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
A person who is the victim of venous bleeding will likely be applying pressure to the wound or cut by the time you arrive to help. Some things to keep in mind with venous bleeding are:
- It will often stop on its own in 4-6 minutes
- It's usually easy to control with direct pressure
- What may seem like a lot of blood is likely to just be smeared, dripping blood which often looks like more than it really is
As always, the first thing you should do is make sure the scene is safe. After that, proceed with the following steps.
- Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol.
- Find the source of the bleeding and ask the victim if he or she is cut anywhere else to make sure you're not missing another wound.
- Place a dressing pad or cloth over the wound.
- Apply pressure.
At this point, the one dressing pad will usually be enough to control venous bleeding. However, you may also want to consider assessing the severity of the cut.
Pro Tip 1: 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.
If a trip to the emergency room is warranted but EMS services are not, it's still a good idea to have someone else drive the victim. There may be a chance that the victim has difficulty seeing his or her own blood, which could cause psychogenic shock. It's always better if the victim is a passenger rather than the driver.
Before you wrap the wound, make sure it's properly cleaned using a bacterial ointment if you have one. This will combat any bacteria that may have gotten into the cut and reduce the chances of infection.
Pro Tip 2: Consider 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.
After cleaning the wound, reapply a dressing pad that completely covers the area. Wait and see if the bleeding stops or if it leaks through. Most venous cuts will stop after applying the first pad.
Warning: There are reasons why venous bleeding cannot be easily controlled and these include: the victim has a bleeding disorder or is on blood thinners. Make sure to ask the victim if it appears that the bleeding is difficult to stop.
It's now time to wrap the wound, and taping the pad is usually sufficient. Just be aware to maintain constant pressure while you tape. And as before with arterial bleeding, pinch the finger or toe nails if the extremities are involved and see if blood returns to the nails. You don't want to cut off blood supply.
Your goals in tapping or bandaging the wound are:
- Maintain pressure and control bleeding
- Cover completely so dirt and debris cannot get inside the cut
At this point it's always a good idea to make sure the patient is stable and not in shock. If their skin has good color and isn't cold or clammy, and if they haven't lost consciousness, EMS probably will not be needed.
A Word About Disease Transmission
To reduce your risk of disease transmission, there are a few guidelines to keep in mind:
- Avoid contact with the victim's blood by wearing latex-free gloves and protective eyewear if you have them.
- Avoid touching your mouth, nose, and eyes while providing care, and don't drink or eat anything before washing your hands.
- Wash your hands thoroughly after providing care, even if you wore gloves.
- Always dispose of the gloves or change gloves before helping someone else.
As venous bleeding is often not a severe injury, it's still important to remember that it still has the potential to become a serious situation, especially if bleeding cannot be controlled or the victim goes into shock. When in doubt, it's best to call 911 and let the EMS professionals handle the situation.