Suspecting Internal Bleeding In An Unconscious Friend Steps After Calling 9-1-1

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When faced with a medical emergency, especially one involving a friend, remaining calm and taking swift, decisive action is paramount. Internal bleeding, a potentially life-threatening condition, requires immediate medical attention. If you suspect your friend is experiencing internal bleeding and is unconscious, your response in the initial moments can significantly impact the outcome. This comprehensive guide will walk you through the crucial steps to take, ensuring you provide the best possible care until professional help arrives.

Initial Assessment and Calling 9-1-1

Your initial assessment is the cornerstone of the response. If you find your friend unconscious, the first step is to immediately check for responsiveness. Gently tap or shake their shoulder and loudly ask, "Are you okay?" If there is no response, it's critical to assume the situation is serious and potentially life-threatening. Simultaneously, have someone call 9-1-1. If you are alone, make the call yourself before proceeding further. When speaking to the emergency dispatcher, clearly and concisely provide the following information:

  • Your location: Give the exact address and any landmarks that can help emergency responders find you quickly.
  • The situation: Explain that your friend is unconscious and you suspect internal bleeding.
  • The number of people involved: Indicate that there is one patient.
  • The patient's condition: Describe your friend's state – unconscious, not breathing, or any other visible signs of distress. If you know of any pre-existing medical conditions, mention them to the operator, as this information can be essential for the paramedics upon arrival.
  • The care being given: Inform the dispatcher of any first aid measures you are taking, such as CPR.
  • Follow instructions: The dispatcher may provide crucial instructions over the phone, such as how to perform CPR or manage the airway. Listen carefully and follow their guidance until help arrives.

Staying on the line with the dispatcher is crucial, as they can guide you through critical steps and relay vital information to the arriving paramedics. While waiting for the ambulance, you should start performing the next essential steps in tending to your unconscious friend who may have internal bleeding.

Prioritizing Airway, Breathing, and Circulation (ABCs)

Once you've called 9-1-1, the next critical step is to assess and address the ABCs: Airway, Breathing, and Circulation. These are the fundamental elements of life support, and ensuring they are maintained is crucial in the moments before emergency medical services arrive. This systematic approach will help you identify and manage the most immediate threats to your friend's life.

Airway

First, check your friend's airway to ensure it's clear. An obstructed airway can quickly lead to oxygen deprivation and brain damage. To assess the airway:

  • Look: Check for any visible obstructions in the mouth, such as foreign objects, vomit, or blood. If you see something, attempt to clear it out carefully.
  • Listen: Put your ear near your friend's mouth and nose, and listen for any sounds of breathing. Gurgling or snoring sounds may indicate an obstruction.
  • Feel: Place your cheek near your friend's mouth and nose to feel for breath.

If the airway seems blocked, you'll need to open it. The most common method is the head-tilt-chin-lift maneuver. To perform this:

  1. Place one hand on your friend's forehead and gently tilt their head back.
  2. Place the fingers of your other hand under their chin and lift it forward. This action helps lift the tongue away from the back of the throat, opening the airway.

If you suspect your friend has a spinal injury, avoid the head-tilt-chin-lift maneuver. Instead, use the jaw-thrust maneuver. To do this:

  1. Place your fingers behind the angles of your friend's jaw.
  2. Push the jaw forward, which can open the airway without moving the neck.

Once the airway is open, reassess for breathing.

Breathing

After ensuring the airway is clear, check if your friend is breathing. Look, listen, and feel for breathing for no more than 10 seconds. Look for the chest rising and falling, listen for breath sounds, and feel for air on your cheek. If your friend is not breathing or is gasping (which is not considered effective breathing), you'll need to provide rescue breaths.

If you are trained in CPR, begin rescue breaths along with chest compressions. If you are not trained, focus on continuous chest compressions, as recommended by the American Heart Association's hands-only CPR guidelines. To give rescue breaths:

  1. Maintain the open airway using the head-tilt-chin-lift or jaw-thrust maneuver.
  2. Pinch your friend's nose closed.
  3. Make a tight seal over their mouth with your mouth.
  4. Give two rescue breaths, each lasting about one second. Watch for the chest to rise with each breath.

Circulation

Internal bleeding can severely compromise circulation by reducing blood volume. If your friend is unconscious, checking for a pulse can be challenging, especially if you are not medically trained. However, if you are trained, check for a carotid pulse (in the neck) or a femoral pulse (in the groin). If there is no pulse, begin chest compressions immediately.

Chest compressions help circulate blood to vital organs, buying time until professional medical help arrives. To perform chest compressions:

  1. Place the heel of one hand in the center of your friend's chest, between the nipples.
  2. Place your other hand on top of the first, interlacing your fingers.
  3. Position yourself directly over your friend's chest.
  4. Push straight down, compressing the chest at least 2 inches (5 cm) but no more than 2.4 inches (6 cm).
  5. Perform compressions at a rate of 100-120 compressions per minute. This is roughly the same tempo as the song