Nosebleed

Put on disposable gloves if available
Have the casualty pinch the fleshy part of the nose just below the bone
Have the casualty lean slightly forward
Ask the casualty to breathe through their mouth
Maintain the pressure and posture for at least 10 minutes - a longer time may be needed in hot weather or after exercise or if the casualty has high blood pressure
Apply cool compress to the nose, neck and forehead
If bleeding persists, obtain medical aid
Advise the casualty not to blow or pick their nose for several hours or to swallow blood

Amputation

Treat as for bleeding from wounds
After bleeding is controlled - collect amputated part - keep dry, do not wash or clean - seal the amputated part in a plastic bag or wrap in waterproof material - place in iced water - do not allow the amputated part to come in direct contact with ice. Freezing will kill tissue
Ensure the amputated part goes to the hospital with the casualty. Often the part can be re-attached using microsurgery

If bleeding occurs through the existing dressing, place a second dressing over the first leaving the existing dressing in place, remove and replace only the bandage and adding. Maintain direct pressure over the bleeding area as much as possible. Avoid disturbing the bandage or pad once the bleeding has been controlled. Wounds can be cleaned with clean water or sodium chloride. With all wounds, the casualty should obtain medical advice for tetanus prevention.

Internal bleeding

Internal bleeding is classified as either visible, in that the bleeding can be seen or concealed, where no direct evidence of bleeding is obvious. Always consider internal bleeding after injury, understanding it cannot be controlled by the first aider. In most instances, obtaining an adequate history of the incident or illness will give the first aid provider the necessary clue as to whether internal bleeding may be present.

Remember current signs and symptoms or the lack of them; do not necessarily indicate the casualty's condition.

Certain critical signs and symptoms may not appear until well after the incident due to the stealth of bleed and may only be detected by the fact that the casualty's worsen despite there being no visible cause.

Visible internal bleeding

Visible internal bleeding is referred to this way because the results can be seen in bleeding from:

Anus or vagina. Usually red blood mixed with mucus
Ears. Bright, sticky blood or blood mixed with clear fluid
Lungs. Frothy, bright red blood coughed up by the casualty
Stomach, bowel or intestines. Bright, dark or tarry blood
Under the skin (bruising). The tissues look dark due to the blood under the skin.
Urinary tract. Dark or red coloured urine

Concealed internal bleeding

Detecting internal bleeding relies upon good observations and an appreciation of the physical forces that have affected the casualty. In these cases, the first aid provider relies heavily on history, signs and symptoms. If you are unsure, assume the worst and treat for internal bleeding.

Remember to look at the important observations that may indicate internal bleeding, which include:

Skin appearance
Conscious state
Pulse
Respiration
Pale, cool, clammy skin

Signs and symptoms

Thirst
Rapid, weak pulse
Rapid, shallow breathing
'Guarding' of the abdomen, with foetal position if lying down
Pain or discomfort
Nausea and/or vomiting
Visible swelling of the abdomen
Gradually lapsing into shock

Care and treatment

Call Triple Zero (000) for an ambulance
Put on disposable gloves if available
If conscious - lie the casualty down with legs elevated and bent at the knees
If unconscious - recovery position and elevate the legs if possible
Reassurance
Treat any injuries
Give nothing by mouth

Shock

Shock is a life-threatening condition and should be treated as top priority, second only to attending to safety, an obstructed airway, absence of breathing, cardiac arrest or severe life threatening bleeding. Shock is a deteriorating condition that does not allow a casualty to recover without active medical intervention.

Causes of shock:

Loss of blood. This is the most common cause of shock. Blood loss may occur immediately or may be delayed. The blood loss could be either seen externally or internally within a particular system or organ.

The greater the loss of blood, the greater the chance of developing shock. A slow, steady loss of blood can also produce shock.

Abdominal emergencies. Burst appendix, perforated intestine or stomach, intestinal obstruction, pancreatitis.
Loss of body fluids. May be due to extensive burns, dehydration, severe vomiting or diarrhoea.
Heart attack. Failure of the heart to function due to an obstructed blood supply to the heart itself can produce shock.
Sepsis or toxicity. Discharge of toxins produced by bacteria in the blood stream can produce shock.
Spinal injury. Due to the injury and the reaction of the nervous system.
Crush injuries. Injuries following explosions, building collapses etc

As a first aider attending a casualty, you should ask yourself the following:

Does the injury appear serious?
If I don't do anything to help, is the casualty likely to become worse?
If the casualty's condition worsens, is death a possibility?

If the answer to any of these questions is 'YES!', then you should treat for shock

Signs and symptoms:

Pale, cool, clammy skin
Thirst
Rapid, shallow breathing
Rapid, weak pulse
Nausea and/or vomiting
Evidence of loss of body fluids or high temperature if sepsis present
Collapse and unconsciousness
Progressive 'shutdown' of body's vital functions

Care and treatment: