Life Threatening Bleeding - Guidance Updates

HSE’s Guidance Update Concerning Life Threatening Bleeding and First Aid Training Course Provision

There is growing awareness around the importance of recognising and treating life- threatening bleeding. Previously described as ‘catastrophic bleeding’ , risk of blood loss can be associated with high impact injuries, significant workplace injuries, loss of limb, severe wounds, internal injuries, long bone fractures, and major trauma. Steps are also being taken to increase the availability of public access bleed kits.

Past versions of the HSE’s Guidance to the Health and Safety (First Aid) Regulations 1981 have included administering first aid to those who are bleeding as part of emergency first-aid at work, paediatric first aid, first aid at work, and annual refresher courses. 2024 updates now provide more guidance as to what an employer should do if life threatening bleeding is identified as a workplace risk.

Why is managing bleeding so important?

Shock

Blood carries oxygen. Oxygen is vital as it is required for essential chemical and energy producing processes within the cells. When blood loss occurs, the volume of blood in the vessels decreases. The body attempts to overcome this by prioritising blood (and therefore oxygen) delivery to the vital organs. As shock worsens, there is a higher demand for the need of oxygen -but a lower delivery rate. Ultimately meaning delivery of blood to the vital organs becomes impaired. In addition, the cells move to an anaerobic process of metabolism. This process is not as efficient, and results in build up of lactic acid.

Signs may include:

Dizziness and confusion

Cold and clammy skin

Changes in normal skin tone

Rapid breathing

nausea and vomiting

reduction in the person’s normal alertness level

Hypothermia (low body temperature)

In blood loss, the body’s normal thermoregulatory processes are affected. In addition, because the body’s normal blood flow is affected, heat is not delivered to the body’s peripheries. Cardiac (heart) contractility is also reduced as a result of hypothermia. This means the patient is a greater risk of an abnormal heart rhythm, and consequently cardiac arrest. Furthermore - hypothermia impacts on the body’s normal blood clotting abilities. Therefore, shock, oxygen delivery and hypothermia have a dangerous relationship!

What are the goals of first aid for bleeding?

Find it - treat it - stop it!!

Direct pressure to the wound is always the first intervention (be mindful of any embedded objects)

Some deep wounds may require packing - haemostatic dressings can be advantageous for this

Wounds to limbs - may require the use of torniquets (manufactured or improvised)

Call for help - in severe bleeding and any injury which is life threatening - call 999

Treat for shock, and be prepared to give CPR if they become unconscious, unresponsive and not breathing / not breathing normally

What should you do if you identify life threatening bleeding as a risk as part of your first aid needs assessment?

Talk to Anglia CPR!! I pride my business on delivering relevant and meaningful content, tailored to your needs. Work with me to:

“Ensure your first-aid provision will cater for the types of injuries and illnesses that have occurred in your workplace”. (or that could happen)

Content can be enhanced to include application of haemostatic dressings, wound packing and/or tourniquets (manufactured or improvised)

Further sources of information:

HSE Guidance Document: here

Control The Bleed - The Daniel Baird Foundation: here