Severe bleeding can be terrifying, but staying calm and knowing what to do can make a critical difference. 

Whilst out mustering an unruly mob of cattle, the sun beat down on Mick, the flies intent on driving him mad, he hears an all mighty yell. He rushes over to find Sarah lay sprawled, a nasty gash on her upper arm.

Years in the bush honed Mick’s response. He grabbed his first-aid kit, opening it he searches for and finds a sterile combine dressing. Unlike flimsy gauze, its absorbent core is a lifesaver for outback-sized bleeds.

With practised efficiency, Mick minimised contamination by cleaning the wound, and applied the combine dressing directly onto the gash. A bandage secured it firmly. Relief flickered on Sarah’s face as the bleeding slowed.

Mick knew the combine dressing was a crucial first step, but for a wound this serious, they needed more help.The call had been put out and help was on its way..

The Best Method: Direct Pressure

The most effective way to stop severe bleeding is by applying direct pressure to the wound. Here’s how:

1. Safety First: Ensure the scene is safe for yourself and the injured person.
2. Wearing gloves protects you from potential infections transmitted through bodily fluids. It also allows you to maintain pressure more effectively without slipping.
3. Call for Help: Dial emergency services immediately or ask someone else to do so.
4. Position the Person: Lay the injured person down, if possible, and elevate the bleeding limb above the heart.
5. Apply Pressure: Use a combine dressing, or even your hand to apply firm, steady pressure directly on the wound.
6. Maintain Pressure: Keep applying pressure for at least 10-15 minutes, even if the bleeding slows down. Don’t peek – adding new cloth over the existing one helps form a clot.

Combine Dressings: Super Absorbent Allies for Wound Care

Combine dressings are a handy tool in any first-aid kit, especially useful for managing serious bleeding wounds. Here’s a breakdown of their use:

What are Combine Dressings?

These dressings are known for their high absorbency. They typically consist of:

• Thick inner layer: Made of a very absorbent material like fleece to soak up blood.
• Soft, non-woven outer fabric: This layer protects the wound and is comfortable against the skin.
• Sealed ends: These prevent pressure points from forming on the wound.

When to Use a Combine Dressing:

Combine dressings are ideal for:

• Large or heavily bleeding wounds: Their high absorbency helps control blood flow.

How to Use a Combine Dressing:

1. Prepare the Scene: Ensure safety for yourself and the injured person. Call emergency services immediately.
2. Clean the Wound (if possible): Gently clean the wound with clean water or antiseptic wipes, avoiding dislodging any clots.
3. Open the Dressing: Maintain sterility by not touching the absorbent pad directly.
4. Apply Pressure: Place the dressing directly over the wound, ensuring it completely covers the area.
5. Secure the Dressing: Use a bandage (ideally, an elastic roller bandage) to firmly secure the combine dressing in place.

Bleed Through the Dressing? Don’t Panic!

If blood soaks through the cloth, don’t remove it. Add another combine dressing on top and continue applying pressure and secure with another bandage. Removing the soaked dressing disrupts clot formation.

Is the Bandage Too Tight?

While firm pressure is crucial, stopping blood flow completely can damage tissues. Here are signs a bandage might be too tight:

• Throbbing pain below the bandage (beyond normal discomfort)
• Tingling or numbness in the affected limb
• Skin turning pale or bluish below the bandage

If you suspect a bandage is too tight, loosen it slightly while maintaining pressure on the wound itself.

Benefits of Combine Dressings:

• Highly Absorbent: Effectively controls blood flow from large wounds.
• Low-Adherent: Minimises discomfort during dressing changes.
• Hypoallergenic: Designed to be gentle on the skin.

Important Reminders:

• Don’t Reuse: Combine dressings are single-use sterile items. Discard them after use.
• Bleed Through? Add More! If blood soaks through the dressing, don’t remove it. Apply an additional combine dressing on top and maintain pressure.
• Seek Medical Attention: While combine dressings help control bleeding, severe wounds require medical evaluation.
• Tourniquets: Tourniquets should only be used as a last resort for severe bleeding from limbs that cannot be controlled with direct pressure. Using a tourniquet incorrectly can cause serious tissue damage.

By understanding combine dressings and their proper use, you can be better prepared to handle situations with serious bleeding. However, remember, first-aid knowledge is just one piece of the puzzle. Consider taking a certified first-aid course for a more comprehensive understanding of emergency wound care.

Combine dressings are an essential part of any first aid kit, available in a variety of sizes suitable for most situations. Available from Rural and Remote First Aid

By Scott Brown

If you would like more information about this topic or any others, purchase any First Aid stock or equipment, or to book a Remote Area First Aid course, please contact us on 0491 057 339 or email info@ruralandremotefirstaid.com.au

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For over 23 years Scott Brown has been training Remote Area First Aid across Australia. Having first joined Rural Ambulance Victoria in 2001 and working in the high-country in Victoria, he began teaching First Aid for Rural Ambulance Victoria. 23 years on, he works with some of Australia’s largest pastoral corporations and property managers that combined manage over 200,000 square kms of the Australian landscape.Known for conveying detailed First Aid information in a relatable and relaxed way, Scott’s courses have become popular with Agricultural Property Managers, overseers and ringers alike. The highly practical course content ensures relevance to actual situations that are possible to encounter on a working property.
Scott continues to work with Ambulance Victoria alongside his First Aid training.
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