Internal bleeding
Internal bleeding may result from a direct blow, strain, or diseases such as peptic ulcers. It may be concealed or visible. Bleeding around a fractured limb may be detected by swelling. Bleeding into the chest or abdomen may be indicated if blood is coughed up or vomited. Stab and puncture wounds can also cause serious internal bleeding.

The casualty will exhibit signs of shock: initially pale, dizzy, faint, and sweating. Pulse and breathing rates increase. Later, the skin becomes cold, extremities turn slightly blue, the pulse becomes weak and rapid, and breathing becomes shallow. The casualty may feel thirsty, nauseated, restless, and complain of difficulty breathing (“air hunger”). These signs indicate ongoing bleeding. Eventually, the casualty may become unconscious.

The most important indicator of continued bleeding is a rising pulse and falling blood pressure. Monitor pulse and blood pressure every 5–10 minutes. After about one hour, it should be clear whether bleeding is continuing. If blood pressure remains stable and pulse decreases or stabilizes, bleeding is unlikely.

Patients with concealed internal bleeding may require blood transfusion. Obtain RADIO MEDICAL ADVICE.
Position the casualty with a slight head-down tilt and elevate the legs to maintain circulation to vital organs. Maintain this position during transport.

Bleeding from the nose

Pinch the soft part of the nose firmly for 10 minutes while keeping the head bent forward over a container. The casualty can do this themselves. After 10 minutes, release slowly and check for bleeding.
Advise the casualty not to blow their nose for four hours and to avoid forceful blowing for two days.
If bleeding continues, repeat for another 10 minutes. If still uncontrolled after 20 minutes, packing with gauze may be required.

Bleeding from the lip, cheek, and tongue

Apply pressure on both sides using gauze or a swab. The casualty may assist under supervision.

Bleeding from the ear passage

Usually caused by head injury or blast. Place a large pad over the ear and bandage it. Keep the affected ear facing downward. If unconscious, place in the unconscious position with the affected ear down.
Never insert anything into the ear. Obtain RADIO MEDICAL ADVICE.