Actively bleeding patient

[shnnon90]

Would doing CPR or stopping the bleeding take precedence? Wouldn't CPR exacerbate the blood loss?

[vulupure]

More info please, how much blood is being lost? Where is the bleeding?

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[vulupure]

Either way, if patient is pulseless you need to start compressions, one you get the pulse back, you can start managing bleeding with pressure or iv fluids

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[nrsang97, BSN, RN]

If there is no pulse then CPR is most important

[Emergent, RN]

In a code in the hospital multiple things will be going on at once. Just remember your first action: start CPR and get help

[shnnon90]

Thanks guys. I just saw many conflicting suggestions on this topic, so I figured I'd get more insight. People who are proponents of stopping bleeding first gave the reasoning that doing compressions on someone who is bleeding is making their blood loss worse. Then on the other hand, CPR first supporters say you can die faster from lack of circulation and oxygen than you will from loss of blood. Another suggestion someone had was if a partner is available, someone can try to apply pressure to wound, while someone else does CPR.

[AgentBeast, MSN, RN]

With someone who is bleeding profusely enough to cause his or her heart to stop beating it's highly likely that no matter what you do this person will die. That doesn't mean you shouldn't try to save them though. Chest compressions, stopping the bleeding, and rapid blood transfusion/volume replacement.

[KelRN215, BSN, RN]

If you're in the hospital coding a patient, multiple things will be happening at once. Someone will be doing CPR while someone else will be managing the bleeding, transfusing blood, plasma, platelets, factor or whatever is needed.

If the heart has stopped, without CPR the patient will die regardless of how fast you stop the bleeding.

[CryssyD]

Remember your ABC's: airway, breathing, circulation. If the patient is without a pulse, CPR comes before stopping bleeding--you need to circulate whatever blood the patient has left. If no one is available to apply pressure on the wound, you need to put on either a pressure dressing or tourniquet (quickly) to at least slow the bleeding down. Ideally, of course, this patient is in the hospital, where someone else would be available to worry about stopping bleeding and getting IV access for blood/fluid administration.

[shnnon90]

Very insightful responses, thanks! I probably should have been more specific and said in a setting where you don't have help, like a prison where there is only one RN. But the solution of applying a pressure dressing and doing CPR would be a plausible solution!

[twinmommy+2, ADN, BSN, MSN]

If you have a patient who is pulseless, congratulations you have stopped the bleeding. Now critically thinking, if you are the only one available to start CPR, then anyone else around you can follow directions to call 911, start a tourniquet, apply pressure, all while you are doing compressions.

[KelRN215, BSN, RN]

Very insightful responses, thanks! I probably should have been more specific and said in a setting where you don't have help, like a prison where there is only one RN. But the solution of applying a pressure dressing and doing CPR would be a plausible solution!

There may be only one RN in a prison but presumably there's an officer or guard present who is trained in CPR and you don't need to be trained in CPR to hold pressure on a wound while another person is doing compressions.