Title: (Optional) Describe methods of dealing with bleeding patients who are in shock.
Course: Emergency Medical Telecommunications (14055-V) > Section: Understanding Legal and Liability Issues

Description should include the following:

- Control of bleeding—Tell the patient to use a universal bandage or clean gauze pad and press down directly on the open wound (the caller should use the cleanest cloth possible and use a lot of pressure). Tell them not to remove soaked bandages because it will rip open the clot forming on the wound (if need be, add another bandage on top and continue pressure). If the bleeding has stopped, the dressing can be tied in place with a bandage.  Note: This should be instructed to the students as “provide bleeding control instructions according to your protocol system."
- Internal bleeding—There is not much you can do about it, but recognize it because of shock issues.

Note: Tourniquets can cause significant damage by stopping the flow of blood completely through a limb. This causes nerve and cell damage that is frequently permanent and can even result in amputation. If a caller says that a tourniquet has already been applied, it should be left on. Never instruct a caller to apply a tourniquet.

Process/Skill Questions:

- What conditions might lead to the application of a tourniquet to control bleeding?
- Who should remove the tourniquet?