Reprinted from the ACJ - June, 1996
Blood is thicker than water. It is also more dangerous. The rapid increase in blood borne, contagious diseases such as AIDS/HIV has prompted even those who don't faint at the sight of blood to feel a little light headed. I suspect that vampires are turning more to fancy French bottled blood to avoid the potential contamination at the "tap."
At almost all industrial sites, radiator shops included, the potential for cuts, scrapes or worse bloodletting is always present. The only place you are more likely to be injured is at home. The difference is that at home it's usually only your blood that you have to be concerned with.
At work it is a different story. You may think you know your co-workers, but exchanging bodily fluids with them is a tough test of a friendship. Because of the potential for injury, we need to be trained in proper first aid procedures.
The hazards that may exist in the blood necessitates that we protect ourselves as we assist the injured. OSHA has instituted a "Blood Borne Pathogen" program requirement for general industry. Much like the "Hazardous Communication Standard" we all know and love, the program lays out what an employer must do to comply.
First aid responses
We will deal with those requirements in an upcoming issue. For now, we will discuss first aid responses to situations where blood is present. The way I figure it, if you are bleeding right now, you probably need first aid information before you need regulation information.
Accidents that result in the loss of blood can be relatively minor (check your hands for Band-Aids) or very nasty (check your hands for fingers). How to respond to both situations is something we should all know. Using a policy of "He who bleeds cleans it up" may not be appropriate in all situations.
Step 1 is to have a supply of clean disposable gloves in the first aid kit. The gloves sitting on the edge of the boilout tank won't cut it here. Step 2, put the gloves on before assisting the injured party.
For most cuts and scrapes, simple pressure at the site will control the bleeding. Take some clean gauze and apply light pressure for five minutes or so to allow clotting. Avoid checking under the cloth too often. That may restart the blood flow and could allow blood to squirt at you. Elevating the injured body part is helpful to reduce the internal blood pressure at the wound.
Pressure points
If the cut is more severe, in addition to site pressure you may need to access "pressure points" upstream to slow blood flow. In the arm, that spot is under the arm, against the bone, near the armpit. Place two fingers under the injured arm and apply light pressure to compress the skin, muscle and vein/artery against the bone. Sticking your hand in a co-worker's armpit is of course another good reason to be wearing gloves.
For severe leg cuts, the main artery runs over the bottom edge of the pelvis, near the hip joint. Use several fingers or the heel of your hand to apply pressure. Do not exceed five or 10 minutes in restricting blood flow at these pressure points to avoid injury to healthy tissue in the arm or leg.
If the wound has not clotted in this time release the pressure at the point, but not the gauze dressing, for a few minutes and then reapply if necessary. Do not use a tourniquet for this pressure because it restricts too much blood and can complicate matters. Generally speaking, tourniquets are seldom used anymore because of tissue damage, but in the case of severe trauma it may be necessary.
Rapid response
Loss of a limb would constitute severe trauma in most people's books, and most people's work places. This type of injury may require use of a tourniquet. If a co-worker is unlucky enough to lose an arm or leg, it is imperative that you respond appropriately and rapidly.
Apply site pressure with gauze or clean rags or your shirt if necessary, as these injuries bleed profusely. Then you can place a two-inch wide strap, belt or torn cloth approximately two to five inches above the stump. I apologize if you are reading this during lunch, but believe me an actual incident can ruin your whole day.
Do not place the tourniquet farther up the limb than necessary due to the tissue damage we mentioned earlier. Don't twist a stick or screwdriver in the fabric to tighten. Instead, just cinch up a knot as snug as you can get it. You may need assistance for the procedure.
Mark it with a `T'
It is important for the emergency medical technician (EMT) and hospital folks to know how long the blood flow has been restricted. To facilitate this, mark a large "T" on the victim's forehead along with the time the tourniquet was applied..
If the injury is a lost finger or toe, apply a pressure dressing at the stump site and wrap something, but not too tightly, at the base of the digit to slow blood flow.
It should be obvious that being the guy who is responding to an amputation injury is not a fun job. But it is better than the next guy's job. That is the person responsible for the amputated part. This person should also be wearing gloves.
For small parts like fingers and toes, place the part in a Zip-Lock type bag and then place that bag into a second bag containing cold water or ice water. Never place the part directly on ice or use dry ice, as this may kill tissue and it needs all the health it can get. For large parts, simply cover it with a clean cloth and tell the EMTs where they can find it. Try not to forget this step in all the confusion.
After bandaging, elevate the injured limb and try to keep the victim calm and warm as you wait for the emergency personnel.
OK, that's enough gore for today. Suffice it to say that injuries are most likely to be cuts of relatively small size and applying site pressure while elevating the injury should do the trick. But accidents happen and we must be ready.
After the victim is in the hands of the medical personnel, cleaning up is the next step. Again, wear gloves and avoid contact with the blood whenever possible. Any individual that has come into contact with the injured person's blood must wash thoroughly with soap and water.
Pull off the gloves, rolling them inside out as you do. This will contain the blood inside the used glove. Remove and wash any contaminated clothing and scrub down any area or equipment in the shop that was affected.
The injured party may take some offense that you don't want to become "Blood Brothers" with him. But in these days of blood borne diseases, joining a lodge may be a safer way to obtain brotherhood.
The above article was written by David M. Brown, Chief Engineer of Johnson Manufacturing Company, Inc. and is published by JOHNSON with the expressed approval of the National Automotive Radiator Service Association and the Automotive Cooling Journal. Other reproduction or distribution of this information is forbidden without the written consent of JOHNSON and NARSA/ACJ. All rights reserved.
JOHNSON MANUFACTURING COMPANY
114 Lost Grove Road / PO Box 96 / Princeton, Iowa 52768-0096
Phone 563-289-5123 or Fax 563-289-3825