Brief overview
- What is a pressure dressing? A first aid measure for heavily bleeding wounds.
- How is a pressure dressing applied? Raise or elevate the injured body part, apply and fix the wound dressing, apply and fix the pressure pad.
- In which cases? For heavily bleeding wounds, e.g., cuts, puncture wounds, contusions.
- Risks: Strangulation of blood and/or nerve pathways.
Caution.
- As a rule, you can and should apply a pressure bandage only to the extremities (arms, legs).
- With the pressure dressing in place, check the areas around it to make sure the blood supply and nerves are not pinched off.
- Observe the dressing to see if blood is bleeding through it. If so, you must apply a second pressure dressing over it.
- Call the emergency medical services! Wounds that are bleeding profusely must be treated by a physician.
What is a pressure bandage?
If a wound is bleeding heavily or splattering, it is important to stop the blood loss as quickly as possible. To do this, you should apply a pressure bandage. For this purpose, it is best to use a sterile wound dressing, a bandage pack as a “pressure agent” and either a gauze bandage or a triangular cloth for fastening.
How to apply a pressure bandage!
Before applying a pressure bandage to an injured person, you should put on thin protective gloves (e.g. made of latex, vinyl, etc.). This serves a dual purpose: First, it reduces the risk of germs getting from your hands into the wound. On the other hand, disposable gloves also protect you yourself from infections caused by direct blood contact. In this way, you prevent the transmission of possible diseases to the patient, such as hepatitis C, via small open wounds on your hands.
You will find disposable gloves and everything else you need for a pressure dressing in the first aid kit. You should have such a box handy at home. There must even be a small first aid kit in the car.
If you need to apply a pressure bandage as a first aid measure for an injury, follow these steps:
- Explain: Talk to the injured person and explain each step you take in applying the tourniquet. Those who are bleeding profusely are usually frightened and distraught. Knowing what you are doing as a first responder and perhaps being somewhat distracted by listening can help calm the casualty.
- Squeeze larger blood vessels: In addition, you can try to squeeze larger blood-carrying vessels into the wound area. On the arm, the correct point for this is the artery between the biceps and triceps (upper arm muscles). On the leg, press into the groin of the injured person (centered) before applying the pressure dressing.
- Apply wound dressing: First place a sterile wound dressing on the wound, covering it completely.
- Secure the wound dressing: Secure the dressing by wrapping a gauze or elastic bandage around it several times with some tension (but not the entire bandage). The bandage should be tight, but not too tight.
- Place pressure pad: Now place a pressure pad over the wound on top of the wrapped dressing. An unopened dressing pack is suitable for this, for example a bandage that is still wrapped. If none is available, a packet of tissues or similar can also be used.
- Secure the pressure pad: Hold the pressure pad in place with one hand and now wrap the remaining bandage around the injured body part with the other. Make sure that there is a certain amount of tension here as well. Secure the end of the bandage so that it does not come loose.
- Continue to elevate: Make sure that the injured body part is positioned further up, preferably above the level of the heart. Gravity then reduces the blood flow to the wound area.
Continue to pay attention to patients
When administering first aid to a bleeding wound, always be aware of possible signs of shock in the patient. Check breathing and pulse regularly and take appropriate action if the patient becomes unconscious.
If the patient faints or is unconscious but is breathing on his own, place him in the recovery position until the rescue service arrives. If the patient stops breathing, start resuscitation immediately.
If the victim has suffered an amputation injury, place the severed body part (e.g., finger) in a sterile cloth, wrap it and pack it in an airtight plastic bag. Place the plastic bag in a second bag of ice water. This increases the chances that a surgeon will be able to reattach the severed body part in the hospital.
Alternative with the triangular bandage
Instead of a bandage, you can use a triangular cloth to apply a tourniquet to first aid an injury.
- To do this, fold the cloth into a “tie” and place it centrally on the wound covered with a sterile pad.
- Now pass the two ends of the “tie” around the injured extremity, cross them at the back and then pass them forward again.
If the wound on the finger or fingertip is bleeding heavily, a fingertip bandage is often sufficient. Cut a wedge out of the middle of both sides of a large plaster. First stick one half over the uninjured side of the finger and then fold the other half over the fingertip. Fold the adhesive surfaces over.
Further dressing in case of severe bleeding
If the bleeding is so severe that it seeps through the pressure dressing, apply another dressing. Place a second pressure pad over the wound and secure it with more gauze bandages and knot them closed.
When do I make a pressure dressing?
Especially for heavily bleeding wounds on arms or legs (e.g. stab wounds, cuts, lacerations), a pressure bandage is the right first aid measure.
Sometimes a pressure bandage on the head is also necessary. However, it is more difficult to apply. If the pressure pad cannot be fastened with a bandage or can only be fastened inadequately, you or the injured person himself must press on and hold the pressure pad with his hand to stop the bleeding.
This can cause a painful bruise and swelling. Then the PECH rule helps:
- Take a break
- Apply ice pack
- Apply a pressure bandage (compression)
- Elevate the injured region
The pressure bandage creates counterpressure from the outside. This limits the bruising and swelling.
Risks of a pressure bandage
As a first responder, you should not apply a pressure bandage too tightly. Otherwise, the blood supply could be completely cut off. In addition, too much pressure can injure nerve pathways. Therefore, always check the areas around the pressure bandage: If the pressure bandage discolors the fingers or toes (in the case of a pressure bandage on the arm or leg) or if they feel very cold, the bandage is probably too tight. Then loosen it a little.
Do not apply a pressure bandage to the neck! It could cut off blood flow to the brain or breathing.
In the case of stab wounds, sometimes the sharp object is still stuck in the wound. This makes it difficult to apply the pressure bandage. However, do not pull it out under any circumstances! This would increase the bleeding. Instead, build the pressure pad around the stuck object and do not wrap the bandage over it either.
