Hint

Apply direct pressure method bleeding management to the wound as discussed above.

Attempt to stop the bleeding by applying sustained direct or indirect pressure on or near the wound.

The casualty can only lose approximately 20% of their blood volume before they lapse into unconsciousness. When direct pressure method fails use

Hint

Foreign objects e.g. dirt, gravel, grass.

Signs of infection.

More severe injury.

DO NOT remove foreign materials that are embedded in the wound as this may increase bleeding and cause further injury to the casualty.

Hint

Internal bleeding may occur within tissues, organs, or in cavities of the body including the head, chest, and abdomen.
Internal bleeding may not be evident for many hours after it begins, with symptoms only occurring when there is significant blood loss or if a blood clot is large enough to compress an organ and prevent it from functioning properly.
Internal injuries can be caused by either a blunt force (driver into steering wheel) or penetrating (stabbing) injury. The signs and symptoms can vary depending on the organs and blood vessels that are involved.

Hint

Causes of pain in children include:

• injury
• disease
• medical interventions such as vaccinatons or surgery
• normal childhood events such as teething.

If you think a child is in pain, they should always be seen by a GP for diagnosis and treatment.

It may not be necessary to give a child a pain medicine. Many other treatments are available that can help relieve a child’s pain. If a pain medicine is needed, always read the label and follow dosage instructions exactly after you have been provided with written consent from the child’s parent or guardian.

For mild pain, such as pain from a new tooth, over-the-counter children’s paracetamol or ibuprofen may be helpful. These are often used in combination with non-medicine strategies. In more serious cases (such as pain from a broken bone), a doctor may need to prescribe stronger medicines.

How to measure pain in children

Measuring a child’s pain level can be tricky, particularly in babies and very young children who have no direct way to communicate.

Suggestions include:

• See how the child responds to the pain. They may cry, moan and groan, grimace, writhe, cradle the sore body part or protect it from accidental bumps.
• See how the child looks. They may be flushed and sweaty, or look pale and tired.
• See how the child behaves. They may be quieter than usual or more irritable, stop playing, lose their appetite, be listless or regress to behaviours they have outgrown such as thumb sucking.
• Listen to the child. If they are old enough, they may be able to use words or drawings to communicate the severity of the pain.
• Ask a child (7 years or older) to rate their pain on a scale of 0 to 10 with 0 being ‘no pain’ and 10 being the worst pain.
• Measure physical reactions. The doctor can check for physical signs of pain such as heart rate, blood pressure and blood oxygen levels.
• For parents trust your parental instincts. No one knows your child better than you do.

Hint

Strategies for managing pain in children

Many non-medicine treatments can be used to relieve a child’s pain. Non-medicine techniques fall into 3 categories including environmental (such as a calm atmosphere), physical (such as hugging) and distraction techniques.

Environmental techniques include:

• Swaddle or wrap babies.
• Show the child that you are taking their pain seriously.
• Tell them what is happening using words they can understand. Fear and anxiety are known to increase perception of pain.
• Reassure them that their pain will be managed and that the treatment (such as an injection) will be less painful than the pain itself.
• Allow your child some control over the situation – for example, older children could decide whether to take their pain medication as a syrup or tablets and ask what flavour of syrup they prefer.

Physical techniques include:

• Give plenty of cuddles and attention.
• If a child is teething, simple measures such as gently massaging the gum with a clean finger or giving them a teething ring to chew may help to relieve discomfort.
• Icepacks or heat treatments can reduce pain. Ask your doctor for advice.

Distraction techniques include:

• Distract your child with games, books or favourite television shows.
• Your health professional may give a baby younger than 12 months a sucrose solution to help with painful procedures.
• If your baby is younger than 6 months and you are breastfeeding, feed them while they are receiving a painful procedure like vaccination.

Unhelpful pain-management strategies

Some approaches only increase a child’s fear and anxiety. Unhelpful strategies that are best avoided include:

• Fake reassurance – don’t tell them that a procedure, such as an injection, won’t hurt when you know it will.
• Belittling – don’t ridicule your child for acting ‘like a baby’ in the hope they will respond with bravery.
• Being anxious yourself – don’t fixate on their pain or scare them with talk about future suffering they may have. Research shows that a person who expects the worst will perceive their pain as more painful.

Hint

 Arterial- An arterial bleed is bright red in colour and spurting with the beat of the heart.

 Venous – A venous bleed is dark red in colour and appears to ooze from the body in a constant flow.

Capillary – Capillary bleed occurs from a surface wound e.g. a graze, and bleeding may include a fluid (plasma) mixed with blood and appears to seep from the wound.

Hint

Apply a firm bandage over the pad.

If bleeding does not stop, DO NOT remove the pad and bandage. Place a second pad over the first pad and re-bandage firmly.

If severe bleeding continues it may be necessary to remove the pad to ensure that a specific point has not been missed. Then re-apply a clean pad and bandage.

Hint

Follow the DRABCD emergency action plan.

Call 000 for an ambulance – Call First and Call Fast.

Assist the casualty into a position of comfort.

Loosen any tight clothing.

Cover the casualty with a blanket to maintain body warmth.

Hint

Nosebleed

Use standard precautions to protect yourself from coming into contact with blood by using gloves.

Have the casualty pinch the soft part of the nostrils, below the bridge of the nose.

Assist the casualty to sit down.

The casualty should lean with their head forward to avoid blood flowing down their throat.

Ask the casualty to breathe through their mouth.

Apply a cold compress to the nose, neck or forehead.

The casualty should remain seated at total rest with their nose pinched for at least 10 minutes.

On a hot day or after exercise, it might be necessary to maintain pressure for at least 20 minutes.

If bleeding continues for more than 20 minutes seek medical assistance.

 Advise the casualty not to blow or pick their nose for several hours or to swallow any blood.

Note: If a head injury is suspected along with the nosebleed; follow head injury management starting with calling 000 for an ambulance.

Hint

DO NOT wash or soak the amputated part in water or any other liquid.

Place amputated part in a sealed plastic bag.

Place the sealed bag in cold water with ice if possible.

The amputated part should not come in contact with ice or water.

Hint

 Clean the area with saline or warm soapy water.

Elevate the bleeding part, unless fractured.

Restrict movement.