Controlling bleeding from wound site

[NN2BVE]

When a wound site is bleeding and applying pressure does not help, would you remove old saturated with blood dressing and put a clean one (and then of course continue to apply pressure until help arrives) or would you just pile up gauze on top of a old one and keep the pressure on? We kind of divided on this one at work. Please share your thoughts.

[applewhitern, BSN, RN]

Personally I would remove the saturated dressing, otherwise it may be harder to see how much/how fast it is bleeding. It depends on just "what" type of wound is bleeding, however. If it is anything involving an artery, then no, I wouldn't release it until help arrived.

[NN2BVE]

Ah yes, should be more specific. :)

It is groin area vein which was accessed for IVC filter placement.

[casi, ASN, RN]

I'd keep applying. Removing the dressing could pull off any clotting that could be taking place.

[Sun0408, ASN, RN]

I leave the old and apply new on top.. PP is correct, pulling off old may remove what clots are there and the wound may bleed more..

[Jolie, BSN]

I'd keep applying. Removing the dressing could pull off any clotting that could be taking place.

It's tempting to peek, but not a good idea for this reason. If the wound continues bleeding, it will saturate the newly added dressings. One way to determine whether bleeding is slowing is to note the amount of time it takes to saturate each newly applied dressing.

[NN2BVE]

Thank you for validating my thoughts. My supervisor and 911 both said remove old one,apply new. I decided against doing that. Not and easy thing to trust yourself when you are new grad and your more experienced supervisor tells you the otherwise. thanks again.

[Biffbradford]

Also, ensure that you're applying pressure in the right spot. Distally for venous, proximally for arterial.

[kool-aide, RN]

Also, ensure that you're applying pressure in the right spot. Distally for venous, proximally for arterial.

I was just thinking that myself, very important point. I would not remove saturated gauze while holding pressure, especially if it was an arterial bleed or a bleed from a large venous vessel.

[Anna Flaxis, BSN, RN]

To control bleeding on a femoral vein puncture, apply firm, direct pressure with the pads of your fingers over a sterile gauze pad. If the gauze pad is becoming saturated, I would question whether your pressure is firm enough, particularly on a venous site.