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Internal bleeding may occur in the chest, abdomen, or skull, following a fall, blow, crash, or injury from a stab or bullet. It can also happen in. certain chest or abdominal illnesses. The bleeding may remain unseen, or blood may escape from the body sometime after the injury. Symptoms of internal bleeding may include shock, dizziness, loss of consciousness, pallor, rapid breathing, severe pain or swelling, and anxiety. If you suspect internal bleeding, do not move the patient. Keep him lying down, warmly covered, with his head low, and send for urgent medical help.

A bullet wound may be superficial or involve internal bleeding and serious damage. Stop heavy bleeding by direct pressure until help arrives. Cover a surface wound with sterile gauze, but don’t try to clean it until you have received medical advice. If the wound is internal, check for breathing and give mouth-to-mouth resuscitation if necessary. Keep the patient lying down, with his head low if possible, to aid the supply of blood to the brain. Wrap coats or blankets under and over his body, and call an ambulance urgently.

Even the most severe and profuse bleeding can almost always be stopped by direct, continued pressure. If the bleeding does not abate, you are probably not pressing in the right place, so shift your pressing fingers until you hit or. the right spot. Several minutes of this firm pressure should be enough to control the bleeding sufficiently for a thick, firm dressing (a makeshift one if need be) to be applied. If bleeding still continues as profusely as even when you take your fingers away, you must just keep on pressing until you can get the casualty to the hospital.

Shouldn’t I use a tourniquet?

No. A tourniquet, if wrongly applied, can be extremely dangerous and cause more harm than the injury itself. A tourniquet, or constrictive bandage, stops bleeding by cutting off the blood supply to an injured arm or leg, but if it is put on too tightly and not loosened often enough, it may cause the entire limb to die. A tourniquet should therefore never be used except by a trained person, and even then, is rarely necessary. Applying direct pressure on to the wound by fingers or hand is usually just as effective and far safer.

1. Above all, do not pull people out of the car, unless it is already on fire. This could further seriously injure or kill them.

2. Send someone to flag down traffic far enough away from the scene of the accident for safety, or do this yourself. The first cars to come along should be sent in opposite directions to telephone for help. The drivers of any other cars can then act as flagmen to block traffic from both directions.

3. Switch off the ignition and lights in the crashed car to prevent fire.

4. If there is more than one victim, see who needs help most urgently. Give attention first to anyone who is not breathing or who is unconscious, and deal with any severe bleeding. Treat everyone involved for shock (even those who protest that they are “perfectly okay”).

5. Even if the crash victims do not appear to  be seriously hurt,  leave them until help arrives. Anyone thrown on the road should be covered with a coat and guarded from the traffic.

A severe stroke may cause headache, nausea, confusion, slurred speech, and sudden or gradual loss of consciousness. One side of the person’s face, or the limbs on one side of his body may become weak or paralysed. In a mild attack, the patient may simply appear to falter and go momentarily blank.

What should I do to help?

Call a doctor or ambulance immediately. Meanwhile, make sure that the person is breathing- If not, give mouth-to-mouth resuscitation. Remove dentures or any other obstruction that may block breathing, and check that the patient has not injured himself in the fall. Leave him where he has fallen but slip a pillow or cushion under his head. If he is unconscious, or loses consciousness later, place him in the coma position. Do not give him anything to eat or drink. Loosen any tight clothing, cover him with a coat or blanket, and keep a careful watch on his breathing until medical help arrives.

A stroke is similar to a heart attack in that it results from the blockage of an artery—in this case to the brain rather than the heart. The commonest type of stroke, called cerebral thrombosis, is also due to the formation of a blood clot in an artery (this time in the brain) that has been damaged by deposits of fatty material. Another kind of stroke is caused by the leakage of a weak blood vessel in the brain. The resulting shortage, or blockage, of the blood supply to the brain interferes with the normal functioning of the brain and may affect the control of movement, sensation, speech, or other bodily functions. Like a heart attack, a stroke may be fatal, or a timely warning that serious trouble could occur if certain health measures  are not taken.  In the majority of strokes, the symptoms disappear after a few weeks. Sometimes, a stroke may leave a permanent handicap, but this can often be overcome with the help of therapy.

The majority of heart attacks are not fatal. And if a person recovers from a heart attack, he stands every chance of living a reasonably long and healthy life. One heart attack does not inevitably lead to another. The heart has great powers of recuperation, which can be helped along by modern medical treatment, and it may become as strong as ever after an attack. It is important, however, to deal with the conditions that led to the attack, and anyone who has suffered a heart attack must follow his doctor’s advice concerning diet, exercise, and other aspects of his general health.

A serious heart attack causes sudden severe and crushing pain in the center of the chest, sometimes radiating down the arms or into the neck and back. The pain may bring on breathlessness, dizziness, and vomiting. The person will be deathly pale, may break out in a cold sweat, and collapse or lose consciousness.

What should I do if someone has a heart attack?

Send for the doctor immediately. If he is not available right away, call an ambulance. Meanwhile, treat the patient for shock, but keep him in a sitting position, with his head and shoulders supported by pillows or cushions, so that he can breathe more easily. Try to keep him as calm and quiet as possible, reassuring him that medical help is on its way. Do not give him any medicines or other drink. Watch him carefully and if his breathing stops, immediately start mouth-to-mouth resuscitation and heart compression.

Heart attack is another name for coronary thrombosis, or a blockage in the arteries that supply blood to the heart. Although the attack is sudden, the conditions that cause it have been building up for years beforehand. As we grow older, changes occur in the inner lining of the arteries and they tend to thicken. In addition, fatty material from the blood may be laid down inside the arteries, thus narrowing the channel. Parts of this material may flake off, contributing to blockage and roughening the arterial wall. The narrowed channel slows down the flow of blood and where the wall is roughened, a blood clot may form. The clot, called a thrombus, cuts off the blood supply to part of the heart, and the heart attack occurs. If the clot blocks a major artery, the attack is likely to be fatal, because without blood the heart will stop beating. If the blockage is less serious, however, blood may find its way around the blocked artery to reach the heart through other blood vessels.

Blood donors give about a pint of blood without ill effects. Yet the same amount of blood pouring from a wound seems pretty serious. How much blood can we lose without danger?

answer:
The average person can lose a pint of blood without danger, and that is why this is the amount usually chosen for blood donating. However, the loss of blood from a wound should always be taken seriously. At a blood donating center, a pint of blood is given under carefully controlled conditions. In the case of accidental bleeding, not only would it be hard to judge the amount of blood being lost, but there is the added risk of infection from germs that may enter a wound. It has been shown that the body can lose up to a third of its blood supply (about four pints for the average person) without apparent serious effect, but the loss of half the body’s blood is almost always fatal, and even the loss of two pints of blood will often cause shock.