Venous Bleeding

Uncontrolled bleeding is the number one cause of preventable deaths due to a trauma. While venous bleeding is usually less serious than arterial bleeding, it still can pose a serious health risk to the victim.

Venous bleeding can be the result of external trauma, as in something cutting or puncturing a vein, or internal trauma, due to a broken bone or organ damage. Venous bleeding involves blood that is returning to the heart, so there won't be as much pressure as arterial bleeding. However, the blood loss can still be severe.

Venous bleeding distinctions are:

• The blood is dark red, not bright like arterial bleeding
• The blood flow is steady but not spurting; it can still be quick, though
• The pressure is lower than arterial bleeding so it's usually easier to control

How to Provide Care

The good news when it comes to venous bleeding wounds is that applying constant pressure for 2-3 minutes will usually be enough to control the bleeding.

Also, unless the patient is showing signs and symptoms of a life-threatening emergency, you probably won't need to call 911. Just make sure to always err on the side of patient safety if you're ever uncertain.

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.

• Find the source of the bleeding. You may have to remove or cut away clothing to reveal the wound.
• Cover the wound as long as no impaled objects are protruding from it. Ideally, a sterile pad or bandage would work best, but use whatever you have available, so long as it's clean.
• Apply direct and constant pressure to the wound. If the victim is conscious and can assist, this will help.
• Apply new dressing pads or bandages as needed, if blood begins to soak through the one(s) already applied. DO NOT remove the old bandage or pad, as this can strip the wound of blood trying to clot and only delay your ability to control the bleeding.
• After bleeding is controlled, you can begin to wrap the wound using an elastic bandage. Start at the furthest point from the body and wrap over any and all dressing pads you placed over the wound. (If the wound is on the arm, begin wrapping at the end where the fingers are.)
• Wrap around the wound at least an inch on each side and overlap the bandage as you wrap. Go down the arm, up the arm, and repeat as many times as necessary.

Remember, to apply even more pressure to a difficult wound, twist the bandage one time directly over the wound while wrapping it and repeat as necessary. This will tighten-up the pressure where pressure is most needed.

• When done wrapping, cut the end of the bandage and either tape it down or tuck it into the wrap to hold it in place.

A Few Common Venous Bleeding Questions

How do I know if stitches are required?

When you remove pressure, do the folds of skin around the cut begin to come apart, or does the skin appear to be staying together. If the skin is coming apart, stitches are likely necessary. If not, the wound will probably heal on its own and stitches can be avoided. As can a trip to the emergency room.

When should I call 911?

Call 911 immediately if …

• The victim is showing signs of shock
• The victim is having trouble breathing or losing consciousness
• You cannot stop the bleeding
• The situation is life-threatening in any way

What about the wound getting infected?

Before you wrap the wound, it's a good idea to properly clean it using an antibacterial ointment if you have one. This will combat any bacteria that may have gotten into the cut and reduce the chances of infection. As will properly wrapping the wound to avoid any dirt or debris from getting into it.

Also, don't forget about the chances of tetanus. If the victim was cut by something dirty and hasn't had a tetanus shot in the last 10 years, a trip to the emergency room is a necessity regardless of the severity of the wound.