The imposition of a tourniquet for arterial bleeding in summer and winter - rules and possible mistakes. How to apply a tourniquet for arterial bleeding

The imposition of a tourniquet for bleeding is not accidentally referred to as the "alphabet of salvation", it is very important point first aid for injuries, often saving the life of the victim. However, the procedure itself is not as simple as it might seem. An incorrectly applied tourniquet will not only not help, but also harm. So that first aid does not turn out to be the last, you need to have basic knowledge of how to apply a tourniquet in different situations.

Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category

The total work experience is over 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 he completed his residency in Traumatology and Orthopedics at the Central Research Institute of Traumatology and Orthopedics named after V.I. N.N. Prifova.

To effectively help with bleeding, you need to have an idea of its nature. It is not difficult to determine the type of bleeding, it is of 3 types:

arterial;
venous;
capillary.

Arterial bleeding

Arteries are vessels that carry blood from the heart to the periphery, to all organs and tissues. Blood in them comes in jerks as a result of contraction of the heart - systole, in addition, it has passed the pulmonary circle and is enriched with oxygen. Accordingly, if the artery is damaged, it will have the following characteristics: output in a pulsating stream, in accordance with the rhythm of the heartbeat, and a bright scarlet color.

Venous bleeding

Through the veins to the heart in the opposite direction is "waste" blood from organs and tissues, which has given up oxygen and saturated with carbon dioxide. It comes as a result of the pulling force of the heart when the heart muscle relaxes (diastole). Therefore, if the vein is damaged, it will flow out in a uniform stream and have a dark color.

Capillary bleeding

Capillaries - multiple tiny endings of blood vessels located in the skin, through which tissue cells receive oxygen from arterial blood. Damage to the capillaries occurs with superficial injuries: abrasions, scalped wounds. Blood with such injuries has a bright scarlet color and is released gradually and evenly over the entire surface of the wound, as if leaking out, without pulsation.

The first 2 types of bleeding can be stopped by applying a tourniquet, but with capillary bleeding, it is contraindicated and does not make sense. It is enough to apply a pressure bandage and cold to the wound area.

Signs of bleeding

Bleeding, in addition to the described external signs, also have symptoms of a general nature associated with blood loss:

pallor of the skin;
dizziness, ringing in the ears;
lowering blood pressure;
increased heart rate - tachycardia;
cold clammy sweat;
fainting.

With severe blood loss, for example from carotid artery, symptoms increase rapidly, develops hemorrhagic shock: sharp lethargy, low blood pressure, weak pulse.

The loss of 2 liters of blood or more in case of untimely assistance can be fatal.

When a tourniquet is needed

A tourniquet is applied to temporarily stop bleeding on those parts of the body where it can pinch a bleeding vessel - on the limbs and neck. The indication for its imposition is arterial bleeding from wounds. shoulder, forearm, hand, foot, lower leg, thigh.

The exceptions are fingers and toes, where the artery can be pressed against the phalanx bone with a pressure bandage. With venous bleeding, a tourniquet is applied only in cases where the imposition of a tight pressure bandage did not give an effect.

If bleeding from the veins of the lower leg on the background varicose veins or deep thrombophlebitis, the tourniquet will not give an effect due to the reverse discharge of blood in the diseased veins.

In addition, it can worsen the condition of the veins.

The technique of applying a tourniquet

The algorithm of actions for bleeding is as follows:

Determine the type of bleeding.
Press over the wound with your hand.
Apply a tourniquet, while "extra" hands will not interfere, especially if the bleeding is severe.
Apply a sterile dressing to the wound.
Write a note indicating the time the tourniquet was applied and attach it by slipping it under the tourniquet.
To urgently transport the victim to the hospital, it is better to call an "ambulance".

When applying a tourniquet, the type of bleeding should be taken into account: if arterial, it is applied above the wound, if venous is below, at a distance of 6-10 cm from the wound. You also need to know the anatomical areas where you can pinch the arteries:

upper third of the thigh;
upper and middle third of the shoulder;

In these areas, the artery runs close to the bone and can be compressed. On the lower leg and forearm, the arteries go deep, in the interosseous space, the application of a tourniquet does not make sense.

A tourniquet is applied to the neck if the carotid artery is damaged. It requires quick action because the blood loss is very large. The neck cannot be wrapped with a tourniquet, like a limb, so on healthy side a hard object is laid on the neck, more often it is the victim's hand raised up. The artery should be pressed to the spine below the site of injury, a bandage should be applied and a tourniquet should be applied on top, secured on the healthy side.

It is imperative to wrap the skin under the tourniquet with a cloth. In the absence of a tourniquet, you can use a belt, thick cord, rope, strip thick fabric tightening them with a twist on the undamaged side. With arterial bleeding, the twist is applied above the wound, with venous bleeding - below. It is also necessary to protect the tourniquet from stretching and relaxing by securing it well.

The maximum application time of the tourniquet should be observed in summer and winter.

With arterial bleeding in cold weather, continuous compression with a tourniquet should not exceed 1.5 hours, in warm weather - 2 hours. It is necessary to loosen the tourniquet every 30-40 minutes, after pressing the bleeding vessel with your hand.

Venous tourniquets are applied for a maximum of 6 hours.

The technique of applying venous tourniquets is different, the compression force should be less, but sufficient to stop bleeding, while maintaining the pulsation of the arteries below the wound.

Errors when applying a tourniquet and their consequences

When applying a hemostatic tourniquet, the following errors are possible:

The wrong choice of place - without taking into account the nature of the bleeding, this will only increase the blood loss.
Weak tightening of the tourniquet with arterial bleeding, as can be judged by the pulsation of the arteries below the wound (on the foot, wrist).
Failure to comply with the time of application of the tourniquet. This can lead to tissue death, the development of atrophy, paralysis and even gangrene of the limb.
The imposition of a tourniquet on bare skin, which causes its infringement up to necrosis.
The absence of a note under the tourniquet indicating the time of its imposition. It is very important to know when to loosen the tourniquet to avoid tissue necrosis.
Closing the tourniquet with clothing, bandage. It should be "in sight" in order to quickly focus on rendering further assistance sick.

Compliance with the rules for the imposition of a hemostatic tourniquet when rendering emergency care plays an important role, the health and life of the victim often depends on it.

How to stop bleeding before an ambulance arrives. It's very important to know.

There are situations in life when bleeding occurs. It can be caused by serious injury, open fractures, etc. If you find yourself in this situation, it is worth applying a tourniquet. It is necessary to carry out the procedure exclusively according to the rules so as not to harm the victim. There are two options for applying a tourniquet: for arterial bleeding and for venous bleeding. It is worth distinguishing them and applying the tourniquet correctly.

What you need to know for arterial bleeding, application of a tourniquet

A tourniquet is a way to stop blood, both venous and arterial. But it should be understood that the idea to put on a tourniquet comes only in extreme cases when the previously applied measures did not give their positive result... This is due to the fact that during this operation not only the artery is squeezed, but also tissues, vessels, nerves, which leads to the fact that oxygen does not enter the limb. It is known that most often the tourniquet is applied to the upper and lower extremities of the human body. Although there are cases when it should be applied to the neck and thigh.

The imposition of a tourniquet for arterial bleeding is necessary in such situations:

in cases where there is no way to stop serious arterial bleeding with other options;
in cases where there is a rupture of the limb;
in situations where the wound contains foreign body, because of which the blood does not stop, when the blood vessel is pressed;
when the bleeding is severe enough and time is short.

Depending on which part of the body is affected, the hemostatic tourniquet can be applied in different ways.

There are two types of bleeding:

Arterial. Serious injury that can be fatal if not treated promptly. This is the most terrible type of bleeding, it is easy to recognize it, as the blood gushes from the place of defeat. Her color is also not the same as the usual venous, it is bright scarlet. And what is most interesting, it flows out with the rhythm of the heart. The danger of such an injury is that a fatal outcome can occur even after quality assistance from a professional turns out to be. It is important here to apply the tourniquet correctly so as not to aggravate the problem.
Venous bleeding. In this situation, the blood flows out on its own, and at the same time, after a couple of minutes, it may end. The color of the blood is dark brown. Despite the fact that the blood can stop the flow on its own, you need to be able to stop it with a bandage and tourniquet.

The rules for applying a tourniquet for arterial bleeding, which must be understood so as not to harm the patient:

Remember that you cannot apply such a bandage to broken bones or joints, as this can harm the patient.
It is very important that the pressure bandage (tourniquet) is made of a wide fabric that will not cut the skin. So, for example, you can take a kerchief. Remember, the rope can not be used, and also do not use the belt, wire. The basic rule is the width of such a bandage, the tourniquet should be 4-5 cm.
The bandage itself is not applied to the wound itself, but higher than it, by 4-5 centimeters. It is important to note that the place where the bandage should be should be between the heart and the wound itself.
Despite the fact that anyone can apply a tourniquet, only a doctor should remove it. This is due to the fact that if the tourniquet is removed incorrectly, microbes can enter the victim's blood. The correct approach of a specialist is important here.
When you apply the tourniquet, be sure to remember the time it was done. This is due to the fact that the tourniquet should not be on the body for more than an hour and a half. Since the death of tissues, nerve endings and so on begins.

Stopping arterial bleeding with a tourniquet should be carried out according to such a simple scheme.

Consider applying this bandage to your thigh:

the first thing to do is to raise the affected limb up;
then it is worth temporarily suspending the blood by pressing the artery;
quickly fold the tourniquet of two small but wide kerchiefs;
then you need to wrap the thigh itself with one kerchief bandage and tie it in a knot;
now you need to put a pillow under the knot. It is a simple gauze bandage;
under the knot, you need to stick a stick, and slightly raise it and begin to rotate, until it touches the very limb, in this text, the leg. When you see that the blood has stopped flowing, you need to press the stick and fix this structure with the second part of the tourniquet, a kerchief bandage.

Tourniquet for arterial bleeding, applied to the shoulder:

as in the first option, it is necessary to raise the affected limb up;
according to the previous scheme, first of all, you need to press the artery;
you need to quickly fold the scarf bandage:
it is important to fold the tourniquet in a loop (fold in half);
the loop should be applied to the shoulder;
when the shoulder is in the loop, begin to pull the tourniquet by the ponytails (in different sides), until the blood stops completely;
when the loop becomes tight, tie the tails into a knot, but at the same time everyone does not need to loosen the tension;
then apply a sterile dressing;
be sure to leave a note with the application time of the tourniquet.

It should be understood that an incorrectly blocked artery with a tourniquet can lead to dire consequences... Therefore, before applying such a bandage, it is worth trying other methods of stopping bleeding.
It is also worth understanding that it is imperative to leave a note to the doctor, where the time will be written when you applied the tourniquet itself, and also write the name of the person who made it. This should make it easier for the doctor to find out the nature of the damage.

Venous bleeding

The venous type of bleeding is characterized by the fact that from the site of damage follows dark blood that can stop on its own. But do not count on this, since there are times when the blood does not stop on its own, and it is important to take drastic measures here.

The application of a tourniquet for venous bleeding should be carried out correctly and carefully, taking into account all the rules and recommendations. It is from correct application such a bundle depends on further measures related to this problem. The doctor will be able to carry out correct diagnosis and will help. Such a tourniquet is applied for one and a half to two hours in the summer, and in the winter - a maximum of one and a half. It is very important to loosen the tourniquet for a while every half hour.

How to apply a tourniquet for venous bleeding:

In this case, the bandage should be applied below the very site of injury.
When you start applying such a bandage to a wound, be sure to put some kind of cloth (gauze) on it so as not to damage the soft tissue.
Further, the main thing is to very quickly stretch the tourniquet and wrap it around the limb.
It is worth noting that the turns of the bundle should overlap, but very small. The wraps of the bandage should not pinch the skin of the affected part of the body.
The most important thing when applying a tourniquet in this case is that the first three turns should be tight enough, while the rest can be slightly loosened.
Be sure to write a note to the doctor, but if there is no paper, leave a mark on the patient's hand. This is very important element the entire procedure, which plays an important role in further treatment.
Remember that the tourniquet should never be covered with clothing. It is important that it is conspicuous.

If there is bleeding of deep veins, then it is important to remember that the limbs need to be given an elevated position, after which the tourniquet itself should be applied. Also, doctors advise to apply ice to the site of the lesion, or a bottle with cold water... Then quickly send the victim to the hospital.

It is logical that a correctly applied tourniquet stops the blood, but at the same time, the pulsation in the arteries is preserved for everyone. The most important thing when applying a bandage is not to get confused on the artery or on the vein. For panic leads to the fact that a person begins to make many chaotic movements, which can subsequently affect the fact that the tourniquet itself will be done incorrectly, which ultimately will lead to dire consequences.

It is important to remember that the basics of the first medical care everyone should know. And if you are afraid of blood, then it is better to have someone else apply a bandage, as you can only aggravate the problem. The ability to stop bleeding plays an important role in a person's life, since no one is immune from accidents.

Correct application of a tourniquet for arterial bleeding will save the life of a person who has received serious injury... It will be useful for each person to know how the tourniquet is applied correctly.

Arterial bleeding is one of the most dangerous species bleeding. Blood from a damaged artery flows like a fountain or strong stream pulsating in the rhythm of the beating of the heart muscle. The blood flowing through the arteries is bright red in color. Arterial bleeding is extremely dangerous, so if the blood is not quickly stopped, the person will die. Arterial bleeding can cause complications and amputation of a limb if first aid is not provided correctly or late.

Emergency help

With this type of bleeding, first aid should be provided quickly. It is important to remember that blood pressure can cause an injured person to faint or even become comatose.

Time should not be wasted, the people around the injured person have a couple of minutes to put a tourniquet on the wound and begin to provide first aid. The first step is to use your fingers to try to close the place of rupture of the artery, thereby temporarily stopping the fountain of blood. Experts recommend considering the following rules for each a separate kind arteries:

1. If the carotid artery is damaged, it is pressed against the transverse vertebral processes on the neck.
2. If the jaw artery is damaged, then it should be pressed against the jaw muscle.
3. The artery of the temporal region should be pressed slightly, in front of the edge auricle above.
4. Subclavian arterial blood loss is stopped by the pressing action of the fist on the outer edges of the clavicle from the back towards the rib.
5. The brachial artery should be pressed against inside bone muscles.
6. The artery in the thigh should be pressed against the pubic bone.
7. Artery under knee joint should be pressed against the middle of the kneecap.

It is clear that these rules are not easy to remember. When an unforeseen emergency situation few people will be able to apply them in practice. But even if you just read the rules, then there is a high probability that they will pop up in your memory when a person in trouble needs help.

After pressing the artery, it is necessary to apply a rubber tourniquet. The medical rubber harness can be replaced with a belt, rope, rag weave. To prevent infection from entering the injured area, a sterile bandage should be applied to the wound. If there is no limb fracture, then the artery can be fixed by bending the injured arm or leg. The limb must be bent, in this state, bandage with a bandage or other clean suitable material.

Algorithm of actions

It is important to work together when providing first aid. While one person is applying a tourniquet, the second must prepare cotton wool, gauze, bandage, clean synthetic fabric, roller. A tourniquet is applied only when the lower or upper limbs are injured. When the wound is in the carotid artery, with back side a splint should be applied to the neck. If there is no splint, then you can put the hand of the injured person. Thanks to the splint or arm of the victim, the carotid artery should be squeezed directly at the site of injury.

Further, a roller must be applied to the place below the injury, and a tourniquet must be applied through the splint or hand. It is forbidden to put a tourniquet on a bare wound. It is imperative to place a gasket under the harness. It should not have creases, it should be soft, not synthetic, cotton is best.

The injured limb should be elevated. The tourniquet should be twisted as close to the injured site as possible. It is applied above the wound. If it is a hand, then it should be applied in the shoulder area. In no case should a tourniquet be applied in the middle of the shoulder, since the radial nerve passes there.

If bleeding occurs lower limbs, then the tourniquet is best applied on the upper third of the thigh. The very first turn of the tourniquet should be tightening, all the rest are done exclusively for fixation. Pinching of the skin must not be allowed. In order to choose what the tension of the tourniquet should be, it is necessary to feel the pulse below the wound site, if it is absent, the tension is normal.

When the tourniquet has been properly applied, the affected person should receive pain medication. It can be analgin or another strong medication. In the event that the artery is severely damaged, the person must be immobilized. The tourniquet should not be hidden under clothing, it should be visible. If a person was injured in the autumn or winter time, then the place of injury must be insulated to avoid frostbite of the limb.

It is important to remember that in the cold season, the tourniquet can be on the limb for no more than half an hour. If it is warm outside, then the tourniquet should be removed no later than an hour later. You can stick a note into the tourniquet, on which the time of the tourniquet application will be written. If the victim does not have time to be taken to the hospital, and it is already dangerous to hold the tourniquet, then the following actions should be taken:

1. It is necessary to press the artery in the area above the imposed tourniquet.
2. The tourniquet must be loosened for half an hour. Thanks to this, blood circulation will be restored.
3. As soon as 30 minutes have passed, the tourniquet should be applied again, but the place should be slightly higher or lower than the previous one.

The procedure is repeated again, if there is a need for this, the main thing is to carry out all the actions according to the rules. It is important to get the victim to the hospital as quickly as possible, not to waste time.

If there is blood loss - what to do?

After the tourniquet is applied, the injured person must be transported as quickly as possible to the nearest medical facility. Only a professional team of doctors will be able to provide the injured person with qualified medical care. If the doctor's help is not provided within a maximum of 10 hours after the application of the tourniquet, then this can cause catastrophic consequences. Up to death.

The tragic consequences can be the most terrible, for example, tissues can die off, which will lead to the amputation of a limb. As a result of gangrene, the limb is removed slightly above the place that it touched. If the victim has lost a lot of blood, then he must be given a blood transfusion and other medical activities to provide emergency medical care.

In addition to bleeding from an artery, there are cases of blood loss from a vein. In this case, the blood flows out in a stream, has the color of a ripe cherry.

It is important to know that in case of loss of blood from a vein, the bandage must be applied a few centimeters below the area of injury.

Any bleeding is a danger to human life, therefore, the people around the injured person must react quickly in an extraordinary situation for them. The main thing is not to panic, but to responsibly apply the tourniquet in accordance with the rules.

Tourniquet for arterial bleeding

A tourniquet is necessary for arterial bleeding. Only with its help is it possible to stop heavy bleeding that occurs when injury is large enough blood vessels... In order to understand how to properly use a tourniquet to stop bleeding, you need to clearly understand what types of hemostatic tourniquets are encountered.

What is a tourniquet?

This is the name of a special device, the task of which is to gradually press the soft tissues of the limb to stop bleeding in this area for a while. Thus, the limb can be turned off for some time from the general blood flow.

In order to ensure a stop of bleeding, a tourniquet should be applied to the limb, as close as possible to the source of bleeding. A bandage should be placed under the tourniquet, it is also possible to put a tourniquet on clothing. When applying a rubber tourniquet, it is required to wrap it around the limb three times in order to ensure a complete stop of bleeding. This tactic will ensure the end of the blood flow from the artery; it is also necessary to additionally fix the tourniquet with a hook. At correct overlay the tourniquet eliminates the pulsation of blood in the area of the arteries. If it is not applied very well, the arteries are only squeezed, while the blood stagnates in them and this only increases the bleeding. After the tourniquet is applied, you should indicate the time when the application was carried out. The time is indicated both on the bandage and on the accompanying documents. This requirement is due to the fact that the tourniquet should be kept for no more than two hours. After an hour, you need to loosen the tourniquet for a while, while pressing it with your finger great vessel... A tourniquet can be used after the operations performed if they have caused certain complications. This will ensure that blood loss is reduced. In particular, this is possible after limb amputation. Its use is also indicated in the case of severe bleeding from damaged veins.

Esmarch styptic tourniquet

Such a tourniquet is most widely used when it is necessary to stop arterial and venous bleeding. It is a rubber tube, the length of which can be up to one and a half meters. At one end, such a bundle has a steel hook, at the other a chain. There are some features of the technique of its imposition:

to ensure complete clamping of the artery with a tourniquet, it must be applied slightly higher than the place where the blood comes from;
if the flow of blood has stopped and there is no peripheral pulse, then the tourniquet was applied correctly;
so that the skin is not infringed upon during application, a towel is placed under the tourniquet;
so that the tissues do not die, the tourniquet is not applied longer than two hours;
during this time, the tension of the tourniquet should be changed in order to avoid numbness of the limb.

The use of Esmarch's tourniquet has proven itself in venous bleeding. The nuances of such an operation are as follows:

The tourniquet should be applied below the damaged area for up to six hours. This applies to cases of bleeding from sufficiently large veins that are located directly under the patient's skin;
otherwise, a simple pressure bandage that is sterile enough is sufficient.

Hemostatic tourniquet Alpha

The tourniquet contains vertical grooves, which make it possible to avoid damage to nerve bundles and arteries, do not infringe on the skin, and also allow direct application of the tourniquet to the skin areas. This is its main advantage over other types of harnesses. The ribbed surface of the tourniquet reliably protects the skin from damage, prevents damage to nerves and blood vessels. The risk of limb amputation is eliminated due to the preservation of blood circulation in the vessels under the skin surface.

The use of a hemostatic tourniquet of this type provides the following advantages when using it:

easy enough to apply and remove the tourniquet. For workers medical services a standard of ten seconds has been developed for these operations;
the imposition of a tourniquet on exposed skin areas is allowed;
it is allowed to use such a tourniquet almost around the clock;
the possible temperature difference is wide enough when using such a bundle. In particular, it is allowed to be used at temperatures from +50 to -50 degrees Celsius;
it is not possible to break such a tourniquet with your hands;
the tourniquet is easily cleaned from dirt.

The technique of applying a tourniquet for arterial bleeding

If it becomes necessary to stop arterial bleeding with a tourniquet, the following sequence of actions must be followed:

Carrying out a thorough examination of the area in which the manipulations are carried out, to assess the nature of the damage, to make sure that there is indeed arterial bleeding.
The artery is pressed with a finger to the bone slightly above the place where bleeding is observed. This is done only in order to completely exclude the possibility of additional blood loss.
The correct location for the application of the tourniquet is chosen.
The presence of contraindications for the application of the tourniquet is established. These may be inflammatory processes in or near the site of bleeding.
The site of application of the tourniquet is raised to a height of 30 centimeters above the level of the patient's heart.
Above the wound and closer to it, a napkin is applied, on which there are no folds. It can also be a soft piece of cloth or clothing.
The tourniquet is stretched several times in order to stop the bleeding process. This is achieved by stopping the blood circulation process in the damaged area.
A note is placed under a certain section of the tourniquet indicating the specific day and moment at which the tourniquet was applied.
An antiseptic dressing is applied to the wound, while bandaging the tourniquet should be avoided.
In this case, the limb must be completely immobilized.
The patient should only be moved to a medical facility while stationary.

Rules for applying a tourniquet for arterial bleeding

The technique of applying a tourniquet to a patient in the presence of bleeding from a damaged artery assumes compliance with certain rules. Their violation often turns into significant problems for the patient himself, which are expressed in an increase in the level of blood loss to them, as well as other problems. Among the basic rules for applying a tourniquet in the case of arterial bleeding, several should be highlighted.

Place of application of a tourniquet for arterial bleeding

When bleeding from an artery, a tourniquet should always be applied above the place where bleeding is observed. In other words, it should be applied above the place where the artery is damaged. This is due to the peculiarities anatomical structure arteries and blood circulation in the injured limb. The blood flow is observed in the limb from its center to the peripheral areas. In this case, it becomes necessary to stop the blood supply precisely in that part of the body, which is located as close as possible to the central part. This applies to the area above the location of the damage received. In no case, when applying a tourniquet for bleeding, do not forget that in addition to stopping bleeding, blood flow also stops in the peripheral part of the body.

Time of application of tourniquet for arterial bleeding

When applying a tourniquet, a plate must be attached to it indicating the time of its application. This is due to the fact that the tourniquet should not be kept on the patient's body for more than two hours, since in this case the clamped limb may die as a result of the lack of blood flow to it. If the season is warm, you can keep the tourniquet on the skin for an hour, at most two. In the cold season, it is not recommended to keep the tourniquet for more than half an hour.

In the event that the maximum allowable time for applying the harness has already passed, and there is no way to untie the harness, the following actions should be taken:

carefully press the artery above the location of the tourniquet;
in order to qualitatively ensure the restoration of blood supply for half an hour, loosen the tension of the previously applied tourniquet;
after the specified period of time has elapsed, it is necessary to apply it to the limb again, but this time in a new place. It must be above or below the previous overlap;
on the newly applied tourniquet, a plate should be applied indicating the time and date of the performed tourniquet application;
in the event that the need arises again, you should first repeat the procedure described earlier.

In the event that, eight or ten hours after a tourniquet is applied to the victim for arterial bleeding, he does not receive proper medical care, the situation becomes dangerous to his health. Therefore, after all mandatory activities designed to stop the patient's bleeding, he should be immediately taken to a medical facility. This will make it possible to provide the patient with qualified medical care. With insufficient blood circulation in the limb, as a result of the application of a tourniquet for a sufficiently long time, necrosis of the limb can develop, which often ends in gangrene. Often in such cases, to save the life of the victim, it is necessary to amputate the limb. In addition, amputation in such cases is often carried out significantly higher than the place where the injury is noted. If the blood loss is significant enough, it is required to transfuse the victim in a hospital setting.

Errors when applying a tourniquet for arterial bleeding

When applying a tourniquet in case of arterial bleeding, the following errors are possible:

Performing the entire procedure in the absence of sufficient indications for the application of a tourniquet.
Do not use tourniquets over open areas. skin, since such a situation is fraught with consequences such as tissue necrosis, as well as infringement of skin areas.
Wrong choice of the place where the tourniquet should be applied. In no case, for example, should a tourniquet be applied to the shoulder or thigh area if there is damage to the blood vessels of the hand or foot.
Pulling on the tourniquet must be done adequately to the injury and the level of blood flow. In the event that it is weakly stretched, the veins are compressed, as a result of which bleeding may increase, as well as congestion in the limb region.
Do not keep the tourniquet on the skin surface enough long time... This can damage the saphenous nerves, leading to paralysis. In addition, all conditions appear for the development of anaerobic infection.

In order for the bleeding to be finally stopped, it is required to immediately deliver the patient to a medical facility.

- this is a very serious injury, which in case of untimely provision of medical care can lead to death. It is considered the most dangerous of all types of bleeding. If the arteries are damaged, blood flows out of them in a gushing stream.
Arterial blood is distinguished by its bright scarlet color. It flows out of the vessel in accordance with the beats of the heart. Such an injury can cause death not only immediately after receiving it, but even with the provision of qualified medical care. Arterial bleeding can lead to loss of an injured limb and other complications.

Rules for stopping arterial bleeding

Blood loss with arterial bleeding occurs so rapidly that it is emergency assistance it is necessary from the very first 2-3 minutes after its formation. When large arteries are injured, the time for providing emergency assistance is reduced to 1-2 minutes. Otherwise, the blood pressure will drop with every second, as a result of which the victim will lose consciousness, fall into a coma, or die immediately.

In case of arterial bleeding, first of all, squeeze (squeeze) the place of injury with your fingers or fist, trying to stop the gushing blood flow.

In this case, certain rules should be observed in pressing and squeezing certain blood vessels:

The common carotid artery is pressed with fingers to the spine, namely, to the transverse processes of the cervical vertebrae. In this case, you should press on the inner edge of the sternocleidomastoid muscle approximately in its middle part.

The external jaw artery is pressed with fingers to front edge chewing muscle.

The temporal artery is compressed with the fingers slightly forward from the upper edge of the ear.

Subclavian artery pressed with fingers or fist behind the outer edge of the clavicular part of the sternocleidomastoid muscle to the first rib.

The brachial artery is squeezed by the fingers along the inner edge of the biceps muscle to the bone.

The femoral artery is pressed by the fist against the pubic bone under the pupar ligament. In thin people, this vessel can easily be pressed against the thigh.

The popliteal artery is pressed with a fist in the middle of the popliteal cavity.

After providing emergency assistance in pressing the vessel in case of damage to large arteries, it is necessary to immediately apply a rubber tourniquet to them. With minor bleeding, a tight roller or one-piece sterile bandage is bandaged to the injury. V extreme conditions instead of a tourniquet, you can use a belt, scarf, thick rope and other improvised means with which to make a pressure bandage. A sterile bandage is applied to the wound itself to prevent infection from entering the body.

In some cases, when there is no bone fracture, it is possible to use forced flexion of the injured limb instead of a tourniquet. With this method of stopping arterial bleeding, the injured limb is bent and fixed in a bent position using a bandage or other available means.

The imposition of a tourniquet for arterial bleeding

Already during the provision of first aid to the victim to squeeze the vessels, someone from the surrounding should prepare a tourniquet or improvised means, cotton wool, gauze or cotton napkins. Gauze or tissue is applied to the damaged areas of the body, without reaching the place of bleeding. The injured limbs should be in an elevated position. The rubber tourniquet is stretched a little and wrapped around the limb in 2-3 turns. The tourniquet should be applied tightly enough to stop bleeding from the artery, but the limb should not be strongly squeezed. Its ends are tied, fastened with a crochet or chain. As a rule, a tourniquet or a pressure bandage is applied 2-3 cm higher.

Features of the imposition of a tourniquet when different types damage to arteries:

If the hands are injured, it is applied to the upper third of the shoulder.

Optimal localization of the bundle on upper limb- the upper or lower third of the shoulder (in the middle of the shoulder, the tourniquet cannot be applied to avoid damage to the radial nerve).

With severe damage femoral artery you may need another tourniquet, which is applied a little higher than the first.

In case of ruptures of the carotid artery and other injuries to the face and head, a soft bandage is placed under the tourniquet so as not to cause additional injuries. At the same time, the tourniquet is not tightened too tightly in order to prevent suffocation of a person and insufficient blood circulation in the brain.

If the tourniquet is applied correctly, then the blood flow stops completely. A note is placed under the tourniquet, in which the data on the damage and the time of applying the pressure bandage are indicated. The area on the body where the tourniquet is applied should not be completely covered by clothing, so that the medical staff in the hospital can immediately find the site of damage.

After applying a tourniquet, the victim is immediately sent to a medical facility, where he will be given help needed... When transporting a patient with wounds on large arteries, he must be immobilized (immobilized).

To prevent severe consequences from insufficient nutrition of tissues, their necrosis and paralysis due to compression of nerve fibers, the tourniquet should not be left on the body for more than 90 minutes. If there is a situation where the tourniquet should still remain on the damaged artery, it is slightly loosened for a few minutes and then tightened again. When using a tourniquet in the cold season, it is necessary to warmly wrap the victim, especially the injured limb.

Danger of arterial bleeding

If a victim with arterial bleeding is not provided with emergency assistance in the first minutes after injury, he will simply bleed out and die. Highly quick loss blood does not allow the body to turn on defense mechanisms... In this case, the heart does not have enough normal blood volume, as a result of which blood circulation completely stops.

Even pinching the arteries in the first minutes after injury is often difficult, because they have thicker and more stubborn walls than veins, and the blood pressure in them is much higher. Even with the final stop of such bleeding in conditions medical institution various complications can arise. When treating a wound, the doctor will bandage the vessel in the wound. In some cases, a vascular suture may be required. Changes in tissue ratios in anatomical terms, crushing and heavy bleeding make the process of finding a vessel and applying a ligature in a wound very problematic. At internal bleeding the victim needs urgent surgical intervention, since a squeezing bandage cannot be applied in this case.

Lack of assistance after the application of a tourniquet often leads to the death of the limb, due to impaired blood flow. The lack of blood in the tissues 8-10 hours after injury to the artery becomes critical. At the same time, the development of gangrene begins, which is an irreversible necrosis of the tissues of the limb. After this, the patient can still be saved only by amputation of the injured limb. Moreover, she is amputated much higher than the place where it began.

With significant blood loss, the victim is transfused after stopping the bleeding donated blood... Its volume can be up to 1000 cc. With such injuries, rapidly growing pulsating hematomas often occur. They also need to be operated on. For bleeding in people with reduced blood clotting and pathological changes the walls of the vessels, a 10% solution of calcium chloride is used. It is prescribed in a volume of 10-20 cubic meters. see intravenously. The best result in the treatment of arterial bleeding is given by repeated blood transfusions in small (homeostatic) doses (100-150 cc). The patient needs complete rest after the operation. A cold compress is applied locally to the wound.

Based on the above, it becomes clear that without the provision of emergency and professional medical care, damage to the arteries that led to bleeding can cost a person his life. That is why it is so important to be able to provide first aid to the victim and quickly deliver him to the hospital. The prognosis for recovery after such an injury depends on the size of the injury, its location on the body, and on a number of other reasons that led to this injury.

About the doctor: 2010 to 2016 Practitioner of the therapeutic hospital of the central medical-sanitary unit No. 21, city of elektrostal. Since 2016 he has been working in diagnostic center №3.