The RICE formula:
Rest – The chances of dislodging a clot already formed, is more while moving the affected part, further increasing the chances of bleeding. Simultaneously, the chances of damage around the affected part are also more due to its movement. It is thus important to provide rest to the affected part.
Ice – All blood vessels have a variable amount of muscles within them. These can either relax or constrict thus being capable of simultaneously increasing or reducing the blood supply at the affected part. Ice reduces the temperature, thus helping to constrict a blood vessel. This helps to reduce the blood flow thus contributing to reduce bleeding. It is thus advised to use either cold water or preferably ice packs around the affected area for a good amount of time. It is also for the same reason that one should avoid using warm fomentation around the affected area for the purpose of reducing pain. Warm packs do help reduce the pain, but due to their ability to dilate a blood vessel they increase the chances of bleeding (swelling) especially if used within approximately 24 hours of its occurrence (wounds, sprains, fractures, muscle pulls, etcetera).
Compression – Compression provides the physical pressure that reduces the blood flow, thus allowing a clot to get stabilized at the bleeding spot. It is advised to use a clean cloth or a gauze piece to facilitate even pressure. Bare hands can be used if a cloth is not available. Pressure applied should be sufficient to stop the bleeding but not enough to cause pain. Pressure can be applied continuously for around 2 – 3 minutes after which it can be slowly released to check for its effect. If bleeding persists, pressure has to be continued intermittently till the time it stops. Pressure should not be applied if a fracture is suspected. Ice can be used abundantly instead.
Elevation- Simple elevation of the part affected helps to reduce bleeding by reducing the blood pressure in the affected area. This can be achieved by using a sling if the arms are affected or by making the person lie down in case the legs are affected.
Source: Dr. Atul Pednekar, Institute of Life Sciences
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