how effective your care to an injured person will be. FSM