There are far too many potential wounds that victims might receive to cover them all, but we’ve included details about how to deal with some of the most common ones below. This information is only an introduction and should never take the place of professional, hands-on instruction.
Control Bleeding. Heavy bleeding is often the most serious, life-threatening injury victims will receive in a fight. For example, Washington Redskin’s standout free safety Sean Taylor was shot in the leg during a home invasion robbery on November 26, 2007. The bullet damaged his femoral artery, causing him to bleed rapidly to death despite the fact that he was a well-conditioned, 236-pound professional athlete.
Fire fighters, military, law enforcement, and emergency medical professionals (for example, paramedic, EMT) often use special blood-clotting sponges, or hemostatic agents as they are called in the business, to treat severe bleeding from gunshots, stabbings, shrapnel, and similarly critical wounds. One brand that is available to the general public is called QuikClot. Made by Z-Medica Corporation, this agent accelerates the body’s natural clotting process by increasing the concentration of platelets and clotting factors at the wound site. Combined with a pressure bandage, this treatment can often be lifesaving even in cases as severe as Taylor’s if it is applied fast enough. The challenge is that uncontrolled hemorrhaging, particularly from weapon wounds, can cause a person to bleed to death very quickly, sometimes in seconds, often in minutes.
If you don’t have a special hemostatic agent such as QuikClot sponges or CE-LOX coagulant granules available, heavy bleeding is controlled first through direct, firm pressure on the injury site, preferably through a gauze pad or sterile dressing. If it is a limb that has been damaged, it will bleed less if it is elevated so that the wound is above the heart. If hemorrhage persists, use pressure points. Only in the worst cases when emergency services will not be available for an extended period of time should you consider use of a tourniquet, which if improperly used could cause gangrene or death. The Red Cross has dropped tourniquet techniques from its civilian training curriculum, as they are rarely needed and dangerous to apply.
Discern the safety of the scene and the condition of the victim, and then call for help before you begin administering first aid. Once you are sure it is safe to proceed, controlling bleeding must be your first priority.
If you are the one who is injured and think that you might pass out, especially if you are bleeding heavily or it is very cold, you have to get help immediately. If you do not, it will most likely prove fatal. Take a moment to gather your wits and locate the nearest cell phone, payphone, or source of friendly human beings. If you are alone and bleeding badly and there is no phone readily available, you will need to decide whether to stay or attempt to go for help. Physical activity will make your heart race faster, increasing blood loss. You are likely to get dizzy and collapse, thereby losing your pressure hold on the wound, and causing even more blood loss.
Firefighters, military, law enforcement, and emergency medical professionals often use special blood-clotting sponges, or hemostatic agents such as QuikClot, to treat severe bleeding from gunshots, stabbings, shrapnel, and similarly critical wounds. This stuff is very expensive to keep in your first aid kit but it saves lives.
If there is a reasonable chance that a rescuer will happen along soon, you may be better off dressing your wounds to the extent you can than putting yourself in “shock position” to wait for assistance. This is done by lying on your back with your legs elevated on something or with your legs bent sharply and your toes locked against a wall or similar object to keep them in position if you pass out. Wrap a garment around yourself if you can to help keep yourself warm. This position helps ensure that as much blood as possible will remain available to your vital organs.
If you don’t have a specialty agent such as QuikClot available, one of the most street-proven trauma dressings is a sanitary napkin or a box of Kleenex, something that ought to be in your first aid kit in addition to regular gauze pads and bandages. Key first aid methods for stopping heavy bleeding include:
• Covering the wound with a sterile dressing such as a gauze pad. If the dressing becomes soaked with blood, apply additional layers over the top of it without removing the original dressing.
• Applying direct pressure to the wound. If bleeding does not stop through a combination of dressings and pressure, remove the dressings, pack the wound with QuikClot (or a similar hemostatic agent), and reapply new sterile dressings. Use a pressure bandage to hold everything in place if available. If you do not have access to specialty agents, you may have to apply direct pressure to a nearby artery to slow the flow of blood. On the arm, the best point is along the inside of the upper arm between the shoulder and elbow. On the leg, the best point is at the crease at the front of the hip in the groin area.
• Elevating the wound above the level of the heart if possible. If you suspect head, neck, or back injuries or broken bones, however, or it may be prudent to remain in place. Moving may increase severity of the damage.
• Never removing imbedded objects before you get to the hospital. Doing so may increase hemorrhaging and severely reduce your chances of survival. Bulky dressings should be placed around the object and bandaged in place to support it so that it won’t move around and cause further damage.
• Wrapping severed body parts, if any, in a sterile dressing, placed in a plastic bag, and covered with ice or cold water sufficient to keep the part cool without freezing. Limbs preserved in this manner can frequently be reattached at the hospital. On the other hand, freezing the severed part will cause irreversible damage.
Head, Neck, and Back Injuries. Head, neck, and back injuries are serious. Do not move the victim unless absolutely necessary. If you do need to move the person, be careful to support the injured area, avoiding any twisting, bending, or other contortions that could cause additional damage. If the person becomes unconscious, you will need to maintain a clear airway and possibly perform rescue breathing or cardio-pulmonary resuscitation.
Concussions. The brain is extraordinarily delicate yet it is protected by a rigid skull and cushioned with cerebrospinal fluid. Trauma to the head, however, can cause the brain to bounce against the skull. This force may damage the brain’s function. There is very little extra room within this cavity, so any resulting swelling or bleeding can quickly become life threatening. In general, a blow to the front of the head is less dangerous than one on the side or back of the head.
If you and/or your loved ones have been wounded in a fight, you may have to tend to the injuries yourself until professional help can arrive. Check the incident scene to make sure that it is safe, call 9-1-1 or your local emergency number for help, and then begin to care for the victims. Once you have taken care of your own life- threatening injuries you will also want to treat your opponent. If your adversary is disabled and no longer a threat, it is both prudent and humane to try to keep him from dying from his wounds too.
Symptoms of a concussion can include severe headache, dizziness, nausea, vomiting, ringing in the ears, mismatched pupil size (left vs. right), seizures, or slurred speech. The person may also seem restless, agitated, or irritable. Often, the victim may experience temporary memory loss. These symptoms may last from hours to weeks, depending on the seriousness of the injury.
Any loss of consciousness or memory resulting from a head injury should be promptly evaluated by a medical professional. As the brain tissue swells, the person may feel increasingly drowsy or confused. If the victim has difficulty staying awake, experiences persistent vomiting, develops seizures, or loses consciousness, medical attention should be sought immediately. These could be signs of a severe injury.
Concussions can run from mild to severe. While only medical professionals can tell for sure, one can surmise what type of concussion has been sustained based upon the observable symptoms. Grade 1 or mild concussions occur when the victim remains conscious after a blow but seems dazed or mildly confused. Grade 2 or moderate concussions occur when the victim remains conscious but continues to be confused for a period of time and does not recall the traumatic event. Grade 3 or severe concussions occur when the victim loses consciousness for a period of time and has no memory of the traumatic event. If you suspect that someone has suffered a Grade 2 or Grade 3 concussion, evaluation from a medical professional should be performed as soon as possible.
Watch the person closely for any changes in level of consciousness until medical help arrives. The victim may need to stay in the hospital for close observation. The standard test to assess post-concussion damage is a computerized tomography (CT) scan. Surgery is not frequently required but may become necessary if swelling persists. Recovery from a traumatic brain injury can be very slow. Sometimes several days can go by without seeing
