Bleeding (Major or Catastrophic)

Table of Contents

Bleeding can occur in a range from a minor cut requiring first aid to a major bleeding incident or even worse, catastrophic bleeding.

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Major Bleeding

Signs of major bleeding:  External bleeding that is visible on the outside of the body and cannot be controlled. 

Actions

  1. Practice universal precautions.
  2. Press firmly with a clean bandage to stop the bleeding.
  3. If a bone fracture is suspected, gently support and elevate the body part.
  4. Bandage the wound firmly without interfering with circulation to the body part.
  5. Do not use a tourniquet.
  6. Have someone contact the school nurse, do not release pressure.
  7. If the wound is gaping, the student may need stitches. Contact the parents immediately.
  8. Remain with the student until help arrives.
  9. Wash your hands.
  10. Document the date and time, any delegated interventions provided, observations, the student response to intervention (if applicable), and your signature and credentials (if applicable).
  11. Follow any additional school or program procedure(s).
  12. Debrief with the school nurse.
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Catastrophic Bleeding

Catastrophic bleeding is associated with amputations or significant damage to major blood vessels. This is usually caused by lacerations or complicated fractures where the broken bone damages blood vessels.

Signs of Catastrophic bleeding: The wound will be gushing with blood. The blood may be pumping or flowing out. 

Actions

  1. Call 911.
  2. Practice universal precautions.
  3. Implement “Stop the Bleed” training, if you are trained.
  4. If there is a detached part of the body:
    1. Place the detached part in a plastic bag.
    2. Tie the bag.
    3. Place the bag in a container of ice water.
    4. DO NOT put the amputated part directly on ice.
    5. Send the bag with the EMS.
  5. If the student is not already, have the student lie down.
  6. Keep the student’s body temperature as normal as possible (provide a blanket if necessary).
  7. Remain with the student until help arrives.
  8. Wash your hands.
  9. Document the date and time, any delegated or certified interventions provided, observations, student response to intervention (if applicable), and your signature and credentials (if applicable).
  10. Follow any additional school or program procedure(s).
  11. Debrief with the school nurse.
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