-----------------------------------------------------------------
                             INTERNAL BLEEDING
    -----------------------------------------------------------------

    This may occur following an injury such as a fracture or a crush
    injury, or because of a medical condition such as a bleeding 
    stomach ulcer. Internal organs, the spleen and liver for example,
    can be damaged by blows to the body even though there may be no 
    EXTERNAL evidence.

    Internal bleeding is as serious, if not MORE serious than external
    bleeding. Although blood is not lost from the body, it is lost
    from the circulatory system and the vital organs become starved of
    oxygen.

    Blood collecting internally will also cause problems if it presses
    on vital structures. For example, blood inside the skull can 
    compress the brain causing loss of consciousness; bleeding inside 
    the chest may prevent the lungs from expanding.

    ALWAYS suspect internal bleeding after a violent injury, if there
    are symptoms and signs of shock without any visible blood loss or
    if there is any "patterned" bruising corresponding to the seams
    and/or texture of the casualty's clothing.


    The Aim
    -------

    Arrange removal to hospital immediately because it is not usually
    possible to control internal bleeding using First Aid.


    Treatment
    ---------

    1 and 2 as in diagram.

    3: Loosen any constricting clothing around the neck, chest and
       waist.

    4: Reassure the casualty and explain the necessity to relax.
 
    5: Check breathing rate, pulse and levels of responsiveness at 10
       minute intervals. Record these if possible for the doctor.

    6: Examine the casualty for other injuries and treat as necessary.

    7: If the casualty becomes unconscious but is breathing normally,
       place in the Recovery Position ( see Resusitation ).

    8: If the breathing and heartbeat stop, begin Resusitation
       immediately.
    
    9: Keep the casualty covered and place a blanket underneath, if
       possible.
 
   10: Keep a record of any specimen passed or vomited by the casualty.
       If possible send samples along to the hospital with the casualty.

   11: Remove to hospital immediately. Transport as a stretcher case,
       maintaining the treatment position.

   ----------------------------------------------------------------------