Yesterday I was at the snow and was right next to a skier who plowed in a steel fence. I didn’t see the accident, I only heard it - an extremely loud bang. By the time I had turned around and comprehended that there was someone lying motionless on the ground nearby, and approached them, perhaps 5-10 seconds had passed. When I looked down at the person, I saw they were lying on their back, their face was expressionless, eyes were open staring straight in to the sky, and blood was absolutely guzzling out out of their nostrils, like it was being pumped <glug> <glug> <glug>. Blood was rapidly pooling around their body.
Thankfully some snow patrol people arrived at the scene, and began administering first aid. I noticed the first thing they did was roll the person off their back and on to their side. Soon after, I heard one of the people tending to the skier say “He has no pulse, he has no pulse”.
They soon had the area surrounded by white sheets acting as “walls” so we could no longer see what was happening, but about an hour later, the person was loaded in to an ambulance with a drip attached. There was no local news report that night of anyone passing away on the ski fields (which does tend to get reported when it happens here), so hopefully the young man survived.
I am wondering - what was the most likely cause of injury this person had suffered that was causing the blood to guzzle out of his nostrils?
In such incidents, what are the chances of fatality due to blood loss (or some other likely cause)?
Experiencing this incident will most likely result in me going and getting some proper first aid training, but what is the absolute minimum that someone can do for a person in this situation, assuming no professional help is immediately on offer?
Well, the blood coming from his nostrils may have reflected nothing more serious than a broken nose (although that clearly wouldn’t explain his overall, unresponsive state).
It may have been the case that he experienced a basal skull fracture (due to which there may be bleeding from the nose).
As an aside, in “closed head injuries” (i.e. where the skull isn’t fractured and there’s no communication of the brain or meninges with the outside), death from blood loss is essentially impossible. The injured person would die of increased pressure on the brain (from the accumulating blood) way before there had been enough bleeding into the brain to cause shock, let alone death from exsanguination).
ETA: In terms of first aid, the most important thing in a case like this is ensuring that the breathing passages are kept clear (of blood, vomit). Turning them onto their side helps to do that - basically that allows gravity to drain the blood (or vomit) out and away from the windpipe. Of course, you need to take care not to flex or otherwise move the injured person’s neck. He may have a broken one and movement could lead to paralysis.
ABC is the minimum - Airway, Breathing, Circulation.
Ie, is their airway clear? Remove any foreign objects from their mouth and around their mouth if it safe to do so, which follows to breathing: are they? Also check pulse: can you feel one, either at the wrist or at the neck?
If the answer to any of those questions is “no” then you have a strong chance of saving their life (or preventing brain damage) if you are the first to arrive and you know CPR while you wait for professional help to arrive.
This does assume that the patient is at no serious risk of a neck or spinal injury - if you are at all unsure, do not move them unless it is essential.
If they are very obviously bleeding from a major wound and it’s gushing out (possibly from an artery) then applying pressure to it if possible will help enormously, but do not tie a tourniquet around a limb to stop bleeding (in the absence of professional advice) as it can do more harm than good.