{"id":69,"date":"2025-10-12T06:31:57","date_gmt":"2025-10-12T06:31:57","guid":{"rendered":"https:\/\/openbook.ums.edu.my\/test\/?post_type=chapter&p=69"},"modified":"2026-01-16T00:56:53","modified_gmt":"2026-01-16T00:56:53","slug":"chapter-3","status":"publish","type":"chapter","link":"https:\/\/openbook.ums.edu.my\/fundamentalfirstaidcompetencies\/chapter\/chapter-3\/","title":{"raw":"Chapter 4: Control Bleeding","rendered":"Chapter 4: Control Bleeding"},"content":{"raw":"
\r\n

Learning Objectives<\/p>\r\n\r\n<\/header>\r\n

\r\n\r\nType your learning objectives here.\r\n
    \r\n \t
  • Define what bleeding is.<\/li>\r\n \t
  • Differentiate between types of bleeding.<\/li>\r\n \t
  • Perform techniques to control bleeding.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n

    4.1 Introduction to Bleeding<\/strong><\/p>\r\n

    Haemorrhage, or bleeding, occurs when blood vessels within the body tissues are damaged, leading to blood loss that can often be identified through visible bleeding or bruising. This condition can be life-threatening, depending on the location and severity of the injury. For instance, a fracture of the humerus may result in an estimated blood loss of 500\u2013750 ml. Therefore, bleeding control is considered a top priority in FA. Bleeding can be categorised as either internal or external, and it is further divided into three types: venous, capillary, and arterial. While each type requires specific management techniques, the fundamental principles of bleeding control remain the same.<\/p>\r\n

    4.2 Types of Bleeding<\/strong>\r\n4.2.1 Arterial Bleeding<\/strong><\/p>\r\n

    Arterial bleeding represents the most critical and life-threatening form of haemorrhage. It typically occurs following a penetrating wound, blunt force injury, or damage to major organs and blood vessels. Unlike other types of bleeding, arterial blood has distinct characteristics. It appears bright red due to its high oxygen content and is expelled in rhythmic spurts that match the heartbeat. Controlling this form of bleeding is challenging, as the strong pressure generated by the heart prevents the blood from clotting or stopping quickly.<\/p>\r\n

    The techniques for controlling the arterial type of bleeding are as follows:<\/p>\r\n\r\n

      \r\n \t
    1. Perform the DRSABC assessment.<\/li>\r\n \t
    2. Clean the wound using sterile solution or clean water with a sterile gauze pad or a clean cloth.<\/li>\r\n \t
    3. Apply firm pressure directly on the bleeding site using a gloved hand and a piece of sterile gauze. If there is no sterile gauze available, you may use a clean cloth instead.<\/li>\r\n \t
    4. If the first layer of gauze\/cloth is soaked with blood, do not remove it, instead, add another layer and continue to press the wound. Removing the first layer may disturb the blood clotting process.<\/li>\r\n \t
    5. If the bleeding slows or stops, the wound should then be secured with a sterile dressing and bandage to maintain continuous pressure.<\/li>\r\n \t
    6. For bleeding from an artery in the arm or leg, raising the injured limb above heart level may help reduce blood flow.<\/li>\r\n \t
    7. If bleeding persists despite these measures, the final option is to place a tourniquet above the site of injury to control the blood loss.<\/li>\r\n<\/ol>\r\n

      4.2.2 Venous Bleeding<\/strong><\/p>\r\n

      Venous bleeding is typically less severe than arterial bleeding, however, it can still become life-threatening depending on the location of the injury and the size of the wound. This requires immediate medical attention. Since the blood originates from a vein, it appears darker in colour due to its lower oxygen content. Unlike arterial bleeding, venous bleeding is not driven by high pressure, so the blood escapes in a steady, continuous flow rather than in forceful spurts.\r\nThe techniques for controlling a venous bleed are similar to those for managing an arterial bleed.<\/p>\r\n

      4.2.3 Capillary Bleeding<\/strong><\/p>\r\n

      Capillary bleeding typically occurs when the skin is damaged and is the most common type of bleeding. Unlike arterial bleeding, which spurts, or venous bleeding, which flows steadily, capillary bleeding seeps slowly from the injured area. This form of bleeding is the least dangerous and the simplest to manage, as it originates from surface-level blood vessels rather than deeper structures within the body.<\/p>\r\n

      The techniques for controlling the capillary bleed are as follows:<\/p>\r\n\r\n

        \r\n \t
      1. Clean the wound with soap and water or using a cell-safe cleansing agent.<\/li>\r\n \t
      2. If necessary, irrigate the area under pressure to remove dirt or foreign material, which helps reduce the risk of infection.<\/li>\r\n \t
      3. To complete the process, place a sterile dressing over the wound and apply firm pressure with a gloved hand, as this is usually enough to stop the bleeding.<\/li>\r\n<\/ol>\r\nThe characteristics of arterial, venous, and capillary bleeding are as follows:\r\n
        \r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
        <\/td>\r\nArterial<\/strong><\/td>\r\nVenous<\/strong><\/td>\r\nCapillary<\/strong><\/td>\r\n<\/tr>\r\n
        Source<\/strong><\/td>\r\nArteries<\/strong> (carry oxygen-rich blood from the heart)<\/td>\r\nVeins<\/strong> (carry deoxygenated blood back to the heart)<\/td>\r\nCapillaries<\/strong> (tiny surface blood vessels)<\/td>\r\n<\/tr>\r\n
        Appearance of blood<\/strong><\/td>\r\nBright red\r\n\r\n(oxygenated)<\/td>\r\nDark red\r\n\r\n(low oxygen)<\/td>\r\nBright to dark red\r\n\r\n(mixed)<\/td>\r\n<\/tr>\r\n
        Flow characteristics<\/strong><\/td>\r\nSpurts in rhythm with heartbeat, forceful<\/td>\r\nSteady, continuous flow (not spurting)<\/td>\r\nOozes slowly from the wound surface<\/td>\r\n<\/tr>\r\n
        Severity<\/strong><\/td>\r\nMost severe, life-threatening<\/td>\r\nLess severe than arterial, but can still be dangerous<\/td>\r\nLeast severe, usually minor<\/td>\r\n<\/tr>\r\n
        Ease of control<\/strong><\/td>\r\nVery difficult to control, often requires advanced intervention (e.g., pressure, tourniquet)<\/td>\r\nModerate difficulty, controlled with firm pressure and dressings<\/td>\r\nEasiest to control, often stops with simple cleaning and dressing<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n
        <\/div>\r\n
        <\/div>\r\n
        \r\n
        \r\n
        \r\n

        Key Takeaways<\/p>\r\n\r\n<\/header>\r\n

        \r\n
          \r\n \t
        • Always protect yourself by using gloves or barriers if available to reduce the risk of infection before assisting the victim.<\/li>\r\n \t
        • Direct pressure over the wound is the most effective initial method to control bleeding, especially for severe or arterial bleeding.<\/li>\r\n \t
        • If an object is lodged in the wound, leave it in place and apply pressure around it to prevent further injury and bleeding.<\/li>\r\n \t
        • Continuously assess the victim for signs of shock (such as pale skin, dizziness, or rapid pulse) and arrange prompt transfer to medical care.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n \r\n\r\n<\/div>\r\n<\/div>\r\n
          [h5p id=\"29\"]<\/div>","rendered":"
          \n
          \n

          Learning Objectives<\/p>\n<\/header>\n

          \n

          Type your learning objectives here.<\/p>\n

            \n
          • Define what bleeding is.<\/li>\n
          • Differentiate between types of bleeding.<\/li>\n
          • Perform techniques to control bleeding.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n

            4.1 Introduction to Bleeding<\/strong><\/p>\n

            Haemorrhage, or bleeding, occurs when blood vessels within the body tissues are damaged, leading to blood loss that can often be identified through visible bleeding or bruising. This condition can be life-threatening, depending on the location and severity of the injury. For instance, a fracture of the humerus may result in an estimated blood loss of 500\u2013750 ml. Therefore, bleeding control is considered a top priority in FA. Bleeding can be categorised as either internal or external, and it is further divided into three types: venous, capillary, and arterial. While each type requires specific management techniques, the fundamental principles of bleeding control remain the same.<\/p>\n

            4.2 Types of Bleeding<\/strong>
            \n4.2.1 Arterial Bleeding<\/strong><\/p>\n

            Arterial bleeding represents the most critical and life-threatening form of haemorrhage. It typically occurs following a penetrating wound, blunt force injury, or damage to major organs and blood vessels. Unlike other types of bleeding, arterial blood has distinct characteristics. It appears bright red due to its high oxygen content and is expelled in rhythmic spurts that match the heartbeat. Controlling this form of bleeding is challenging, as the strong pressure generated by the heart prevents the blood from clotting or stopping quickly.<\/p>\n

            The techniques for controlling the arterial type of bleeding are as follows:<\/p>\n

              \n
            1. Perform the DRSABC assessment.<\/li>\n
            2. Clean the wound using sterile solution or clean water with a sterile gauze pad or a clean cloth.<\/li>\n
            3. Apply firm pressure directly on the bleeding site using a gloved hand and a piece of sterile gauze. If there is no sterile gauze available, you may use a clean cloth instead.<\/li>\n
            4. If the first layer of gauze\/cloth is soaked with blood, do not remove it, instead, add another layer and continue to press the wound. Removing the first layer may disturb the blood clotting process.<\/li>\n
            5. If the bleeding slows or stops, the wound should then be secured with a sterile dressing and bandage to maintain continuous pressure.<\/li>\n
            6. For bleeding from an artery in the arm or leg, raising the injured limb above heart level may help reduce blood flow.<\/li>\n
            7. If bleeding persists despite these measures, the final option is to place a tourniquet above the site of injury to control the blood loss.<\/li>\n<\/ol>\n

              4.2.2 Venous Bleeding<\/strong><\/p>\n

              Venous bleeding is typically less severe than arterial bleeding, however, it can still become life-threatening depending on the location of the injury and the size of the wound. This requires immediate medical attention. Since the blood originates from a vein, it appears darker in colour due to its lower oxygen content. Unlike arterial bleeding, venous bleeding is not driven by high pressure, so the blood escapes in a steady, continuous flow rather than in forceful spurts.
              \nThe techniques for controlling a venous bleed are similar to those for managing an arterial bleed.<\/p>\n

              4.2.3 Capillary Bleeding<\/strong><\/p>\n

              Capillary bleeding typically occurs when the skin is damaged and is the most common type of bleeding. Unlike arterial bleeding, which spurts, or venous bleeding, which flows steadily, capillary bleeding seeps slowly from the injured area. This form of bleeding is the least dangerous and the simplest to manage, as it originates from surface-level blood vessels rather than deeper structures within the body.<\/p>\n

              The techniques for controlling the capillary bleed are as follows:<\/p>\n

                \n
              1. Clean the wound with soap and water or using a cell-safe cleansing agent.<\/li>\n
              2. If necessary, irrigate the area under pressure to remove dirt or foreign material, which helps reduce the risk of infection.<\/li>\n
              3. To complete the process, place a sterile dressing over the wound and apply firm pressure with a gloved hand, as this is usually enough to stop the bleeding.<\/li>\n<\/ol>\n

                The characteristics of arterial, venous, and capillary bleeding are as follows:<\/p>\n

                \n\n\n\n\n\n\n\n\n
                <\/td>\nArterial<\/strong><\/td>\nVenous<\/strong><\/td>\nCapillary<\/strong><\/td>\n<\/tr>\n
                Source<\/strong><\/td>\nArteries<\/strong> (carry oxygen-rich blood from the heart)<\/td>\nVeins<\/strong> (carry deoxygenated blood back to the heart)<\/td>\nCapillaries<\/strong> (tiny surface blood vessels)<\/td>\n<\/tr>\n
                Appearance of blood<\/strong><\/td>\nBright red<\/p>\n

                (oxygenated)<\/td>\n

                		Dark red<\/p>\n

                (low oxygen)<\/td>\n

                		Bright to dark red<\/p>\n

                (mixed)<\/td>\n<\/tr>\n

                Flow characteristics<\/strong><\/td>\nSpurts in rhythm with heartbeat, forceful<\/td>\nSteady, continuous flow (not spurting)<\/td>\nOozes slowly from the wound surface<\/td>\n<\/tr>\n
                Severity<\/strong><\/td>\nMost severe, life-threatening<\/td>\nLess severe than arterial, but can still be dangerous<\/td>\nLeast severe, usually minor<\/td>\n<\/tr>\n
                Ease of control<\/strong><\/td>\nVery difficult to control, often requires advanced intervention (e.g., pressure, tourniquet)<\/td>\nModerate difficulty, controlled with firm pressure and dressings<\/td>\nEasiest to control, often stops with simple cleaning and dressing<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
                <\/div>\n
                <\/div>\n
                \n
                \n
                \n
                \n

                Key Takeaways<\/p>\n<\/header>\n

                \n
                  \n
                • Always protect yourself by using gloves or barriers if available to reduce the risk of infection before assisting the victim.<\/li>\n
                • Direct pressure over the wound is the most effective initial method to control bleeding, especially for severe or arterial bleeding.<\/li>\n
                • If an object is lodged in the wound, leave it in place and apply pressure around it to prevent further injury and bleeding.<\/li>\n
                • Continuously assess the victim for signs of shock (such as pale skin, dizziness, or rapid pulse) and arrange prompt transfer to medical care.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n

                   <\/p>\n<\/div>\n<\/div>\n

                  \n
                  \n