Deadly Bleeds: A Level 1 First Aid Attendant Guide

A deadly bleed, also known as massive hemorrhage, is a critical situation requiring immediate and effective intervention. As a first aid attendant with OFA Level 1 certification, your ability to recognize and manage such a scenario can be life-saving. This comprehensive guide, drawing from the WorkSafeBC Basic First Aid course, will outline the steps you should take to handle a deadly bleed scenario.

Recognizing a Deadly Bleed

A deadly bleed involves significant blood loss and can quickly lead to shock, a life-threatening condition where the body’s cells are not adequately supplied with oxygen. Recognizing the signs of a severe bleed is crucial for timely intervention.

Types of Bleeding

• Arterial Bleeding: Blood spurts or pulses out and is usually bright red. This type of bleeding indicates damage to an artery and requires rapid control.
• Venous Bleeding: Blood flows steadily and is usually darker than arterial blood. While not as immediately dramatic as arterial bleeding, it can still lead to significant blood loss if not controlled.
• Capillary Bleeding: A continuous, steady ooze. This type of bleeding is usually less severe but requires attention.

Signs of a Deadly Bleed

• Visible, profuse bleeding: Especially spurting or pulsing blood.
• Rapid soaking of dressings: If the dressing becomes soaked with blood, it indicates a severe bleed.
• Signs of shock: Pale, cool, and clammy skin, anxiety, dizziness, and altered level of consciousness.

Priority Action Approach

When dealing with a deadly bleed, follow the priority action approach to ensure no critical steps are missed.

1. Scene Assessment

• Ensure the scene is safe for you and the injured worker.
• Identify any potential hazards, such as machinery, that may pose further risk.
• Determine the number of injured workers.

2. Responsiveness Assessment

• Check the worker’s level of consciousness using the AVPU scale: Alert, Verbal, Pain, Unresponsive.

3. Primary Survey

• Airway (A): Ensure the worker has a clear airway. For a responsive worker, confirm they are speaking clearly. For an unresponsive worker, use a head-tilt chin-lift maneuver.
• Breathing (B): Check for normal breathing. Look, listen, and feel for the movement of air.
• Circulation (C): Look for signs of shock (pale, cool, clammy skin). Conduct a rapid body survey to check for massive external hemorrhage.

4. Activate Emergency Response Procedures

• Instruct a co-worker to call for an ambulance or the workplace Emergency Transport Vehicle (ETV), if required.
• Provide the dispatcher with key information, including the number of injured workers, the location, and the nature of the injuries.
• Instruct the co-worker to report back once the ambulance has been called.

5. Critical Interventions

• Controlling the bleeding is the priority.

Controlling the Bleeding

The primary goal is to stop the bleeding as quickly as possible.

1. Direct Pressure

• Expose the wound: Remove any clothing or obstructions to see the source of the bleeding.
• Apply pinpoint direct pressure: Use sterile gauze or dressings directly over the wound site.
• Maintain pressure: Have a helper hold direct pressure while you complete a primary survey. Ensure the helper is also wearing PPE.
• Do not remove soaked dressings: Instead, apply additional dressings and bandages over the first ones if they become soaked with blood.

2. Tourniquet Application

• When to use a tourniquet: Apply a tourniquet only if direct pressure is not controlling the bleeding, or the limb is entrapped and you do not have access to the bleed.
• Where to apply a tourniquet: Apply a commercially prepared tourniquet on a limb, proximal to the wound site (closer to the torso), but not over a joint.
• How to apply a tourniquet:
  • Secure the tourniquet strap firmly around the limb.
  • Tighten the windlass until the bleeding stops. Do not tighten a tourniquet during practice.
  • Lock the windlass in the tightened position.
  • Mark the worker with the time the tourniquet was applied.
• Important Note: Inform the injured worker that a tourniquet may cause pain but is necessary to save their life.

Additional Measures

• Position the worker: Keep the worker lying down to slow blood loss.
• Keep them warm: Apply a blanket to protect them from the elements and help manage shock.
• Avoid unnecessary movement: Moving the worker unnecessarily may aggravate their condition.
• Do not give anything to drink: The worker may require surgery or be at risk of vomiting.

Ongoing Assessment

• Reassess ABCs: Reassess the worker’s airway, breathing, and circulation every five minutes while waiting for the ambulance.
• Monitor for shock: Watch for pale, cool, and clammy skin, and any changes in responsiveness.
• Update ambulance dispatch: Relay any changes in the worker’s condition to the ambulance dispatch.
• Complete a secondary survey if time and resources permit. Take vital signs, history of injury, and complete a head-to-toe examination.

Amputation

If an amputation occurs:

• Manage the bleeding at the injury site.
• Preserve the amputated part by rinsing off any contaminants, wrapping it in a clean dressing, placing it in a waterproof bag, and keeping it cool.

Documentation

• Complete a first aid record. Document all findings, actions, and recommendations.

Key Takeaways

• Act quickly: A deadly bleed requires immediate intervention.
• Prioritize safety: Ensure the scene is safe before approaching the injured worker.
• Control bleeding: Apply direct pressure and use a tourniquet if necessary.
• Monitor for shock: Be aware of the signs and symptoms.
• Maintain clear communication: Keep the worker calm and reassure them, and communicate effectively with emergency responders.

By following these guidelines, OFA Level 1 Vancouver attendants can effectively manage a deadly bleed scenario, significantly improving the injured worker’s chances of survival.

For those looking to enhance their workplace safety skills, enrolling in a first aid course in Vancouver, such as Basic First Aid certification, will provide the necessary training to handle workplace emergencies. To meet WorkSafeBC requirements, consider Fundamental First Aid’s comprehensive training programs.