Danger of blood loss
An adult’s body contains about 5 liters of blood, and a loss of about 2 liters is already life-threatening (and men tolerate blood loss worse than women). As the amount of blood decreases, blood pressure drops and the oxygen supply to the brain, heart and other organs is disrupted.
Capillary bleeding
Capillary bleeding occurs even with minor injury.
Signs of bleeding from the capillaries are: dark red color of the blood, bleeding in a small stream (for superficial cuts) or even bleeding over the entire surface of the wound (for abrasions). Blood moves through the capillaries slowly, so this bleeding is easy to stop.
When providing assistance, you need to treat the wound with tincture of iodine or a solution of brilliant green (“green”) and apply a clean gauze bandage.
Venous bleeding
More severe bleeding occurs when the veins are damaged - venous bleeding. A stream of blood (dark red with a bluish tint) flowing from a large vein at a fairly high speed prevents the formation of a blood clot that stops the bleeding.
A person can lose a lot of blood in a short time. To stop minor venous bleeding, it is enough to apply a pressure bandage (tightly bandage) to the wound. The bandage, compressing the walls of the wounded vessel, will prevent blood from flowing out of it. Then the victim must be sent to a medical facility.
If large veins are damaged, a pressure bandage may not stop the bleeding. Therefore, in such cases, proceed in the same way as in case of arterial bleeding - applying a tourniquet (below the wound site).
Arterial bleeding
The most dangerous to human life are bleeding that occurs when arteries are damaged. The pressure in the arteries is high, and with arterial bleeding bright scarlet blood pulsates and bflows like a fountain from the wound.
First aid: squeeze damaged artery above the bleeding site, apply a tourniquet and note the time it was applied(write a note and put it under the tourniquet).
Pay attention!
For arterial bleeding a tourniquet is applied above the wound site, with venous- a tourniquet or pressure bandage is applied below the wound site.
The tourniquet is made of cloth, rubber or any other material that can be used to tightly tighten the limb. Be sure to place a soft cloth under the tourniquet so as not to damage the skin when twisting it. If the tourniquet is applied correctly, the bleeding stops, the limb turns pale, and the pulse disappears.
Pay attention!
If you do not achieve complete disappearance of the pulse on the radial artery, then within 10-15 minutes the hand will swell and turn blue. Then the tourniquet can be removed only if the arm is amputated.
The victim must be urgently taken to a doctor, since it is impossible to deprive the limb of blood supply for a long time.
Pay attention!
Every 30-40 minutes, regardless of the time of year, you should remove the tourniquet for 20-30 seconds (until the skin below its application turns pink). This is done so that blood can enter the damaged limb to supply it with oxygen and remove metabolic products. Then the tourniquet should be applied again below or above its previous location. Thus, you can do this within a few hours. Do not change the time indicated in the note.
Internal bleeding
If, during an injury to the body, blood comes out of damaged vessels into the body cavity and interstitial spaces, then such bleeding is called internal bleeding. The results of minor internal bleeding are bruises, arising from minor bruises, sprains, etc.
Internal bleeding(into the abdominal cavity, chest and skull cavities) are especially dangerous. Although the blood does not leave the body, it leaves the bloodstream: the pressure in the vessels drops and the organs do not receive enough oxygen and nutrients.
With internal bleeding, the victim turns pale, his pulse quickens and weakens, breathing becomes frequent and shallow.
In this case, you need to urgently call a doctor. Before his arrival, the injured person should be laid down, fresh air should be provided, and something cold should be applied to the suspected site of bleeding: a bottle or heating pad with cold water, a bag of snow or ice.
Head injuries
If the head is bruised, then a lump appears at the injured site, that is, an accumulation of blood in the periosteum. If you apply something cold to this area, the blood flow in this area will weaken and the lump will be smaller.
The victim of a head injury should be closely monitored. If such a person lost consciousness or experienced bouts of vomiting, then we are talking about concussion and the patient must be taken to a medical facility, and lying down (ensuring that the head is still).
Pay attention!
Venous bleeding from head wounds is much more dangerous than arterial bleeding. When the veins of the head are injured, air is sucked into them, which can lead to instant death from air embolism within 3-5 seconds.
Bleeding can be external - when blood flows out from damaged vessels, and internal - when blood enters and accumulates inside the body - in cavities, in tissues.
If the blood flowing out beats in a pulsating stream (gushing) synchronously with the pulse and has a bright red color (scarlet), you have arterial bleeding. This is very life-threatening, since a sudden loss of 1-2 liters of blood can be fatal (in total there are 5-6 liters of blood in the adult body).
If the blood leaking out is dark red in color and flows out in a continuous stream, you have venous bleeding. If large veins of the upper half of the body are damaged, blood may flow out in an intermittent stream, but not synchronously with the pulse, as with arterial bleeding, but with breathing.
When small vessels are damaged, capillary bleeding occurs, from capillaries - superficial small vessels. This happens with abrasions, shallow wounds, and scratches. If different vessels are damaged, bleeding may be mixed in nature.
How should you act to quickly and effectively stop bleeding?
Venous bleeding and bleeding from small arterial vessels can be controlled using a pressure bandage. This method helps in those places where soft tissues lie in a thin layer on the bones - on the integument of the skull, in the area of the joints of the wrist, knee, elbow and on the front of the lower leg.
How to stop bleeding from a small artery in the wrist joint?
To do this, press the adductor artery with your finger above the bleeding site; the pressure should be strong. Apply a sterile gauze napkin, folded in several layers, to the wound, and on top of the napkin place a tight roll of cotton wool, bandage or gauze, or, in extreme cases, a handkerchief or other clean material. Remember that you cannot put cotton wool on the wound without a gauze pad! Then bandage everything tightly. With these actions you compress the bleeding vessels and stop the bleeding. The affected limb must be elevated by placing a pillow or a roll of clothing under it. The elevated position reduces blood flow and helps stop bleeding from the artery. In case of failure, as well as if arterial blood flows like a fountain (a continuous and strong stream), immediately proceed to apply a hemostatic tourniquet.
Rule for applying a hemostatic tourniquet.
1. A tourniquet is applied when large arterial vessels are damaged.
2. In case of bleeding from the arteries of the upper limb, place the tourniquet on the upper third of the shoulder; in case of bleeding from an artery of the lower limb - on the middle third of the thigh.
3. A tourniquet is applied to the elevated limb. A soft pad is placed under the tourniquet: bandage, cotton wool, clothing, etc.
4. The tourniquet is applied tightly, but not excessively, and be sure to attach a note with the time of its application.
5. The tourniquet cannot be held continuously for more than 1.5 hours.
6. If you do not have a special tourniquet on hand, you can use improvised means (kerchief, tie, suspender, belt, etc.).
7. When a part of a limb is torn off, a tourniquet must be applied, even in the absence of bleeding.
It is useless to apply a tourniquet around the wrist and ankles!
In cases where there are no limb fractures, methods can be used to stop bleeding by bending the limb as much as possible. Strong bending of the knee stops bleeding from the arteries of the foot and leg. To increase pressure on the vessel, a roller made of a bandage or other material is used. Strong bending and bringing the knee towards the abdomen compresses the femoral artery. When the axillary artery is injured, compression is carried out as follows: the hand is placed behind the back and pulled strongly to the healthy side, or both arms, bent at the elbow, are pulled back strongly and the elbow joints are tied behind the back. This stopping method is used very rarely.
How to stop bleeding in other parts of the body, not on the limbs?
If you see a strongly gushing (gushing) stream of blood where it is impossible to apply a tourniquet, what should you do?
1. Press the wound with your fingers to stop bleeding;
2. Lay the victim horizontally;
3. Urgently call an ambulance
If there is bleeding from the main cervical artery (carotid), apply pressure to the wound with your fingers or fist, and then pack it with a large amount of clean gauze. This method is called stamping.
What to do if you suspect internal bleeding?
Such bleeding can occur when a blow to the stomach occurs due to a rupture of the liver or spleen. In the event that the victim complains of severe abdominal pain after a blow, or he lost consciousness after a blow to the stomach, one should think about possible internal bleeding (into the abdominal cavity). Place the victim in a semi-sitting position with knees bent, and place a cold compress on the abdominal area. You can't give him anything to eat or drink. Urgently arrange delivery to the hospital.
With a strong blow to the chest, internal bleeding into the pleural cavity may occur. If there was such a blow and the victim breathes with difficulty and begins to choke, he should be given a semi-sitting position with his lower limbs bent and a cold compress should be placed on the chest.
How to support the life of a person who has lost a lot of blood?
As a result of bleeding, changes occur in the human body that can become irreversible and lead to death. Therefore, to maintain the life of a person who has lost a lot of blood, it is necessary to take urgent measures. After the bleeding has stopped, a pressure bandage must be applied to the wound. Then release the victim from compressive clothing to facilitate breathing. If the victim is conscious and has no wounds in the abdominal area, you should give him sweet tea and lay him on his back so that his legs are raised and his head is down. This position will support the blood supply to the brain; the brain is most sensitive to its lack. Arrangements should be made to transport the victim to hospital as quickly as possible
From this article you will learn: what happens to the body as a result of blood loss, why a decrease in the concentration of the main components is dangerous, and how blood is restored.
Bleeding leads to a decrease in the normal concentration of the main components of blood: red blood cells, platelets, leukocytes. Circulating blood volume (CBV) is quickly restored due to plasma, but restoring normal composition requires a long time, from 1 week to several months, and assistance to the body through nutritional correction, a gentle lifestyle and taking special medications.
Blood loss can occur for various reasons:
- Surgery;
- External and internal bleeding caused by injuries and diseases;
- Donating blood;
- Menstruation;
- Termination of pregnancy, natural birth and caesarean section.
Due to a decrease in the volume of circulating blood, the blood supply to all organs deteriorates. With a small loss, symptoms characteristic of anemia are observed: weakness, fatigue, dizziness. A loss of large volume can be fatal. Therefore, it is first necessary to identify the source of bleeding, if necessary, to replenish the fluid volume with plasma substitutes, and then proceed to restore the normal composition.
What happens to the body during blood loss
In a state where the body loses blood, compensatory mechanisms are activated. Small arteries spasm, the strength increases and the speed of heart contractions decreases, fluid from the interstitial spaces enters the blood and replenishes its volume. There is a transition from circulatory hypoxia to anemic, which in this case is less dangerous to the life and health of the patient. Thus, the body is able to tolerate blood loss of up to 10% of the blood volume without serious consequences.
Loss of blood more than this volume leads to severe hypoxia, which primarily affects the central nervous system. The composition of the blood and the properties of the components change. Therefore, restoration of blood after blood loss should concern not only volume replenishment, but also stimulation of the hematopoietic system and normalization of the condition of all components separately.
If there is little or slow blood loss, there may be no symptoms. The body can successfully compensate for the lack of volume for some time, but anemia will inevitably develop.
The severity of symptoms depends on the amount of blood lost:
- Up to 0.5-10% of the blood volume - tolerated with virtually no symptoms, restoration of blood components occurs in a short time;
- 11-20% BCC – manifested by a drop in blood pressure by 10%, pale skin, increased heart rate and respiration, nausea, weakness;
- Up to 40% of the bcc – there is a rapid heartbeat (up to 120 beats/min) and a weak pulse, irregular rhythm and increased breathing; severe pallor of the skin and mucous membranes, cold sweat, thirst, tremor;
- Up to 70% of the bcc – a strong decrease in blood pressure (up to 60), heart rate up to 160 beats/min, state of delirium, confusion, convulsions;
- More than 70% of the volume is fatal blood loss, shallow breathing, convulsions, and agony are observed.
Restoring blood in the body after blood loss is necessary for the patient to return to normal life. Lack of help in the form of medications will lead to disruption of the functioning of all organs and systems. Even a small loss of blood leads to the development of posthemorrhagic anemia, which will worsen against the background of a general weakening of the body.
Features of blood restoration after blood loss
Methods for restoring blood during bleeding are determined by the lost volume. In case of hemorrhagic shock (sudden and large loss of blood), measures must be taken immediately. Rapid blood restoration can be ensured by the introduction of plasma replacement solutions (gelatin solutions, sugars, salts, etc.) and blood products (erythrocyte mass, plasma). If there is no result, vasoconstrictor drugs are administered.
When the patient's condition is stabilized, it is necessary to normalize individual blood components. If the loss was insignificant, therapy with drugs to restore blood in the body is prescribed immediately after the bleeding stops.
Treatment after blood loss includes:
- Taking iron supplements to restore hemoglobin levels and the number of red blood cells;
- Taking certain types of vitamins involved in the process of hematopoiesis (group B);
- Diet therapy – the maximum amount of vitamins and microelements should enter the body with food;
- Decreased physical activity;
- Drinking large amounts of liquid (water, juices).
Restoration of blood in the body is required for any blood loss, including after menstruation and donation of donor blood, as well as during transfusion.
Restoring blood after bleeding
Acute and chronic bleeding are especially dangerous. The first - because they happen quickly and on a large scale, the second - because they are not immediately noticeable. They arise due to diseases of internal organs, during injuries and during surgical operations. Compensatory mechanisms for restoring blood after bleeding may be exhausted or simply not have time to turn on.
If more than 30% of the blood volume is lost, a blood transfusion or plasma replacement solutions are administered. After which restorative therapy is prescribed, in the form of taking iron supplements (Hemobin) and hematopoietic stimulants. It may take several months for blood to recover after severe bleeding.
Recovery after blood transfusion
Together with donor blood, protein breakdown products and a host of components enter the body, which can cause non-hemolytic transfusion reactions (the response of the immune system to components of someone else's blood). Therefore, the most important stage of recovery after blood transfusion is the normalization of blood composition and stimulation of one’s own hematopoietic system. Taking B vitamins, iron supplements and erythropoietin injections is indicated.
Recovery after donating blood
The recovery stage after donating blood is necessary, despite the fact that only healthy people participate in this procedure. BCC normalizes within 2 days due to plasma, but complete recovery after blood donation will occur over the course of a month, during which time anemia may occur. To prevent it, donors are recommended to take Hemobin as a prophylaxis and after each blood donation. Unlike other iron preparations, it has no contraindications or side effects, so the intake will be easily tolerated by the donor. It is based on divalent heme iron, it is absorbed almost 100% and will help quickly restore blood.
Blood restoration after donation with iron supplements can be supplemented with diet therapy and taking B vitamins and vitamin C.
Restoration of blood after menstruation, termination of pregnancy and childbirth
Women tolerate blood loss more easily, but especially need blood restoration. Women with heavy menstruation and chronic bleeding often develop iron deficiency anemia. Even more often, anemia in the weaker half of humanity is caused by pregnancy and childbirth. In addition to blood loss, the increased need for iron complicates the situation.
Low hemoglobin during pregnancy and after childbirth or delivery is diagnosed in almost all women. The rate can only be raised with iron supplements. Hemobin will cope best with this task. It contains concentrated purified animal hemoglobin and vitamin C, which improves the absorption of iron. The drug can be used without harm to the body of the mother and child, both during pregnancy and lactation.
Normalization of blood composition
Transfusion of blood and its components, as well as the introduction of plasma-substituting solutions are methods of emergency saving the life of a patient. Unfortunately, they are not able to normalize the composition of the blood, but rather disrupt it. To restore the balance of components, it is important to bring your own hematopoietic system into working condition.
| Blood Component | Normal content in the blood of a healthy person | How to level up |
| Platelets | Men – 200-400 thousand units/µl Women – 180-320 thousand units/µl |
Taking vitamins A, C and group B. Taking hormonal drugs - Dexamethosone, Prednisolone. Taking platelet formation stimulators - Thrombopoietin |
| Leukocytes | Men – 4.2-9x109 U/l Women – 3.98-10.4x109 U/l |
Diet therapy. Stimulators of leukocyte formation – Pentoxyl, Leukogen |
| Red blood cells | Women – 3.7-4.7x10 to 12 degrees/l Men – 4.0-5.3x10 to 12 degrees/l |
Taking iron supplements - Hemobin |
When blood is lost, restoring hemoglobin and red blood cell levels is the initial task. Anemia and associated hypoxia will drive the patient into a vicious circle, when normal hematopoiesis is impossible due to lack of oxygen. You can increase hemoglobin levels with iron supplements. Hemobin is a product that has no analogues; unlike other drugs containing inorganic ferric iron, it contains only natural components in the form of ferrous iron, which is easily absorbed into the gastrointestinal tract, and vitamin C, which improves its absorption.
Today you learned how to restore the hematopoietic system and individual blood components after bleeding, surgery or donating blood, as well as how and why posthemorrhagic anemia develops and why it is dangerous.
As a result of blood loss, changes occur in the human body that can become irreversible and lead to death. Therefore, to maintain the life of a person who has lost a lot of blood, it is necessary to take urgent measures. After you have stopped the bleeding (or it has stopped spontaneously), you must apply a pressure bandage to the wound. Then release the victim from constrictive clothing to facilitate breathing (unfasten, remove). If the person is conscious and has no wounds in the abdominal area, you should give him sweet tea and lay him on his back so that his legs are raised and his head is down. This position will support the blood supply to the brain; the brain is most sensitive to its lack. Arrangements should be made to transport the victim to the hospital as quickly as possible.
Chapter 8. First aid for fractures
Quickly ensuring bone immobility in the fracture area - immobilization - reduces pain and prevents complications and shock.
Fracture - This is a violation of the integrity of the bones.
They can be closed (without damaging the skin) and open (with violation of the integrity of the skin and sometimes even with exposure of bone fragments).
Signs of a fracture are: swelling, sharp pain in the fracture area, change in shape and shortening of the limb and disruption of its function.
The most important condition for providing first aid for a broken limb is to ensure immobility of the injured limb (immobilization).
Methods of immobilization.
Most often, limbs have to be immobilized. It must be remembered that two joints located above and below the fracture site are subject to immobilization. This ensures complete rest for the broken limb. Immobilization methods are shown in Fig. 24.
The upper limb can be immobilized with bandages or a scarf that is tied around the neck (Fig. 24).
The lower limb can be immobilized by tying both legs together as shown in Fig. 24, if there are no other possibilities, for example, using special tires. Instead of tires, you can use improvised means - sticks, skis, boards, etc.
When the bones of the forearm are fractured, two splints are used, which are applied on both sides of the forearm - palmar and dorsal. When immobilizing the lower leg and thigh, splints are applied to the inner and outer sides of the affected limb. For open fractures, applying a splint gives it the appearance of a broken limb.
Before applying the splint, a layer of cotton wool or light cloth should be placed on the bony protrusions (knees, heels). Do not put pressure on painful points - on a wound or fracture. The wound should be covered with a bandage, the damaged organ should be immobilized, and the victim should be positioned correctly. Apply cold to the area of injury (ice, snow or cold water in a plastic bag - on a bandage). Careful positioning and gentle transportation of the victim is the most important condition in the fight against pain and prevention of shock.
In case of fractures of the cervical spine, as well as in case of damage to the bones of the skull, the head is immobilized using a bandage, which is strengthened under the chin and tied to a stretcher. If there is no consciousness and the tongue is in danger of falling, then the head is fixed with bandages in a position on its side. A simplified way of fixing the head is also possible: cover it with sandbags (Fig. 24) or place it on a slightly inflated rubber tire or circle of cloth.
If the victim complains of pain in the spine, which intensifies when pressed and palpated, and a protrusion (hump) is visible in the area of pain, think about a spinal fracture. This is a very dangerous injury; if handled carelessly, damage to the spinal cord and paralysis of the limbs can occur. Therefore, the victim should be transferred and placed on a hard bed with the help of two or three rescuers in such a way that the body remains motionless during the transfer (Fig. 24).
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immobilization
chest suspension splint
Rice. 24. Immobilization of body parts .
If you are unconscious, watch your breathing, as your tongue may fall back and obstruct your airway.
If the victim had compression of the pelvis, which occurs during rubble, rock collapse, and other situations, or if he fell from a height onto his buttocks, or onto his legs and side, think about a fracture of the pelvic bones. With such an injury, ruptures of internal organs are possible, so be careful and carry the victim as shown in Fig. 25.
Rice. 25. Positioning and transporting a victim with pelvic fractures.
If rib fractures are suspected (severe pain when breathing, especially when exhaling), the chest is tightly bandaged with bandages or a towel.
In cases where there are no limb fractures, methods can be used to stop bleeding by bending the limb as much as possible.
Strong bending of the knee stops bleeding from the arteries of the foot and leg. To increase pressure on the vessel, a roller made of a bandage or other material is used. Strong bending and bringing the knee towards the abdomen compresses the femoral artery. When the axillary artery is injured, compression is carried out using a technique - the arm is placed behind the back and pulled strongly to the healthy side, or both arms, bent at the elbow, are pulled back strongly, and the elbow joints are tied behind the back. This stopping method is used very rarely.
Temporarily stopping bleeding by maximal flexion of the limb:
A-from the axillary and subclavian arteries; B-femoral artery; B-from the artery of the forearm; G – arteries of the leg.
The duration of the limbs being in a maximally bent state, causing ischemia of their distal parts, corresponds to the duration of the tourniquet being on the limb.
What to do if there is external bleeding?
Don't get lost, do the following:
Press the wound with your fingers to stop bleeding;
Place the affected person horizontally;
Urgently send someone for an ambulance;
If you start to get tired, have someone present press your fingers from above (it is necessary to keep the vessel pressed without stopping for at least 20 minutes; during this time, thrombosis of the damaged vessel usually occurs and the intensity of bleeding will decrease.
If there is bleeding from the cervical (carotid) artery, you should immediately apply pressure to the wound with your fingers or fist, and then the wound can be stuffed with a large amount of clean tissue. This method is called tamponing. It can be used in cases where applying a tourniquet is not possible. Tamponade is carried out for at least 20 minutes. The injured person must be taken to the hospital as quickly as possible to provide specialized care. After ligating the bleeding vessels, the victim should be given a soft drink.
What to do if you suspect internal bleeding?
Such bleeding can occur when you are hit in the stomach, fall from a height, etc. due to rupture of the liver or spleen. In the event that the victim complains of severe abdominal pain after a blow, or he loses consciousness after a blow to the stomach, one should think about the possibility of internal bleeding (into the abdominal cavity). Place the affected person in a semi-sitting position with your knees bent, and place a cold compress on the abdominal area. A cold compress or ice pack is applied for 30 minutes, then the cold is removed, a break is taken for 30 minutes and the cold is applied again for 30 minutes. This alternation is carried out until hospitalization. You can't give him anything to drink or eat. It is necessary to urgently arrange for the victim to be transported to the hospital.
With a strong blow to the chest, bleeding into the pleural cavity may occur. If there was such a blow and the victim breathes with difficulty and begins to choke, you should give him a semi-sitting position with bent lower limbs and put a cold compress on the chest.
Place the victim in an anti-shock position. Place the unconscious victim in a stable lateral position.
How to support the life of a person who has lost a lot of blood?
As a result of blood loss, changes occur in the human body that can become irreversible and lead to death. After you have stopped the bleeding (or it has stopped spontaneously), you must apply a pressure bandage to the wound. Then release the affected person from constrictive clothing to facilitate breathing (unfasten, remove). If a person is conscious and has no wounds in the abdominal area, you should give him sweet tea. It is necessary to lay the victim on his back so that his legs are raised and his head is down. This position promotes the redistribution and temporary increase in the amount of blood in the heart, lungs, brain and other vital organs (the brain is most sensitive to its lack). It is necessary to organize the evacuation of the injured person to the hospital as quickly as possible. The final stop of bleeding and complete surgical treatment of wounds are carried out in medical institutions, and we must not forget that stopping bleeding is the prevention of shock.
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