How Do You Do Cpr If Someone Won’t Stop Bleeding?
I won’t lie- I got certified in CPR/AED by the red cross last summer and I learned that you’re supposed to stop any bleeding before you perform CPR on someone. Only thing I never asked was, what do you do if the bleeding doesn’t stop? Do you just have someone continue putting pressure on the bleeding site while you do CPR?
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September 17, 2009 @ 8:49 pm
It isn’t ‘stop ANY bleeding’, it is ‘check for other life-threatening conditions, such as severe bleeding’, and then use your judgment on what to treat first- with the CPR being a very, very high priority.
This question also has different answers based on your level of training, the equipment you have available, how long 911 will take, and the severity of the bleed.
I am going to assume a common situation- lay responder, no equipment, about 10 minute 911 response, and a bad bleed.
You are between a rock and a hard place. If every CPR compression is visibly forcing blood out and there has already been significant blood loss*, you really need to try to care for both.
Your best option is to get a bystander to get 911 and a first aid kit or basic supplies, and another bystander to apply direct pressure on the injury. When you have some supplies, have the bystanders work on the bleed as you continue CPR.
If you are by yourself and have some basic supplies on hand, and it is a bad bleed, do a quick and dirty wrap on the wound (infection is the least of your concerns now!) and get CPR going ASAP! After 2 minutes of CPR you can re-evaluate the bleed if needed.
Avoid tourniquets… but if that is your only option in a life or death situation, when you are otherwise alone, go for it. Tie a band around the limb, stick a stick or tool under the band and twist it and the band until it stops the bleeding, then tie or tuck the tool to keep it from unwinding.
*One note that some other posters have missed (yeah, some of you ‘experts’ missed this, didn’t you? Snicker!) is that if there IS a bad bleed AND no pulse-the blood loss is probably the cause of the heart emergency! Odd are slim you will have a heart attack, THEN fatally wound yourself.
The odds are that the bleed happened first, and the victim went unconscious because of loss of blood. Odds are also that they have already lost a lot before they were found (or the rescuer would have treated them and they would not have passed out!)
If the victim has already lost a great deal of blood, then CPR WITHOUT treating the bleeding, will a.) cause even more blood loss, and b.) not have a great chance for success.
September 17, 2009 @ 9:59 pm
If you have to do CPR because someone is not breathing or has no pulse, it doesn’t matter if they’re bleeding. They will die faster from lack of circulation and oxygen than they will from loss of blood. Always remember your ABC’s = Airway, Breathing, Circulation (in that order). Establish an airway by extending the neck and the jaw thrust maneuver Clear the airway if there is an obstruction or vomitus. Do chest compressions if there is no spontaneous breathing or pulse. THEN, if you have time and personnel available, attend to the bleeding. Also remember = LIFE BEFORE LIMB. It doesn’t matter if you stop the bleeding if the patient is DEAD!
There are ATLS (Advanced Trauma Life Support) and Emergency Nurse training courses for trauma certification. A common mistake is to attend to the visible problem (bleeding, or even a traumatic amputation) and lose sight of the fact that the patient is about to die from lack of oxygen and circulation. So remember: A_B_C_N_E (Airway, Breathing, Circulation, Neurological status – like a spine or skull injury- and then, finally, extremities)
Addendum: Every one is missing the point. Assuming that the heart is still beating but that the patient is NOT breathing, then remember that the stroke volume of the heart is 70 cc per beat. at a heat rate of 100 bpm, that’s 700 cc per minute. With a normal circulating blood volume of 5 liters, it will take over 7 minutes to bleed out. The patient will be dead by then (3 to 4 minutes to die of asphyxiation.) If the heart is not pumping, then there will be minimal blood loss, even in the event of traumatic amputation of a limb. DO YOUR A-B-C’S FIRST! Establish an airway. Assist ventilation, if necessary. Get the heart beating again, or at least get the blood circulating. Then do something about the bleeding. Don’t focus on the blood. Yes, it looks dramatic and terrifying. But if the patient isn’t breathing or the heart isn’t beating, or if you allow him to become brain dead, then all that blood that you’re seeing is irrelevant.
September 18, 2009 @ 2:49 am
“Any” bleeding? Small blood loss isn’t a major concern.
———-
Control severe bleeding, first, and quickly.
If you can’t stop it yourself, get help.
Direct pressure works well.
If you direct pressure doesn’t work well, clamp the vessel if possible.
Use a well-placed tourniquet as the last option because, as you know already, it may cause the loss of the limb. Depending on the rate of blood loss, releasing it slightly to allow some flow may help survivability of the limb if the pt’s pressure is adequate…meaning IV’s started.
Good luck.
September 18, 2009 @ 7:38 am
it depends on the amount of bleeding. it all comes down to priorities – are they going to die from not getting enough oxygen or from losing too much blood?
if the bleeding is severe (i.e. a severed artery) then that is probably the biggest issue. Just lots of pressure/clothes as bandages – do the best you can
in an ideal situation you would have another person so you would be able to do both at the same time. it is surprising how long people can last without oxygen, wouldn’t leave it much longer than 5 mins though – should be enough time to do as much as you can on the bleeding.
probably the most important thing is to get help though! cus this hypothetical patient is in a pretty dire condition….
September 18, 2009 @ 7:49 am
< Do you just have someone continue putting pressure on the bleeding site while you do CPR?
That might be a viable option. Maybe someone else can give you a better answer for this questions.
September 18, 2009 @ 9:17 am
It depends on the bleed, if it’s a catastrophic hemorrhage the person might bleedout before you do cpr. We have various methods to stop bleeding now, including dressing made from shellfish shells and volcano lava.
September 18, 2009 @ 4:06 pm
All I can add to what other’s have said above is:
You can do the most beautiful bandaging job in the world and stop the bleeding but it does the patient no good in the after life. A in ABC’s Airway…come’s first. God Bless!
September 18, 2009 @ 7:25 pm
Well, if they’re bleeding continuously, that means that their heart is beating, which means they have a pulse, so would CPR even be necessary?