Bleeding is the outflow of blood from blood vessels in violation of the integrity of their walls. Most common cause injuries (blow, injection, incision, crush, sprain).
Bleeding happens different strength and depend on the type and caliber of the damaged vessel. Bleeding, in which blood flows out of a wound or natural openings, is called outdoor. Bleeding in which blood accumulates in body cavities is called internal. Especially dangerous are internal bleeding into closed cavities - into the pleural, abdominal, heart shirt, cranial cavity. These bleedings are imperceptible, their diagnosis is extremely difficult, and they can remain unrecognized.
Internal bleeding occurs with penetrating wounds, closed injuries (ruptures internal organs without damaging the skin as a result of a strong blow, falling from a height, squeezing), as well as in diseases of internal organs (ulcer, cancer, tuberculosis, aneurysm of a blood vessel).
With a decrease in the amount of circulating blood, the activity of the heart worsens, the supply of oxygen to vital organs - the brain, kidneys, liver - is disrupted. This causes a sharp disruption of all metabolic processes in the body and can lead to death.
There are arterial, venous, capillary and parenchymal bleeding.
arterial bleeding most dangerous for a short time a person loses a large amount of blood flowing under high pressure. Blood of bright red (scarlet) color beats with a pulsating jet. This type of bleeding occurs with deep chopped, stab wounds. If large arteries, the aorta, are damaged, blood loss that is incompatible with life can occur within a few minutes.
Venous bleeding occurs when a vein is damaged blood pressure much lower than in the arteries, and the blood (it is dark cherry in color) flows out more slowly, evenly and continuously. Venous bleeding is less intense than arterial bleeding and is therefore rarely life-threatening. However, if the veins of the neck and chest are injured at the moment deep breath air can be drawn into the lumen of the veins. Air bubbles, penetrating with blood flow into the heart, can cause blockage of its vessels and cause lightning death.
capillary bleeding occurs when the smallest blood vessels (capillaries) are damaged. It happens, for example, when superficial wounds, shallow skin cuts, abrasions. Blood flows out of the wound slowly, drop by drop, and if the blood clotting is normal, the bleeding stops on its own.
Parenchymal bleeding associated with damage to internal organs that have a very developed network of blood vessels (liver, spleen, kidneys).
Stop bleeding. First aid for bleeding at the scene of the accident aims to temporarily stop the bleeding, then to deliver the victim to medical institution where the bleeding will stop completely. First aid for bleeding is carried out by applying a bandage or tourniquet, maximum flexion of the injured limb in the joints.
capillary bleeding easily stopped by applying a conventional bandage to the wound. To reduce bleeding during the preparation of the dressing, it is enough to raise the injured limb above the level of the body. After applying a bandage to the area of the injured surface, it is useful to put an ice pack.
Stop venous bleeding is carried out by applying a pressure bandage (Fig. 10 ). To do this, several layers of gauze are applied over the wound, a tight ball of cotton wool and tightly bandaged. The blood vessels squeezed by the bandage are quickly closed by clotted blood, therefore this way stop bleeding may be definitive. With severe venous bleeding during the preparation of a pressure bandage, bleeding can be temporarily stopped by pressing the bleeding vessel with your fingers below the wound.
To stop arterial bleeding vigorous and swift action is needed. If blood flows from a small artery, good effect gives a pressure bandage.
Rice. 10. Applying a pressure bandage
Fig.11. Places of cross-clamping of arteries:
1 - femoral, 2 - axillary, 3 - subclavian,
4 - sleepy, 5 - shoulder.
To stop bleeding from a large arterial vessel, the technique of pressing the artery above the injury site is used. This method is simple and based on the fact that a number of arteries can be completely blocked by pressing them against the subject bone formations in typical places (Fig. 11, 12 ).
Prolonged hemorrhage control finger pressure artery is not possible, as it requires a large physical strength, tedious and virtually eliminates the possibility of transportation.
Reliable way to stop heavy bleeding from the artery of the limb is the imposition of a hemostatic tourniquet (standard or impromptu).
The tourniquet is applied over the sleeve or trousers, but not on the naked body: the skin can be damaged. They hold the tourniquet of an adult for no more than 2 hours (in winter - no more than 1 hour), a longer squeezing of the vessels can lead to necrosis of the limb. A note must be placed under the tourniquet with an exact (up to a minute) indication of the time of its application (Fig. 13)
Rice. 12. Finger clamping of the arteries
Rice. 13. Proper tourniquet application
If the tourniquet is applied correctly (Fig. 14), the bleeding stops immediately, the limb turns pale, and the pulsation of the vessels below the tourniquet disappears. Excessive tightening of the tourniquet can cause crushing of muscles, nerves, blood vessels and cause limb paralysis. With a loose tourniquet, conditions are created for venous congestion and increased bleeding.
If there is no special tourniquet, you can use improvised means: a belt, a scarf, a piece of cloth, a scarf, etc. A tourniquet made from auxiliary materials is called a twist. To apply a twist, you must freely tie the object used for this at the required level. A stick should be passed under the knot and, rotating it, twist until the bleeding stops completely, then the stick should be fixed to the limb (Fig. 15 ). The application of the twist is painful, so it is necessary to put cotton wool, a towel or a piece of cloth folded 2-3 times under it. All errors, dangers and complications noted during the application of the tourniquet fully apply to twisting.
Rice. fourteen . Places for applying a tourniquet for bleeding from the arteries:
1 - lower leg, 2 - lower leg and knee joint, 3 - hand, 4 - forearm and elbow joint, 5 - shoulder, 6 - thigh
To stop bleeding during transportation, pressure on the arteries is used by fixing the limbs in a certain position. When injured subclavian artery bleeding can be stopped by the maximum abduction of the arms back with their fixation at the level of the elbow joints (Fig. 16, a). pressing of a popliteal and femoral artery is shown in fig. 16, a, b, c.
Rice. 15. Overlay spin
Fig.16. Fixation of limbs
Stopping bleeding from wounds on the forearm (shoulder, thigh or lower leg), in the elbow bend ( armpit, inguinal fold or popliteal fossa) put a roller of cotton wool or tightly folded tissue, bend the arm to failure in elbow joint(or, respectively, in the shoulder, pressing it to the body, and the leg - in the hip or knee joint) and fix in this position with a bandage, scarf, belt, towel ( rice. 17 ). You can leave the limb in this position, like a tourniquet, for no more than 2 hours.
This method is not suitable for broken bones or severe bruises.
Rice. 17. Stop bleeding from a wound on the forearm
First aid has to be provided not only for blood loss from wounds, but also for other types of bleeding.
Bleeding from the nose. With a bruised nose, and sometimes without apparent reason, in some infectious diseases, increased blood pressure, anemia, etc. d. nosebleeds often occur.
First aid. First of all, it is necessary to stop washing the nose, blowing your nose, coughing up blood that enters the nasopharynx, sitting with your head down, etc., since these measures only increase the bleeding. The patient should be seated or laid down with his head raised, his neck and chest freed from restrictive clothing, access fresh air. The patient is advised to breathe open mouth. Most nosebleeds stop when the patient is calm. You can put cold (blister or plastic bag with ice, cold lotions) on the bridge of the nose. Stopping bleeding in most cases helps to compress the nose for 15-20 minutes, especially after the introduction of a lump of cotton wool into the nostril (you can moisten it with a solution of hydrogen peroxide or a vasoconstrictor, such as a solution of naphthyzinum). If the bleeding does not stop soon, it is necessary to call a doctor or refer the patient to a medical facility.
Bleeding after tooth extraction. After a tooth is removed or after it is damaged (knocked out teeth), bleeding from the tooth bed (hole) is possible, especially when the victim sucks blood from the hole, rinses the mouth, and sometimes with insufficient blood clotting. If the bleeding that occurs during the extraction of a tooth does not stop, becomes more abundant or resumes, measures should be taken to stop it.
First aid. It is necessary to make a small roller of sterile cotton wool or gauze, lay it between the top and lower teeth according to the place of the extracted tooth, after which the patient tightly compresses his teeth. The thickness of the roller should correspond to the gap between the teeth and, when the jaws are closed, will press on the place of bleeding.
Hemoptysis, or pulmonary hemorrhage. In patients with tuberculosis and some other lung diseases, as well as heart defects, sputum with streaks of blood (hemoptysis) is separated, blood is coughed up in a significant amount or profuse (pulmonary) bleeding occurs. Blood in the mouth may also be from the gums or mucous membranes, with vomiting due to gastric bleeding. Pulmonary bleeding is usually not life threatening, but makes a painful impression on the patient and others.
It is necessary to reassure the patient, pointing out the absence of danger to life. Then you should put him to bed with a raised top torso. To facilitate breathing, unfasten or remove squeezing clothing, open the window. The patient is forbidden to speak and drink hot, he should not cough, if possible, they are given cough-calming medicines from home first aid kit. An ice pack should be placed on the patient's chest, heating pads or mustard plasters should be placed at the feet. When thirsty, drink in small sips cold water or concentrated solution table salt(1 tbsp. salt per 1 glass of water).
A doctor is called for first aid. Only a doctor, having determined the severity of bleeding and the nature of the disease, can dictate further actions.
Hematemesis. With a stomach ulcer duodenum and some other diseases of the stomach, as well as with varicose veins veins of the esophagus often occurs vomiting dark clots of color coffee grounds, and sometimes unclotting bright blood. Vomiting blood can be single, a small amount and multiple, profuse, life threatening sick.
Symptoms. With gastric bleeding, blood is released with vomit. In some cases, blood from the stomach and duodenum enters the intestine and is detected only by the presence of black stools. At heavy bleeding there are signs of acute anemia: dizziness, weakness, pallor, fainting, weakening and increased heart rate.
First aid. The patient is subject to immediate hospitalization (in the surgical department). Before transportation, the patient needs complete rest, giving a lying position, prohibition of any movements, placing an ice pack on the epigastric region. You should not feed the patient, but you can give teaspoons of cold jelly. Transportation is carried out in a supine position on a stretcher with great care, even if hematemesis has stopped; in case of collapse, measures are taken at the scene until the patient exits a serious condition.
Intestinal bleeding. With intestinal ulcers and some of its diseases, significant bleeding into the intestinal lumen may occur. It is accompanied by general signs of blood loss, and later - the appearance of black stools.
From the dilated veins of the area anus with hemorrhoids and other diseases of the rectum, it is possible with a bowel movement to excrete unchanged or mixed blood with feces. Such bleeding is usually mild, but often repeated many times.
First aid. At intestinal bleeding complete rest, giving a lying position, placing ice on the stomach are necessary. You should not feed the patient, give him laxatives and put enemas.
With significant bleeding from the anus, it is recommended to put an ice pack on the sacral region.
Blood in the urine (hematuria). Damage to the kidney and urinary tract (ruptures), tuberculosis of the kidney and Bladder, stones in the urinary tract, tumors and a number of other diseases may be accompanied by the appearance of an admixture of blood in the urine or its release through urinary tract in significant quantities, sometimes in the form of clots or even pure blood.
First aid. Required bed rest, ice on the lower abdomen and lumbar region. In view of the fact that blood in the urine is often a sign of a serious illness, the patient is subject, even after stopping the bleeding, hospitalization for a special examination.
Uterine bleeding. Many diseases of the female genital organs (miscarriages, disorders menstrual cycle, inflammatory processes, uterine tumors) are accompanied by uterine bleeding during menstruation or in between.
First aid. The patient should be given a horizontal position or, even better, raise the foot end of the bed, put an ice pack on the lower abdomen. On the bed you need to put an oilcloth and on top of it - to absorb blood - a towel folded several times. The patient should be given a cold drink. The question of admission to the hospital maternity hospital, gynecological department hospital) is decided by the doctor. With heavy and prolonged bleeding, referral to the hospital should be urgent.
Internal bleeding during ectopic pregnancy. Life-threatening internal (abdominal) bleeding occurs during a pregnancy that does not develop in the uterus, but in fallopian tube what happens most often after inflammatory diseases tubes and abortions. Ectopic pregnancy complicated by rupture of the tube and bleeding.
Symptoms. Internal bleeding occurs suddenly
2 - 3 months of pregnancy. It is accompanied by scarce spotting from the genital tract, cramping pains in the lower abdomen; dizziness occurs cold sweat, pallor, rapid breathing, weak pulse, sometimes vomiting and fainting. The presence of pregnancy is confirmed by a preliminary delay in menstruation, pigmentation of the nipples and swelling of the mammary glands.
First aid. The patient should lie with ice on the stomach. It is necessary to ensure the most urgent delivery in surgery department.
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All people experience bleeding throughout their lives. Hemorrhage is a condition in which blood leaks from a damaged vessel. The most common is capillary bleeding, which the body usually copes with on its own. Venous and arterial bleeding is life-threatening and requires medical intervention. But the most insidious are considered internal bleeding, which is difficult to detect.
It is important to be able to distinguish between types of bleeding and know their main characteristics in order to provide first aid in a timely manner and save a person's life. After all, incorrect diagnosis or violation of the rules for stopping bleeding can cost the victim his life.
What types of bleeding are there, what are the main signs of external and internal hemorrhages, what are the actions when providing the first medical care(PMP) - you will learn about this and much more later in the article.
Classification of bleeding
Hemorrhages are divided into different types, this is necessary to save time and make it easier to determine the treatment plan. After all, thanks to operational diagnostics You will not only save a life, but also minimize blood loss.
General classification of types of bleeding:
- Depending on the site of bleeding:
- External - a type of bleeding that is in contact with the external environment;
- Internal - blood is poured into one of the body cavities;
- Depending on the damaged vessel:
- - damaged capillaries;
- - the integrity of the veins is broken;
- - blood flows out of the arteries;
- Mixed - different vessels are damaged;
- Depending on the body cavity into which the blood flows:
- Bleeding into the free abdominal cavity;
- Blood flows into the internal organs;
- Hemorrhage in the cavity of the stomach or intestines;
- Depending on the amount of blood loss:
- I degree - the victim lost about 5% of the blood;
- II degree - loss of up to 15% of the fluid;
- III degree - the volume of blood loss is up to 30%;
- VI degree - wounds lost from 30% of blood or more.
The most dangerous for life are III and VI degree of blood loss. Next, we consider in detail the characteristics of various and at the same time the most common and dangerous types of bleeding.
capillary
The most common is capillary hemorrhage. This is external bleeding, which is considered not life-threatening, unless the area of injury is too large or the patient has reduced blood clotting. In other cases, the blood ceases to flow out of the vessels on its own, since a blood clot forms in its lumen, which clogs it.
Capillary bleeding occurs due to any traumatic injury during which the integrity of the skin is violated.
As a result of an injury, blood of a bright scarlet color evenly flows out of damaged capillaries (the smallest blood vessels). The liquid flows out slowly and evenly, there is no pulsation, since the pressure in the vessels is minimal. The amount of blood loss is also insignificant.
First aid for capillary bleeding is to disinfect the wound and apply a tight bandage.
In addition, a cold compress can be applied to the damaged area. Usually, with capillary bleeding, hospitalization is not needed.
Venous
Venous hemorrhage is characterized by a violation of the integrity of the veins that are under the skin or between the muscles. As a result of a superficial or deep wound, blood flows out of the vessels.
Symptoms of venous hemorrhage:
- Blood of a maroon hue flows from the vessels, a barely perceptible pulsation may be present;
- The hemorrhage is quite strong and is manifested by a constant flow of blood from the damaged vessel;
- When you press on the area under the wound, bleeding decreases.
Venous bleeding is life threatening, because in the absence of timely medical care, the victim may die from heavy blood loss. The body in rare cases can cope with such a hemorrhage, and therefore it is not recommended to hesitate to stop it.
If the superficial veins are damaged, the hemorrhage is less intense, and if the integrity of the deep vessels is violated, profuse blood loss is observed ( copious excretion blood).
With venous bleeding, the victim can die not only from massive blood loss, but also from an air embolism. After damage to a large vein, air bubbles clog its lumen at the time of inspiration. When the air reaches the heart, it cuts off the flow of blood to important organs, as a result, a person can die.
Arterial
Arteries are large blood vessels that lie deep in soft tissues. They transport blood to all important organs. If the integrity of the vessel is violated, blood begins to flow out of its lumen.
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Arterial bleeding is rare. Most often, the injury occurs as a result of a knife, gunshot or mine-explosive wound. This is dangerous damage threatens human life, because the blood loss is quite large.
If you do not help the victim with arterial bleeding within 3 minutes after the injury, then he will die from exsanguination.
It is easiest to identify arterial hemorrhage, for this, pay attention to the following signs:
- The blood is bright red;
- Blood does not flow, but pulsates from the wound;
- The bleeding is very profuse;
- The blood does not stop even after pressing under the wound or above it;
- The wound is localized at the site of the proposed passage of the artery.
Intense arterial hemorrhage quickly provokes profuse blood loss and shock. If the vessel ruptures completely, then the victim can die from exsanguination of the body in just 1 minute. That is why arterial bleeding requires surgery. first aid. A tourniquet is most often used to stop the bleeding.
What are the main signs of external bleeding, you now know, then we will consider what to do if the hemorrhage occurs inside the body.
internal
This type of hemorrhage is the most insidious, since, unlike external bleeding, it does not have obvious symptoms. They appear when a person has already lost a lot of blood.
Internal hemorrhage is a condition characterized by bleeding into one of the cavities of the body due to damage to blood vessels.
Check for bleeding early stage possible by the following signs:
- The victim feels weak, he is drawn to sleep;
- Feeling uncomfortable or pain in the abdomen;
- Without a reason, blood pressure drops;
- The pulse quickens;
- The skin turns pale;
- There is pain when the victim tries to get up, which disappears when he assumes a semi-sitting position.
Types of internal bleeding occur as a result of penetrating wounds of the abdomen, lower back, broken ribs, stab-knife or gunshot injuries. As a result, the internal organs are injured, because of which the integrity of their vessels is violated and bleeding begins. As a result, blood accumulates in abdominal cavity, chest, impregnates wounded organs or subcutaneous adipose tissue(hematoma).
The intensity of internal bleeding is different, that is, they can develop quickly or increase over several days after the injury. The severity of such hemorrhages depends on the size of the injury of a particular organ.
In most cases, the spleen is damaged, a little less often - the liver. A one-time rupture of an organ provokes instantaneous and rapid bleeding, and a two-stage one provokes a hematoma inside the organ, which ruptures over time, and the victim's condition deteriorates sharply.
Gastrointestinal
This type of hemorrhage is most often a complication of diseases digestive tract(for example, a stomach ulcer and 12 duodenal ulcer). Blood accumulates in the cavity of the stomach or intestines and does not come into contact with air.
It is important to detect symptoms of gastrointestinal hemorrhage in time in order to transport the victim to a medical facility.
Symptoms of gastrointestinal hemorrhage:
- The patient feels weak, dizzy;
- The pulse quickens, and the pressure decreases;
- The skin turns pale;
- There are attacks of vomiting with an admixture of blood;
- Liquid bloody stools or thick black stools.
The main causes of this complication are ulcers, oncological diseases, various necrotic processes on the inner lining of the gastrointestinal tract, etc. Patients who know their diagnosis should be prepared for such situations in order to go to the hospital on time.
First aid for different types of hemorrhages
It is important to be able to conduct a differentiated diagnosis in order to determine the type of bleeding in time and provide competent first aid.
General rules that should be followed for any bleeding:
- If symptoms of bleeding occur, the wounded person is laid on his back;
- The person providing assistance should observe that the victim is conscious, periodically check his pulse and pressure;
- Treat the wound antiseptic solution(hydrogen peroxide) and stop bleeding with a pressure bandage;
- A cold compress should be applied to the damaged area;
- Then the victim is transported to a medical facility.
The above actions will not harm a person with any type of bleeding.
Detailed tactics of actions for different types of bleeding are presented in the table:
| Type of hemorrhage | The procedure for temporarily stopping the hemorrhage (first aid) | Procedure for the final stop of bleeding (medical care) |
| capillary |
|
Sew up the wound if necessary. |
| Venous |
|
|
| Arterial |
|
The damaged vessel is sutured or prosthetized, the wound is sutured. |
| Internal (including gastrointestinal) | Held general events for first aid. |
|
The above measures will help stop the hemorrhage and save the victim.
Harness rules
This method of stopping blood is used for severe venous or arterial hemorrhages.
To properly apply a tourniquet, follow these steps:
It is important to be able to distinguish between different types of bleeding in order to competently provide first aid to the victim.
It is important to strictly follow the rules of first aid, so as not to worsen the condition of the wounded. By remembering even the basic rules, you can save a person's life.
Since trauma, and therefore bleeding due to it, can happen anywhere and anytime, every adult should know how to provide first aid for bleeding.
Types of bleeding and their features
Depending on the type of injured vessel, there are the following types bleeding:
- arterial;
- Venous;
- Capillary.
Also, bleeding is distinguished by location. The most commonly injured hands are bleeding upper limbs this is the most common type. In second place are leg injuries, and nosebleeds are in third place. by the most dangerous view are bleeding of internal organs, since it is difficult to notice them in time, it is even more difficult to keep the situation under control. Below we will consider the principles of first aid for arterial, venous, nasal and internal bleeding.
First aid for arterial and venous bleeding
Many people vaguely remember that first aid for arterial bleeding consists in applying a tourniquet to the vessel, but few people know how to do it correctly. Doctors warn: the application of a tourniquet can be no less dangerous than the loss of blood, an ineptly applied tourniquet can lead to the need for amputation of a limb, and alas, it often leads. How to provide first aid for arterial bleeding without causing harm? Remember, with an injury to a large artery, there is not much time left, only 3-5 minutes. The algorithm of actions is as follows:
- Do not wash or in any other way try to decontaminate the wound, do not remove small fragments that have got there;
- Apply a pressure bandage as follows: directly on the wound, apply a sterile bandage or a clean cloth folded in several layers (it is desirable that the dressing be sterile, if one is not at hand, use any). Put another roller made of fabric on top. Then bandage everything tightly, after which the limb must be placed above the level of the body. If done correctly, the bleeding should stop;
- If there was nothing at hand that could serve as a dressing, you can try to stop the bleeding by maximum flexion of the joint located above the wound;
First aid for bleeding and wounds with a tourniquet. This method is resorted to if it was not possible to stop the blood in another way. The rules are as follows:
- A tourniquet (or any long piece of rubber, such as a rubber hose) is applied 5-7 cm above the wound, but not on bare skin, but on the fabric that should be wrapped around the limb, it can be on a sleeve or trouser leg;
- After stretching the tourniquet, lay it in several turns without gaps between them, the first is not too tight, each subsequent turn is tighter. A sign of a correctly applied tourniquet is to stop bleeding;
- The tourniquet should not be applied too tightly so as not to injure the nerves. If severe pain occurs from the tourniquet, the injured vessel must be pressed with a finger, and the tourniquet removed, give the victim a break from the tourniquet, then apply again;
- Be sure to record the time of applying the tourniquet! This is extremely important condition which can save a person from possible disability. It is advisable to write the time of applying the tourniquet with a pen directly on the skin or clothing of the victim. The maximum time for which a tourniquet can be applied is one and a half to two hours in summer and one hour in winter. During this time, the patient should be taken to the hospital, if this is not possible, and the time has elapsed, the tourniquet must be removed very carefully and slowly, if the bleeding has resumed, press the vessel with your finger above the wound.
First aid for venous bleeding occurs according to a similar algorithm, the only difference is that the vessel should be pressed below the wound.
First aid for nosebleeds
As a rule, nosebleeds are not life-threatening, although they look frightening. However, blood loss can be significant. To prevent this, you must take the following actions:
- Into the nostril from which there is blood, you need to insert a small swab of cotton, bandage, napkin or handkerchief. The tampon should not cause pain;
- The person must be seated with his head slightly tilted down. A common mistake is made by people who, as first aid for nosebleeds, lay a person on his back or make him throw his head back. This can cause blood to flow down the back wall pharynx;
- Put a cold compress or any cold object on the nose area;
- Slightly squeeze the wings of the nose.
First aid for internal bleeding
Internal bleeding is difficult to recognize on its own. An indirect sign of it after an injury that has occurred is a deterioration in a person’s condition, blanching of the skin, cold sweat that has come through, darkening in the eyes. In this case, blood may be excreted with vomiting or with feces, but not necessarily. If you notice these signs, the following should be done as first aid for internal bleeding:
- In case of a chest injury, give the person a semi-sitting position, in case of an abdominal cavity injury - lying down;
- Provide fresh air supply;
- Apply cold to the abdomen or chest;
- Forbid the victim to eat, drink, move and talk;
- Take the person to the hospital immediately.
The last point is relevant not only for injuries of internal organs. In case of massive blood loss, the main point of first aid for bleeding of any kind will be the delivery of the victim to the clinic for the provision of qualified medical care.
The main danger in bleeding is the lack of blood flow to the tissues and, as a result, the cessation of the supply of oxygen to organs, primarily the heart, brain and lungs. The ability of blood to coagulate can ensure the cessation of bleeding from small vessels, called capillaries, but more serious types of wounds are forced to turn to special first aid techniques. At car accidents any injury causes bleeding because tissues are damaged and skin covering, entirely and across permeated with blood vessels.
To start helping the victim, you must first protect yourself. Look around and assess the situation, you need to make sure that nothing will threaten you at the moment when you rush to the rescue of a wounded person.
Type of bleeding
External bleeding are those in which there are wounds from which blood flows, or bleeding from the natural openings of the human body (ears, eyes, nose, mouth). Much worse in terms of symptoms. internal bleeding when blood pools in body cavities. There are three types of external bleeding:
- capillary - slight bleeding, when the blood from the wound comes out in drops;
- arterial - blood from a scarlet color and beats with a pulsating jet;
- venous - blood has a dark shade and flows out in a jet,
- mixed bleeding.
Venous bleeding is quite difficult to stop, as it occurs as a result of deep wounds.
Venous bleeding is dangerous not only because it loses a significant amount of blood, but also because venous wounds, especially of the cervical vessels, involve the absorption of air through damaged bleeding sites. Air through the veins reaches the heart muscle and can cause a fatal condition called air embolism .
Arterial bleeding is considered the most dangerous, as blood flows from the wound into huge quantities fountain, which can quickly lead the victim to complete bleeding. Carotid, axillary and femoral arteries can "kill" the victim in 3 minutes.
Help with bleeding
The most important thing during bleeding relief is a tourniquet or any other handy tool capable of squeezing a bleeding limb. This is how the tourniquet looks like (in this case, a belt is used). Always, on any pressure bandage, attach a note with the time of its application, so that in the future, doctors or anyone else will know how long the limb is in a bleeding state. The figure shows a special loop and its correct fastening to the legs.
The main task during the treatment of a bleeding wound is to stop the bleeding itself, since as a result of a significant loss of blood, the victim quickly loses strength, which can lead to a threat to his life.
capillary bleeding
Capillary bleeding can be quickly stopped by applying a gauze bandage or bandage to the wound, put a layer of cotton wool on top and bandage the wound, if a bandage with gauze is not at hand, then a clean handkerchief will do. New first-aid kits have complete list bandages, use them. Shaggy fabrics and cotton wool directly on open wounds cannot be applied, as their villi may contain bacteria that can cause infection and suppuration of the wound.
Venous bleeding
Venous bleeding is stopped by applying a pressure bandage. It is necessary to apply clean gauze to the bleeding area, an unfolded bandage over the gauze, or gauze folded in several layers, on top of the gauze. extreme case- a clean handkerchief, folded several times. This method closes the wound edges, as a result of which the lumen of the vessels is compressed and, as a result, the bleeding stops. Pressure bandages are left on the wound for no more than an hour, as they can cause necrosis - tissue necrosis, so the bandage must be loosened every hour.
arterial bleeding
First aid for arterial bleeding is also provided by the imposition of a pressure bandage. Arterial bleeding from large vessels must be stopped immediately by clamping the damaged area above the wound. Such a measure is a temporary solution until a pressure bandage is applied.
Bleeding from natural orifices
In addition, there may be not only wound bleeding. For example, blood can flow from the nose as a result of hard hit and traumatic brain injury. To stop it, it is necessary to lay the victim on his back, raise his head a little, and put a cold compress or ice on the bridge of the nose, heart area and neck.
With this type of bleeding, in no case should you blow your nose and clean your nose with water. The blood flowing into the nasopharynx must be spit out.
Ear bleeding occurs as a result of injuries to the external ear canal and skull fracture. A clean gauze bandage should be applied to the affected ear. Lay the victim on a healthy side and slightly raise his head. Washing the ear is also prohibited.
internal bleeding
A hard blow to the chest, broken ribs, or exacerbated tuberculosis can cause pulmonary hemorrhage, the symptoms of which are coughing up bright red frothy blood and shortness of breath. To stop him, the victim must be placed in a semi-sitting position, and a roller should be placed under his back. The chest must be freed from clothing and a cold compress placed on it, while the victim is not allowed to speak or move.
Esophageal bleeding can be caused by ruptured veins that may have been dilated as a result of some liver disease. stomach bleeding contribute to a gastric ulcer or tumor or trauma to the stomach. Symptoms of these bleedings are vomit of dark red or even already coagulated blood. The victim must be laid in a semi-sitting state and his legs bent at the knees. Put a compress on the abdominal region and ensure complete rest of the victim, who also cannot eat or drink. As soon as possible, the victim with these types of bleeding must be taken to the hospital for surgical intervention.
Internal bleeding is dangerous because their determination is often delayed. Abdominal bleeding occurs as a result of a strong blow to the stomach, when the spleen and liver rupture. This type of bleeding is characterized by severe pain in the abdomen, shock and loss of consciousness of the victim. Emergency help to the victim is similar, as well as at gastric bleedings.
Internal bleeding in the pleural cavity (chest) occurs as a result of a blow or damage to the chest. Accumulating blood compresses the lungs in the damaged part and prevents their normal operation. The victim's breathing is difficult, and with severe injuries it is suffocating. The victim must take a semi-sitting position and bend his knees, on chest you need to put a cold compress. The victim is immediately transported to the hospital.
Any bleeding is accompanied by weakness, sinking eyeballs, weak pulse, apathy, cold sweat, the victim may also fall into state of shock or fainting.
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Assistance in an accident must be provided thoughtfully and confidently. Knowing the skills and techniques will help both you and the victim in an accident. Be careful and follow traffic rules. In the next article, we will talk about helping with fractures.
Injuries that are accompanied by extensive damage to blood vessels are quite dangerous. Sometimes the life of the victim depends on how quickly and skillfully first aid is provided. Bleeding is arterial, venous and capillary, and each type requires a special approach in first aid.
Ways to stop bleeding from an artery
Arterial bleeding is the most dangerous. In this case, the blood acquires a bright red (scarlet) color and pours out in time with the contractions of the heart in a pulsating stream. The rate of blood loss in case of damage to a large arterial vessel (aorta, femoral, brachial, carotid artery) is such that in a matter of minutes a person can die.
You can stop bleeding from an artery in one of the following ways:
- apply a hemostatic tourniquet;
- to give the wounded limb or part of the body an elevated position;
- pinch the artery with your fingers.
Applying a hemostatic tourniquet. When there was no tourniquet at hand, for this purpose you can use improvised means - a rubber tube, a piece thick fabric, waist belt, strong rope. The tourniquet is applied to the forearm, shoulder, thigh or lower leg (necessarily above the place of blood loss). So that it does not injure the skin, put a tourniquet on top of the clothes, after straightening its folds, or place some material under the device. Make 2-3 turns of the tourniquet around the limb, then tighten it so that the bleeding stops. If you did everything correctly, then the pulsation of the artery below the damaged area will not be determined.
However, be careful - if the tourniquet is tightened excessively, you can pinch the nerves, damage the muscle, and this is fraught with paralysis of the limb (in some cases even necrosis). Also remember: the tourniquet is allowed to be applied for no more than 30 minutes in the cold season and for 1.5-2 hours in the warm season. With a longer period, there is a risk of tissue necrosis. If you need to keep the tourniquet longer than the prescribed time, press the artery with your finger above the damaged area, then remove the tourniquet for 10-15 minutes, then apply it again a little lower or higher than the previous place.
Giving the limb an elevated position. You can also temporarily stop bleeding from an artery by holding the injured limb in a certain position. So, for example, by maximally bending the leg or arm in the knee or elbow joint, it is possible to press the femoral, popliteal, ulnar and brachial arteries. At the same time, the pressure in the vessels decreases sharply, blood flow to the damaged area decreases, and a thrombus quickly forms, preventing blood loss. After stopping the bleeding from the artery, you need to take the victim to the nearest hospital as soon as possible.
Finger pressing of the artery. This method is one of the most effective for emergency bleeding control. Its essence lies in the fact that the torn artery is pressed with a finger to the bone formations. This method can only be used for a short period of time, since it requires a lot of physical strength from the person providing assistance. Nevertheless, there are certain advantages - you have a few minutes to prepare the necessary tools (twist, tourniquet) to provide better care. You can press the artery with your palm, fist, thumb arms.
Ways to stop venous and capillary bleeding
Venous bleeding not as intense as arterial. From the injured veins, dark, cherry-colored blood flows in a uniform, continuous stream. Stopping venous bleeding is carried out using a pressure bandage. A sterile gauze or bandage is applied to the bleeding site. If you cannot use a special dressing, take a clean cloth and drip some iodine on it. Place a dense roll of handkerchief, cotton wool or bandage on top of the fabric. Then bandage it tightly and, if necessary, continue to lightly press on the roller with your hand. At correct overlay pressure bandage will stop bleeding and the bandage will not get wet. It is also desirable to raise the bleeding limb above the level of the body in order to reduce blood flow.
capillary bleeding appears as a result of damage to capillaries (the smallest blood vessels) - with superficial wounds, extensive abrasions. The blood flows out slowly and if the victim has normal clotting, the bleeding stops on its own. If it continues, you can apply a regular sterile bandage to the wound.
In all the cases described above, it is recommended to apply an ice pack to the injured area (over the bandage).
First aid rules
If you had to provide first aid to the victim, be sure to follow the following rules:
- it is forbidden to fill the wound with powder or lubricate with ointments - this prevents healing;
- it is possible to wash the damaged area only if poisonous or caustic substances get into it;
- when the wound is contaminated, it is necessary to carefully remove the dirt from the skin around it (in the direction from the edges of the wound outward);
- if rust, sand or other elements get into the wound, wash it with solutions medicines or water is not allowed;
- only a specialist should remove small pieces of glass from an injured limb or part of the body;
- it is forbidden to remove blood clots from the wound, as this can provoke severe bleeding;
- you can not touch a bleeding wound with your hands, even thoroughly washed;
- before applying a bandage, the edges of the wound are treated with tincture of iodine, while it should not be allowed to get inside the wound;
- if the blood loss turned out to be significant, after providing first aid, the patient must be immediately sent to a medical institution.
First aid for arterial, venous and capillary bleeding, first of all, is to stop it. The main thing in this situation is not to panic and carefully consider each action. Remember that the life of another person depends on how well you do everything.
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