Message first aid for wounds. What to do if you are deeply injured by a contaminated or rusty object? Help with capillary bleeding

While working or relaxing in a summer cottage, there are many opportunities to get hurt. Sharp and dirty garden tools, saws, screwdrivers, wire cutters and other tools can be dangerous. Even if you came to the country to rest, you should be careful. You can seriously cut yourself even with an ordinary sheet of paper, carelessly turning over the pages.

What to do if you still get hurt?

What are wounds

Wounds may be:

• stab;
• cut;
• torn;
• chopped;
• bitten;
• bruised;
• crushed;
• mixed.

According to the degree of skin damage, the wound can be superficial or deep. A superficial wound is one in which only the skin is damaged, vessels, muscles or internal organs.

If any body cavity is damaged during the cut, such injuries are considered penetrating. Penetrating cuts are the most dangerous.

Is a superficial wound dangerous?

If the damage is caused by a sharp object and is quite extensive, the healing process may take longer. An infection can get into the wound, which can lead to the most unpleasant consequences. In order to avoid them, it is important to treat the cut correctly.

First aid for a small superficial incised wound

Attention! Do not use water from ponds, lakes or other unverified sources for flushing! If you do not have a clean or boiled water, rinsing with contaminated water can harm.

After you have cleaned the wound, try to align the edges of the cut with each other and press firmly. This will help stop bleeding and speed up skin recovery. Clean wounds, such as those caused by a knife that you have just washed, can be pressed immediately without rinsing.

Wound edges can be treated brilliant green or iodine unless the victim is allergic to them. Do not pour iodine or brilliant green into the cut.

To seal the wound with a band-aid or not?

When is the best time to seal a cut?

• if the edges of the cut diverge;
• if the wound is large enough;
• if you need to continue working with soil or contaminated materials.

Wounds should not be covered with plaster:

• deep or punctured - oxygen restriction will promote the growth of dangerous bacteria;
• with continued bleeding.

If you continue to work in the garden after a skin cut, be sure to wear rubber gloves. The patch cannot prevent dirt from entering the wound if you work without gloves.

What if the wound is deep?

A deep, heavily bleeding wound is a reason to see a doctor!

How do you know if a cut is deep? A wound is considered deep if:

• visually, the depth of the cut is more than 6-7 mm;
• damaged muscle;
• the tendon is damaged or there is a limitation of the mobility of the injured limb;
• damaged large or middle vessel which may indicate heavy bleeding;
• adipose tissue is visible.

What to do if you get hurt and the bleeding won't stop?

If we have already started talking about bleeding from blood vessels, it would be nice to talk a little more about them.

What is the difference between venous and arterial bleeding?

• Vienna located superficially, so their damage is quite common. Venous blood is dark red, flows evenly, fills the wound.
• Arterial bleeding is significantly different from venous bleeding. Blood out arteries bright scarlet. Blood squirts, spouts, or pulsates.

How to properly apply a tourniquet for bleeding

Venous tourniquet
In case of venous bleeding, a tourniquet is applied to the limb below the wound. This is due to the fact that blood flows through the vein from the fingertips to the heart. The venous tourniquet tightly wraps around the limb, but does not tighten too tightly.

It is ideal to use a flat rubber band to apply the tourniquet. From improvised means, a deflated and cut along the camera from a bicycle wheel is excellent. If there is no rubber band, you can use a leather belt, a bandage, or just a strip of cloth.

If the tourniquet is applied correctly, the bleeding should stop. At the same time, a pulse should be felt on the arteries below the application of the tourniquet. If the pulse is not felt, you need to slightly loosen the tourniquet.

A tourniquet to stop venous bleeding can be successfully replaced with a clean pressure bandage on the wound.

Arterial tourniquet
superimposed above the wound. Must be imposed as quickly as possible.

The ideal improvised material for applying an arterial tourniquet is rubber jump ropes twisted 2 times. If they are not at hand, you can use a bandage or cloth, after twisting it. Place a layer of cotton under the tourniquet.

The tourniquet is applied rather tightly to the artery. If it is applied correctly, the pulse should not be determined on the limbs below the tourniquet.

Be sure to put a note under the tourniquet with the exact time of application. For reliability, repeat the recording on the victim's skin and set a reminder on your phone for 30-40 minutes. After you fix the tourniquet application time, you have no more than an hour to take the victim to the medics.

Students are usually taught that maximum time tourniquet application - 1 hour in winter and 1.5-2 hours in summer. In practice, holding the tourniquet continuously for more than 30-40 minutes at any time of the year can be dangerous. If the transport time is longer, periodically loosen the tourniquet, replacing it with finger pressure.

The decision to apply a tourniquet must be made only as a last resort with massive arterial bleeding. Important: an incorrectly applied arterial tourniquet can lead to tissue necrosis, paresis or paralysis.

First aid for deep cut and stab wounds

1. Determine type of bleeding, apply finger pressure if you see a source of bleeding in the wound.
2. You can pack the wound with sterile wipes moistened with an antiseptic. A good remedy for deep wounds - hemostatic sponge . It can be found in an old car first-aid kit.
3. If you managed to stop the bleeding, match the edges of the wound with a bandage.
4. If it is impossible to stop bleeding by the listed methods, you should apply a tourniquet.
5. When present in a deep wound foreign object, it is not recommended to remove it yourself. This is due to the fact that an injured vessel may be hidden behind the object, from which massive bleeding will open.
6. Deliver the victim to admission department nearest hospital or emergency room. If bleeding continues or a tourniquet is applied, insist on an early examination by a doctor, without waiting in line. Delay in this case can be dangerous.

Important! Do not drive yourself if you have a deep cut and cannot stop the bleeding. Ask for help from people around you.

Torn wounds: what to do?

An unpleasant consequence of lacerated wounds can be the formation rough scars and scars. This must be taken into account when lacerations are located on open parts of the body, neck and face.

What to do if you are deeply injured by a contaminated or rusty object?

Serum should be administered immediately after injury. With frequent contact with the ground, it is recommended to vaccinate against tetanus in advance. This procedure will save you from this deadly disease for 10 years.

In addition to the causative agent of tetanus, there are other bacteria that "love" deep wounds. If the wound is puncture and deep - for example, you stepped on Rusty Nail, - there is risk of developing gangrene. For prevention, the doctor cuts such wounds crosswise for air access and treats them.

Is it worth it to see a doctor?

Let's clarify the situations when it is worth seeking medical help from a specialist:

• deep wounds;
• bleeding that lasts for several minutes;
• any wounds on the neck or face;
• puncture wounds with a contaminated object and lack of a tetanus shot;
• long cuts or lacerations when it is impossible to match the edges;
• wounds in immunocompromised children or the elderly.

The concept of a wound, the danger of injury(bleeding, wound contamination, damage to vital important organs).

Wounds- damage to body tissues due to mechanical, thermal, electrical, ionizing effects, accompanied by a violation of the integrity of the skin and mucous membranes

Complications of wounds are:

bleeding with the possibility of developing acute anemia;

development of infection;

the possibility of violation of the integrity of vital organs.

Wound Clinicconsists of local and general symptoms.

Local symptoms include pain, bleeding, gaping. Common symptoms are symptoms characteristic of a particular wound complication: acute anemia, shock, infection, etc.

The intensity of pain depends on:

quantity nerve elements in the area of ​​damage;

individual properties of the organism. Each person reacts to pain differently. sharpness pain It is determined both by the nature of the damaging agent and by the neuropsychic state of the person at the time of injury. So, with fear, unexpected injury, and other things, the strength of pain sensations is greater;

3) the nature of the injuring weapon and the speed of injury: the sharper the weapon, the less the number of cells and nerve elements is destroyed, and therefore the pain is less. The faster the injury occurs, the less pain. Bleeding depends on how and how many blood vessels were damaged. The most intense bleeding occurs when large arterial trunks are destroyed.

The gaping of the wound (the degree of its openness) is determined by its size, depth and the number of damaged elastic fibers of the skin. The degree of wound gaping is also related to the nature of the tissues.

So, wounds with a complete dissection of the muscles lead to a large divergence of the edges of the wound. Wounds located across the direction of the elastic fibers of the skin usually have a greater gaping than wounds running parallel to them.

Wound classification

There are several classifications of wounds depending on the underlying principle.

1. According to the nature of tissue damage, wounds are distinguished: chipped, cut, chopped, bruised, torn, bitten, poisoned, gunshot.

stab wounds applied with a stabbing weapon (bayonet, needle, awl, etc.). A feature of these wounds is their considerable depth with little damage to the integument (skin or mucous membrane).

With these wounds, there is always a danger of damage to vital organs located deep in the tissues (such as vessels, nerves, hollow and parenchymal organs).

The appearance of stab wounds does not always tell the whole story about the nature of the injury. So, with a stab wound of the abdomen, there may be an injury to the intestines or liver, spleen, but at the same time, the discharge of intestinal contents or blood from the wound, as a rule, cannot be detected.

With a stab wound in the area of ​​​​a large array of muscles in depth, a large artery may be damaged, but due to muscle contraction and, as a result, displacement of the wound channel, there may be no signs of external bleeding. An interstitial hematoma may form, followed by the development of a false aneurysm.

Stab wounds are dangerous because, due to the scarcity of symptoms, damage to deeper tissues and organs may not be noticed. With such injuries, a particularly thorough examination of the patient is required.

Also, stab wounds are dangerous because microorganisms are introduced into the depths of the tissues with a wounding weapon, and the wound discharge, without finding an outlet, serves as a good nutrient medium for them, which creates especially favorable conditions for development. purulent complications these wounds.

cut wounds applied with a sharp object (knife, saber, etc.). They are characterized by a small number of destroyed cells, the absence of damage to surrounding tissues. The gaping of the wound allows you to examine the damaged organs and creates good conditions for the outflow of the wound discharge. With an incised wound, there are most favorable conditions for healing, therefore, when treating any fresh wounds, surgeons try to turn them into incised ones.

Chopped wounds applied with a heavy sharp object (saber, ax, etc.). They are usually characterized by deep tissue damage, wide gaping, bruising and concussion of surrounding tissues, which reduce their resistance to infection and regenerative ability.

bruisedandlacerations are the result of the impact of a blunt object. They are characterized by a large number of mashed, bruised, blood-soaked tissues with reduced viability. Bruised blood vessels often thrombose. In such wounds there are favorable conditions for the development of wound infection.

Bite wounds characterized by not so much extensive and deep damage how much mass infection of the virulent flora of the mouth of a person or animal. These wounds are more likely than others to be complicated by the development of an acute infection. Bite wounds can be infected with the rabies virus, therefore, if this nature of the injury is detected, the patient must be vaccinated against rabies.

poisoned wounds - these are wounds into which poison enters when bitten by a snake, scorpion, penetration of toxic substances, etc.

gunshot wounds different from everyone else:

the nature of the injuring weapon (such as a bullet, a fragment);

the complexity of their anatomical characteristics;

a feature of tissue damage with zones of complete destruction, necrosis and molecular shaking;

high degree of infection;

a variety of characteristics (such as through, blind, tangent, etc.).

2. Due to damage, the wounds are divided operational (deliberate) and accidental.

3. According to infection, wounds are distinguished aseptic (surgical), freshly infected (applied with a non-sterile object) and purulent.

4. In relation to body cavities(cavities of the skull, chest, abdomen, joints, etc.) distinguish between penetrating and non-penetrating wounds. Deep wounds in which the internal membranes of the cavities (abdominal, thoracic, skull, joints) are damaged are called penetrating. Penetrating wounds are by far the greatest hazard, as damage to or involvement in inflammatory process shells of the cavity and the organs located in it.

5. There are also simple wounds and complicated ones. in which there is any additional tissue damage (poisoning, burns) or a combination of soft tissue injuries with bone damage, hollow organs.

wound infection

The development of microbes in the wound and the reaction of the patient's body to their vital activity change the course wound process causing complications and delaying wound healing. Every accidental wound is infected.

The entry of microorganisms into the wound at the time of injury is called primary infection, while its infection during subsequent treatment is called secondary infection.

With primary infection, microbes, once in the wound, begin to multiply and show their pathogenic properties only after a while. This period is considered to be 6-8 hours. This time, microorganisms are usually in the wound, do not show activity, and then begin to multiply rapidly, penetrate the tissues of the wound walls through the lymphatic pathways and show their pathogenic properties.

Of great importance in the development of infection in the wound are the presence of a nutrient medium in it (blood, non-viable, dead tissues) and poor resistance of the tissues of the wound walls, which is associated with a change in the circulatory system and a weakening of the protective (immune) forces of the body (such as shock, blood loss , exhaustion).

Secondary infection of the wound is the result of a violation of asepsis in the provision of first aid and inadequate treatment of the victim. Microbes that have entered the wound often increase the pathogenicity of microbes already present in it, leading to a sharp activation and spread of the inflammatory process.

Prevention of primary infection of wounds consists in the early surgical treatment of wounds with antiseptics (antimicrobial) agents with the removal of all infected, non-viable tissues.

Warning secondary infection consists in the strictest observance of all the rules of asepsis in the treatment of the victim.

The course of the wound process

The course of the wound process is determined by the reactions that occur both in the wound itself and in the body as a whole. After inflicting a wound, dead tissues, blood and lymph from damaged vessels appear in it. During the processes of wound healing, dead cells, blood, lymph are resorbed, under the influence of the body's defense systems, the processes of wound cleansing are carried out.

Stages of wound healing:

resorption of dead tissue cells and hemorrhage,

the development of granulations that fill the defect of tissues formed as a result of their death;

scar formation.

This division of the wound healing processes into three stages is very conditional, because in the wound these processes can occur both sequentially and almost simultaneously.

The treatment is complex, that is, it includes measures that act locally on the wound process, and general measures that affect the body as a whole. The bottom line boils down to one thing: together they should improve the conditions for the natural course of the wound process.

However, it must be taken into account that the treatment different stages wound process should be different.

Objectives of wound care:

prevent the danger of injury;

reduce the number and virulence of the infection;

remove dead tissue;

enhance the regeneration process.

Basic principles of first aid for injuries.

The cause of most deaths after injury is acute blood loss, so the first measures should be aimed at stopping bleeding by any means. possible way(pressure of the vessel, pressure bandage, etc.). An equally important task of first aid is to protect the wound from contamination and infection. Proper handling wound prevents the development of complications in the wound and almost 3 times reduces its healing time.

Wound treatment should be carried out with clean, preferably disinfected hands. must be removed from the wound free-lying foreign objects, leaving deeply entrenched bodies and adherent clothing in place. Cut the hair around the wound with scissors. Treat the skin around the wound with alcohol and brilliant green (1% solution of brilliant green). The wound can be protected by a simple application of an aseptic bandage (bandage, individual bag, scarf). When applying an aseptic dressing, do not touch those layers of gauze with your hands that will be in direct contact with the wound.

The wound should not be washed with water - this contributes to infection. Cauterizing antiseptic substances should not be allowed to enter the wound surface, since the disinfectant solution, entering the wound, causes the death of damaged cells, and also causes significant pain. The wound should not be covered with powders, ointment should not be applied to it, it should not be directly to wound surface apply cotton wool - all this contributes to the development of infection in the wound.

If the edges of the wound are strongly dispersed, they must be brought together (but not until they close) and fixed, for example, with adhesive tape. To strengthen the bandages on the head, it is convenient to use a mesh bandage. In case of extensive deep wounds, it is necessary to ensure the rest of the injured limb: hang the arm on a scarf or bandage it to the body, immobilize the leg with a transport splint. Bandages on the torso and abdomen are best done according to the type of bandages-stickers (napkins should be strengthened with a bandage or adhesive tape).

In case of severe pain, inject 1-2 ml of a 2% solution of promedol intramuscularly or non-narcotic painkillers.

Topic number 13: First aid for wounds and bleeding.

Lesson 1. The rules that must be observed when providing first aid for injuries. Performing injections and dressing rules for wounds. Techniques for self-help and mutual assistance.

Types of bleeding. Blood loss and infection. Stopping bleeding by pressing a bleeding vessel above the wound with a finger, bending the limb at the joint, pressure bandage, applying a tourniquet or twisting. Making a tourniquet from improvised means.

Priority actions in the provision of pre-hospital medical care are the simplest urgent measures necessary to save the life and health of the victim in case of injuries, accidents, etc. First aid is provided at the scene of the incident before the arrival of a doctor or the delivery of the victim to the hospital, and its type is determined by the nature of the injuries, the condition of the victim and the specific situation in the area. emergency.

A wound is an injury skin, deeper tissues and organs. Wounds make up the majority of injuries in accidents and injuries. They are superficial and deep. Signs of a wound are gaping, bleeding, pain, and dysfunction of the organ.

In the event that the wound is deep and there is bleeding, treatment of the wound begins with bleeding control (section 7).

In case of severe bleeding through a folded sterile napkin or other dressing material (bandage, gauze or clean cloth), press on the wound with your hand and hold it without taking your hands off for at least 20 minutes.

It should be borne in mind that one should not waste time looking for sterile material.

After stopping the bleeding, the skin around the wound should be treated with a bandage, gauze or other material moistened with one of the disinfectant solutions - 3% hydrogen peroxide, 5% alcohol solution of iodine, 70% or 96% alcohol or other antiseptic available in the first aid kit. After stopping the bleeding, the wound should be covered with a sterile napkin or bandage and bandaged tightly. Move the injured limb to an elevated position. If a fracture is suspected, immobilize (immobilize). In the event that there is no disinfectant solution at hand, simply cover the wound with clean material (but not cotton wool).

You can not treat the wound with tincture of iodine, alcohol, the treatment of the skin should be carried out only around it. Treating the wound itself will greatly increase the pain and can cause bleeding, shock, and other complications, as well as delay healing time.

Only if the wound is superficial (scratches, abrasions, shallow wounds), and heavily contaminated with earth, dirt, etc., the surface of the wound should be treated with a 3% hydrogen peroxide solution, which cleans, disinfects and stops bleeding. Very dangerous microbes - tetanus and gangrene - can get into the wound with the earth. After treatment, the wound must be bandaged and bandaged. In a medical institution (trauma center or others), tetanus toxoid will be administered.

To hold the dressing, an elastic mesh-tubular bandage is convenient, which should be in the emergency kit. Close the wound with a sterile dressing, over which put on such a bandage, after stretching it. In addition, the dressing can be fixed with an adhesive patch, which is glued to the skin with its sticky side, 1.5-2.0 cm beyond the edge of the material (crosswise or with an asterisk). Do not apply adhesive patch, if any heavy discharge from the wound, as well as on the scalp.

For first aid for extensive wounds and burns, small and large sterile dressings are very convenient. In the rescuer's first aid kit, there must be analgin (to relieve or relieve pain) and Corvalol (heart drops). After treating the wound before the arrival of the doctor or on the way to deliver him to the hospital or emergency room, if he is conscious, you must give water, two tablets of analgin and 30-40 heart drops. So, stop the bleeding, cover the wound with clean material and tightly bandage her. If the affected person is conscious, give him a drink of water and any available remedy for pain (for example: analgin 2 tablets and 30-40 drops of corvalol diluted in a glass of water).

Bleeding refers to the release of blood from damaged blood vessels.

A bandage is a dressing used to close a wound. The process of applying a bandage to a wound is called dressing.

The rules that must be observed when providing the first honey. help with injuries. Methods for stopping bleeding.

The human body tolerates the loss of only 500 ml of blood without any special consequences. The flow of 1000 ml of blood is already becoming dangerous, and the loss of more than 1000 ml of blood threatens human life. If more than 2000 ml is lost, it is possible to save the life of a bled man only if the blood loss is immediately and quickly replenished. Bleeding from a large arterial vessel can lead to death in just a few minutes. Therefore, any bleeding should be stopped as quickly and reliably as possible. It must be borne in mind that children and the elderly over 70-75 years old do not tolerate relatively small blood loss. First aid is aimed at stopping bleeding and protecting the wound from secondary infection.

Arterial bleeding is the most dangerous. At the same time, bright red (scarlet) blood is poured out in a pulsating stream in time with the contraction of the heart muscle. The rate of bleeding when a large arterial vessel (carotid, brachial, femoral artery, aorta) is injured is such that life-threatening blood loss can occur literally within minutes. If a small vessel bleeds, it is enough to apply a pressure bandage. To stop bleeding from a large artery, one should resort to the most reliable method - the application of a hemostatic tourniquet. If it is not there, then you can use improvised means for this purpose - a waist belt, a strong rope or a piece of dense fabric.

Venous bleeding is much less intense than arterial bleeding. From the damaged veins, dark, cherry-colored blood flows out in a continuous, uniform stream. Stopping venous bleeding is reliably carried out with the help of pressure bandage without resorting to a tourniquet.

Capillary bleeding occurs due to damage to the smallest blood vessels (capillaries) - with extensive abrasions, superficial wounds. The blood flows out slowly, drop by drop, and if its clotting is normal, the bleeding stops on its own. Capillary bleeding is easily stopped with a conventional sterile dressing.

internal bleeding (in abdominal cavity, chest cavity, skull) present special difficulties for self-help and mutual assistance, since it is almost impossible to stop them. Internal bleeding can be suspected by appearance victim: his skin turns pale, sticky cold sweat, breathing is frequent, shallow, the pulse is frequent and weak filling. The person feels weakness, dizziness, tinnitus, darkening in the eyes. With such signs, urgently lay the victim down or give him a semi-sitting position to ensure complete rest, and apply a plastic bag with ice or snow or a bottle of cold water to the suspected bleeding area (stomach, chest, head). If trouble happened away from locality, try to deliver the victim as soon as possible to where he can be provided with specialized medical assistance. If this is not done, the victim will be doomed.

As a result of strong external or internal bleeding acute anemia occurs. With a significant loss of blood (2-2.5 liters), there may be a loss of consciousness due to bleeding of the brain and, if urgent action is not taken, death may occur. First aid - applying a pressure bandage to the wound, after which the victim should be laid on a flat surface to prevent bleeding of the brain; with significant blood loss and loss of consciousness, the victim is placed in a supine position, in which the head is lower than the body. With the preservation of consciousness and the absence of damage to the abdominal organs of the victim, you can drink hot tea or water. In the absence of breathing and heartbeat, revival (resuscitation) is performed. It should be remembered that the main method of treatment life threatening acute anemia is an urgent blood transfusion.

The second, very formidable general reaction of the body, concomitant severe injuries, there may be a shock, the signs of which are: the complete indifference of the victim to everything around him while maintaining consciousness, a quiet voice, pallor of the covers, cold sticky sweat, weak rapid pulse, shallow breathing, motionless (like a corpse) facial expression of the victim. In some cases, in initial phase shock, phenomena of mental and emotional arousal are observed. The following assistance is provided to victims who are in a state of shock: if there is a wound, it is necessary to apply a bandage, and in case of severe bleeding, a tourniquet; in case of a fracture - immobilize the limb; warm the victim - wrap up, put heating pads at the feet; provide complete peace; inside give a large amount of strong sweet tea, coffee. In such cases, a doctor is always needed.

Never use any painkillers for suspected diseases or injuries of the abdominal organs without a doctor's examination!

Making a tourniquet from improvised means.

As an aid to emergency cases to temporarily stop bleeding, you can use: trouser belt, tie, rope, twisted handkerchief. A stick is inserted into the loop formed, with which the twist is tightened until the bleeding stops and secured with a bandage. Attach a sheet of paper to the tourniquet indicating the time of its application. The use of thin or hard objects such as rope or wire can cause damage to tissues and nerves, so their use is not recommended. The tourniquet can be left on the limb in the summer for no more than 2 hours (and in the winter outdoors - for 1.0 hour), since with prolonged squeezing, necrosis of the limb below the tourniquet may occur. The victim, who is put on a tourniquet, must be observed.

The tourniquet is used only for extensive multiple wounds and crush injuries of the hand or foot.

In case of any bleeding, especially when a limb is injured, it is necessary to give it an elevated position and ensure its rest.

DEFINE THE TYPE AND DEGREE OF SEVERITY

DAMAGE

ALGORITHM FOR PROVIDING FIRST MEDICAL AID AT THE INCIDENT SITE

STOP EXTERNAL BLEEDING

GIVE A PAIN RELIEF MEDICINE

MEANS

APPLY AN ASEPTIC BANDAGE

PERFORM TRANSPORT IMMOBILIZATION

COOL THE PLACE OF DAMAGE, WARM THE INJURED

Light wounds of the limbs.

Reassure the victim;

Apply a tourniquet or pressure bandage if bleeding occurs. Attach a note indicating the time;

Give 2 crushed analgin tablets under the tongue or other pain reliever;

Free up the injured area for dressing. Treat the skin around the wound and an improvised (not sterile) dressing with a disinfectant liquid - iodine, alcohol, vodka. AT field conditions it is allowed to wash the wound with hydrogen peroxide or boiled (clean sea) water with the addition of potassium permanganate, furacilin.

Cover the wound with a napkin, completely covering the edges of the wound. Do not touch the part of the napkin that is applied to the wound with your hands;

Bandage the napkin or attach it with adhesive tape.

Severe injuries of the extremities (bullet, shrapnel, gunshot and mine-explosive fractures, amputations):

For severe bleeding, apply a tourniquet. Attach a note indicating the time;

Provide a safe location and rest of the injured limb;

Administer pain medication (tube syringe or otherwise) and antibiotics;

Bandage the wound using an individual dressing bag, other clean or decontaminating material;

Splint or bandage the injured leg to the healthy one;

Cover and calm the victim, give tea with vodka.

Rules for applying a hemostatic tourniquet

1. A hemostatic tourniquet is applied in case of damage to large arterial vessels.

2. When bleeding from the arteries upper limb place the tourniquet on the upper third of the shoulder; with bleeding from the artery of the lower limb - on the middle third of the thigh.

3. The tourniquet is applied to the raised limb. A soft pad is laid under the tourniquet: bandage, clothes, etc.

4. The tourniquet is applied tightly, but not unnecessarily. Be sure to attach paper indicating the time of its application.

5. The tourniquet must not be kept for more than 1 hour if the evacuation time of the affected person is up to medical institution is delayed, it is necessary to loosen the tourniquet for 10-20 seconds every 20 minutes.

6. If the rescuer does not have a special tourniquet at hand, improvised means can be used: a scarf, tie, suspender, belt, etc. (Fig. 20).

7. When a part of a limb is torn off, a tourniquet is necessarily applied, even in the absence of bleeding (Fig. 20).

Remember that a tourniquet for arterial bleeding must be applied above the bleeding site, after raising the limb. In the area of ​​\u200b\u200bthe wrist and ankles, it is useless to apply a tourniquet.

Other Ways to Stop Bleeding

In cases where there are no fractures of the limb, methods can be applied to stop bleeding by flexing the limb as much as possible.

Strong flexion at the knee stops bleeding from the arteries of the foot and lower leg. To increase pressure on the vessel, a roller made of a bandage or other material is used. Strong flexion and bringing the knee to the stomach compresses the femoral artery. When the axillary artery is injured, compression is carried out by a technique also shown in Figure 23. The arm is placed behind the back and pulled strongly to the healthy side, or both arms, bent at the elbow, are strongly pulled back, and the elbow joints are tied behind the back. This stopping method is used very rarely.

What to do with external bleeding?

Don't get lost, do the following:

Pinch the wound with your fingers to stop the bleeding;

Lay the affected person horizontally;

Urgently send someone for "ambulance";

If you start to get tired, let someone from those present press your fingers from above (it is necessary to keep the vessel in a pressed state without breaking away for at least 20 minutes, during this time, as a rule, thrombosis of the damaged vessel occurs and the intensity of bleeding will decrease, this will eliminate the bleeding.

In case of bleeding from the cervical (carotid) artery, immediately squeeze the wound with your fingers or fist, and after that the wound can be stuffed large quantity clean gauze. This method is called plugging.

After ligation of the bleeding vessels, the affected person should be given a soft drink to drink and taken to the hospital as soon as possible.

What to do if you suspect internal bleeding?

Such bleeding can occur when hit in the stomach, falling from a height, etc. due to rupture of the liver or spleen. When the affected person complains about severe pain in the abdomen after a blow that took place, or he lost consciousness after a blow to the stomach, one should think about the possibility of internal bleeding (into the abdominal cavity). Move the affected person to a semi-sitting position with legs bent at the knees (Fig. 23 a), and put a cold compress on the abdomen. A cold compress or ice pack is applied for a period of 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 let him drink or eat. Urgently arrange transport to the hospital.

At strong blow in chest bleeding into the pleural cavity may occur. If there was such a blow and the affected person 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.

How to support the life of a person who has lost a lot of blood?

As a result of blood loss in the human body, changes occur that can become irreversible and lead to death. Therefore, to maintain the life of a person who has lost a lot of blood, urgent measures must be taken. After you have stopped the bleeding (or it stopped spontaneously), a pressure bandage must be applied to the wound. Then release the affected person from squeezing clothing to facilitate breathing (unfasten, remove). If a person is conscious, and he has no wounds in the abdomen, you should give him sweet tea to drink, lay him on his back so that his legs are raised and his head is lowered. This posture will support the supply of blood to the brain, the brain is most sensitive to its lack. It is necessary to organize the evacuation of the affected person to the hospital as soon as possible.

How to stop bleeding elsewhere in the body?

What to do if you see a strongly beating (gushing) stream of blood where it is impossible to apply a tourniquet?

It is necessary to press the bleeding vessel in the wound. To do this, the edges of the wound are squeezed with fingers, observing the intensity of bleeding, if in this way it is not possible to stop the bleeding immediately, the wound is tightly plugged with a clean bandage, handkerchief and held in this position for at least 20 minutes. The victim must be transported to the hospital as soon as possible.

Gaping and wound infection

The gaping, i.e., the divergence of the edges of the wound, is dangerous because it creates the possibility of infection of the wound or, as doctors say, the possibility of wound infection. What is a wound infection? In nature, countless tiny living creatures live around us. Their size is so small that they are invisible to the human eye; they can only be seen with a microscope that magnifies hundreds of times. These creatures are called microbes or bacteria, otherwise - microorganisms. Microbes live everywhere: in soil, in water, on plants, in human dwellings and household items, on skin, hair, and in the internal organs of humans and animals.right0 Microbes vary in appearance. They can be in the form of short sticks, straight or curved in the form of a comma, in the form of balls or long spirals similar to a corkscrew. The body of a microbe is so small that up to a thousand microorganisms can be laid in a row on a line 1 mm long (a tenth of a centimeter). Microbes reproduce by division. Each microbe divides in half, forming two new microbes, each of which in turn divides in two, and so on. The speed of this division is so great that in a day from one microbe a "offspring" of hundreds of thousands of new microbes can be obtained. Under adverse conditions, such as freezing, drying, especially when heated, many types of microbes quickly die. Others just stop breeding, but remain viable for a long time and, once in a suitable environment, come to life again and multiply. Some microbes are so tenacious that only a long boil in water kills them completely. The importance of microbes in nature is enormous. Feeding on various organic substances - protein, starch, sugar, etc., they quickly destroy dead plants, animal corpses, and all kinds of sewage. In this case, the simplest constituents of dead organic matter, such as carbon, nitrogen, sulfur, phosphorus, and others, are released into the soil or into the air. Living plants absorb these "elements" from the soil or from the air and rebuild them into an organic, complex substance- its stems, leaves and fruits. The animal eats the plants; from those found in plants nutrients bones, meat and other tissues and organs are built in the animal body. When an animal dies, its corpse is decomposed by bacteria, the constituents pass back into the soil and air, and everything starts over again. So, with the help of microbes, there is a continuous cycle of substances in nature. Without microbes, life on earth would have ceased long ago, since the globe would have been covered with undecomposed remains of plants and animals, in which all the nutrients necessary for life would have accumulated uselessly. Many microbes are useful to humans. Some soil bacteria help legumes produce proteins, which accumulate in the grains of peas, beans and other legumes. Microbes that live in the gut healthy person contribute to proper digestion. Man made some of these tiny creatures to work for himself, using microbes in the dairy, tobacco and leather industries, in winemaking and baking, in the processing of flax and hemp, etc. The most valuable medicinal products- antibiotics: penicillin, streptomycin, etc. Among microbes, a person has not only useful servants and friends, but also the most dangerous enemies that harm his health. Some microorganisms have the ability to produce strong poisons. Such a microbe is the causative agent of the disease; having settled in the human body, it poisons it and causes a painful condition. The development of microbes in the human body, sickening , is called an "infection", and the disease itself is called an infectious disease. Very many diseases, including all contagious diseases, are of an infectious nature, that is, they are associated with the reproduction of microbes in the human body. Microbes can affect various organs of a person, develop in his lungs or intestines, in the blood, in the liver, etc. Each infection occurs in different ways: the tubercle bacillus enters the human body through the lungs, infection with dysentery (bloody diarrhea) occurs through the mouth and digestive organs, infection with cholera also. A person becomes infected with the plague through the bite of a flea that has sucked blood from a plague rat. And some pathogenic microbes infect a person through a wound, settling in the wound and causing a special painful process in it - inflammation, suppuration of the wound. These microbes are called the causative agents of wound infection. Under normal conditions, a person does not encounter such dangerous microbes as the plague bacillus or cholera "comma" (vibrio). And there are always a lot of microbes that cause wound infection around each person. They live in large numbers even on his skin, especially if the skin is not clean enough. These microbes cannot cause any harm to a person until he is injured - healthy, undamaged skin reliably protects the body from the penetration of microbes. But it is worth damaging, for example, scratching or pricking, especially cutting through the skin, as causative agents of wound infection can immediately get into the wound. The wound begins to fester, an abscess may form, and it is no longer difficult for microbes to penetrate into the depths of the body and even into the blood. Then there will be infection of the blood (and at the same time of the whole organism) with a purulent microbe. It is clear that if even a small scratch, a small injection can lead to a dangerous purulent infection, then a large, deep, widely gaping wound is even more easily affected by a wound infection and even more often leads to dangerous consequences. Each wound is an open door through which microbes freely penetrate into the depths of the body. The wider the edges of the wound diverge, the easier it gets into any dirt, and with it microbes. The most dangerous is the contamination of wounds with earth, especially black soil or well-manured garden soil. In such soil, containing a large amount of decaying organic matter, there are always many especially dangerous microbes that cause very severe damage to the wound. That is why the gaping of the wound is its first danger, and the protection of the wound from infection with germs is the first concern in helping the wounded. We can say that if the wound managed to be protected from the ingress of microbes, then the most important and difficult part of the matter has already been done. An injury that is not fatal in itself, i.e., does not damage the heart, brain, major blood vessel, or other vital organ, can heal safely if there is no infection. If infection of the wound occurs, then it is impossible to say in advance how any minor injury may end; it is very difficult to fight microbes that have already entered the wound. Although medicine has many remedies against microbes, it is far from always possible to stop the development of a wound infection that has begun. No matter how we treat an infected wound, it will always heal worse than a wound that has been protected from infection. Protecting wounds from contamination is the first task when helping a wounded comrade or oneself. How does a newly inflicted gunshot wound get infected? Microbes - the causative agents of a wound infection sometimes enter the wound at the very moment of its application, along with a bullet or shrapnel. The bullet, flying out of the bore, does not contain microbes. But, before penetrating the body, it must pierce the clothes and skin of a person. There are always germs on the dress and on the skin; there are especially many of them on worn linen, on skin that has not been washed for a long time. A bullet can drag small particles of clothing or skin into the wound, and with them microbes. An artillery shell, a mine, an aerial bomb, etc., when burst, scatter clods of earth, dust or dirt around. The scattered fragments themselves can be heavily contaminated. In addition, when piercing a dress, an uneven jagged fragment often tears out and drags into the wound a whole large flap of an overcoat, footcloths or trousers, a wad of cotton wool or fur from a hat, and the like. In this case, a very large number of microbes can get into the wound. But still, most of the wounds become contaminated and become infected with microbes not at the very moment of injury, but after it. Dirty clothes touch the wound, the wounded person falls on dusty ground or in liquid mud; finally, a very strong infection of the wound can occur when touching it with your hands; the skin of the hands contains microbes, even if the hands are apparently clean. The number of microbes entering the wound along with a bullet or shrapnel will be the smaller, the cleaner the clothes and especially the underwear. It is not for nothing that the Russian soldier has long established the custom of putting on a clean shirt before battle. But, of course, it is impossible to completely avoid the introduction of microbes into the body by a bullet or a fragment. But it is quite possible to prevent infection of the wound after injury, to prevent microbes from entering it from the ground, from the air, from the hands, and so on. This is achieved by bandaging the wound. that is, by applying a bandage to it, which will protect the wound from contamination until the wounded person is taken to the medical center. Only such a bandage that is itself completely clean, that is, does not contain microbes, will protect the wound from infection. Bandaging a wound with some dirty rag can often even increase the risk of infection. For dressing wounds, therefore, dressing material (gauze and cotton wool) is used, which is processed in a special apparatus with hot water vapor. Even boiling water is fatal to microbes, and water vapor heated to a temperature of 120° above zero kills all microbes within a few minutes. A bandage subjected to such treatment does not have a single living microbe on it. Such a bandage is called sterile. A sterile bandage provides reliable protection of the wound from infection. Each fighter has a sterile dressing in the form of an individual dressing bag, which is designed to provide first aid for wounds. Two cotton-gauze pads and a rolled gauze bandage are enclosed in a double sheath of waterproof parchment paper, which protects the dressing from contamination. Each soldier must know the device of an individual dressing bag and the rules for handling it. The dressing material remains sterile, that is, free from germs, only as long as it is not touched. Touching the gauze with your fingertip leaves a stain of dirt on it, invisible to the eye, but containing many microbes. Therefore, the pads of the dressing and the bandage are placed in a bag so that you can take them out and unfold them without touching the side that will lie on the wound. There are two pads in the package: one is sewn tightly to the end of the bandage, the other can move along the bandage in one direction or the other. This is done in case of a through wound, when one pad is placed on the inlet, the other on the outlet. If there is only one wound, then both pads are placed on it, one on top of the other. The fixed pad is held by the short end of the bandage sewn to it; the movable pad, if necessary, is moved along the bandage, holding on to its outer side, that is, the one that will not be placed on the wound with a pad.

2. Bandaging for various injuries

Bandages on the head and neck.

To apply bandages on the head and neck, a bandage with a width of 10 cm is used.

Circular (circular) headband. It is used for small injuries in the frontal, temporal and occipital regions. Circular tours pass through the frontal tubercles, above the auricles and through occiput which allows you to securely hold the bandage on your head. The end of the bandage is fixed with a knot in the forehead.

Cross headband. The bandage is convenient for injuries of the back of the neck and the occipital region (Fig. 1). First, fixing circular tours are applied on the head. Then the course of the bandage is led obliquely down behind the left ear to the back of the neck, along the right side of the neck, go to the front of the neck, its side surface on the left and obliquely raise the course of the bandage along the back of the neck above the right ear to the forehead. The bandage moves are repeated the required number of times until the dressing material covering the wound is completely closed. The bandage is finished with circular tours around the head.

Rice. 1. Cross-shaped (eight-shaped) headband

Hippocratic hat. The bandage allows you to securely hold the dressing on the scalp. Apply a bandage with two bandages (Fig. 2). The first bandage performs two to three circular strengthening rounds around the head.

Rice. 2. Stages of applying a bandage "Cap of Hippocrates"

The beginning of the second bandage is fixed with one of the circular tours of the first bandage, then the second bandage through the cranial vault is carried out until it intersects with the circular motion of the first bandage in the forehead area. bandage. Bandages are crossed in the occipital region and the next round of the bandage is carried out through the cranial vault to the right of the central round. The number of returning bandage moves on the right and left should be the same. Finish applying the bandage with two to three circular rounds.

Bandage "cap". A simple, comfortable bandage, firmly fixes the dressing on the scalp (Fig. 3). A piece of bandage (tie) about 0.8 m long is placed on the crown and its ends are lowered down anterior to the ears. The wounded person or assistant keeps the ends of the tie taut. Perform two fixing circular tours of the bandage around the head. The third round of the bandage is carried out over the tie, circled around the tie and obliquely led through the forehead to the tie on the opposite side. The tour of the bandage is again wrapped around the tie and led through the occipital region to the opposite side. In this case, each move of the bandage overlaps the previous one by two-thirds or half. With similar moves of the bandage, the entire scalp is covered. Finish the bandage with circular tours on the head or fix the end of the bandage with a knot to one of the ties. The ends of the tie are tied in a knot under the lower jaw.

Rice. 3. Bandage "bonnet"

Bandage "bridle". It is used to hold the dressing on wounds in the parietal region and wounds of the lower jaw (Fig. 4). The first fixing circular moves go around the head. Further along the back of the head, the course of the bandage is led obliquely to right side neck, under the lower jaw and make several vertical circular moves that cover the crown or submandibular region, depending on the location of the damage. Then the bandage on the left side of the neck is led obliquely along the back of the head to the right temporal region and the vertical tours of the bandage are fixed with two or three horizontal circular moves around the head.

Rice. 4. Bridle bandage

In case of damage in the chin area, the bandage is supplemented with horizontal circular strokes with the chin grasped (Fig. 5).

Rice. 5. Bridle bandage with chin grip

After completing the main tours of the “bridle” bandage, the bandage is moved around the head and driven obliquely along the back of the head, the right side surface of the neck and several horizontal circular moves are made around the chin. Then they switch to vertical circular passages that pass through the submandibular and parietal regions. Next, the bandage through the left surface of the neck and the back of the head is returned to the head and circular tours are made around the head, after which all tours of the bandage are repeated in the described sequence. so that the bandage does not interfere with opening the mouth and does not squeeze the neck.

Bandage on one eye - monocular (Fig. 6). First, horizontal fixing tours are applied around the head. Then, in the back of the head, the bandage is led down under the ear and carried obliquely up the cheek to the affected eye. The third move (fixing) is done around the head. The fourth and subsequent moves are alternated in such a way that one move of the bandage goes under the ear to the affected eye, and the next one is fixing. Bandaging ends with circular moves on the head. The bandage on the right eye is bandaged from left to right, on the left eye - from right to left.

Rice. 6. Eye patches: a - monocular bandage on the right eye; b - monocular bandage on the left eye; c – binocular patch for both eyes

The bandage on both eyes is binocular (Fig. 6 c). It begins with circular fixing rounds around the head, then in the same way as when applying a bandage to the right eye. After that, the course of the bandage is from top to bottom on the left eye. Then the bandage is directed under the left ear and along the occipital region under the right ear, along the right cheek to the right eye. The tours of the bandage are shifted downwards and towards the center. From the right eye, the course of the bandage returns over the left ear to the occipital region, passes over the right ear to the forehead and again passes to the left eye. The bandage is finished with circular horizontal tours of the bandage through the forehead and back of the head.

Neapolitan bandage on the ear area. The moves of the bandage correspond to the moves when applying a bandage to the eye, but pass above the eye on the side of the bandaged ear (Fig. 7).

Fig.7. Neapolitan bandage on the ear area

Bandage on the head. The base of the scarf is placed in the back of the head, the top is lowered onto the face. The ends of the headscarf are tied on the forehead. The top is wrapped over the tied ends up and strengthened with a safety pin (Fig. 8).

Rice. 8. Headband

Sling bandage. Sling-like head bandages allow you to keep the dressing in the nose (Fig. 9 a), upper and lower lip, chin (Fig. 9 b), as well as on wounds of the occipital, parietal and frontal regions (Fig. 10). The aseptic material in the wound area is closed with the uncut part of the sling, and its ends are crossed and tied at the back (upper ones - in the neck area, lower ones - on the back of the head or on the crown of the head).

Rice. 9. Sling bandage: a - nose; b - chin

Rice. 10. Sling-like headbands: a - on the occipital region; b - on the parietal region

To hold the dressing on the back of the head, the sling is made from a wide strip of gauze or cloth. The ends of such a bandage intersect in the temporal regions. They are tied on the forehead and under the lower jaw. In the same way, a sling-like bandage is applied to the parietal region and forehead. The ends of the bandage are tied at the back of the head and under the lower jaw.

Bandage around the neck. It is applied with a circular bandage. To prevent it from slipping down, circular tours on the neck are combined with tours of a cruciform bandage on the head (Fig. 11).

Rice. 11. Circular bandage around the neck, reinforced with cross passages on the head

Bandages on the chest.

The cone-shaped shape of the chest and the change in its volume during breathing often lead to slippage of the dressings. Bandaging of the chest should be performed with wide bandages and additional methods of strengthening the bandages should be used. To apply bandages on the chest, gauze bandages 10 cm, 14 cm and 16 cm wide are used.

Spiral bandage on the chest. It is used for chest wounds, rib fractures, treatment of purulent wounds (Fig. 12). Before applying the bandage, a gauze bandage about a meter long is placed in the middle on the left shoulder girdle. One part of the bandage hangs freely on the chest, the other - on the back. Then, with another bandage, fixing circular tours are applied in the lower parts of the chest and the chest is bandaged with spiral moves (3-10) from the bottom up to armpits, where the bandage is fixed with two or three circular rounds. Each round of the bandage overlaps the previous one by 1/2 or 2/3 of its width. The ends of the bandage, freely hanging on the chest, are placed on the right shoulder girdle and tied to the second end hanging on the back. A belt is created, as it were, that supports the spiral moves of the bandage.

Rice. 12. Spiral chest bandage

Occlusive bandage. It is superimposed using an individual dressing package (PPI) for penetrating chest wounds. The bandage prevents the suction of air into the pleural cavity during breathing. The outer shell of the package is torn along the existing incision and removed without violating the sterility of the inner surface. Remove the pin from the inner parchment shell and remove the bandage with cotton-gauze pads. It is recommended to treat the skin surface in the wound area with boron vaseline, which provides more reliable sealing of the pleural cavity. Without violating the sterility of the inner surface of the pads, unfold the bandage and cover the wound penetrating the pleural cavity with the side of the pads that is not stitched with colored threads. Unfold rubberized outer shell the package and the inner surface are covered with cotton-gauze pads. The edges of the shell should be in contact with the skin lubricated with boron vaseline. The bandage is fixed with spiral tours of the bandage, while the edges of the rubberized sheath are pressed tightly against the skin. In the absence of an individual dressing package, the bandage is applied using small or large sterile bandages. Cotton-gauze pads are placed on the wound and covered with a paper bandage, after which the dressing material in the wound area is fixed with spiral tours of the bandage.

Bandages on the abdomen and pelvis.

When applying a bandage to the abdomen or pelvis at the site of injury or accident, gauze bandages 10 cm, 14 cm and 16 cm wide are used for bandaging.

Spiral bandage on the abdomen. In the upper part of the abdomen, strengthening circular tours are applied in the lower parts of the chest and the stomach is bandaged with spiral moves from top to bottom, covering the area of ​​damage. In the lower part of the abdomen, fixing tours are applied in the pelvic area above the pubic joint and spiral tours are carried out from the bottom up (Fig. 13). The spiral bandage, as a rule, is poorly held without additional fixation. A bandage applied to the entire abdomen or lower divisions, strengthened on the hips with a spike-shaped bandage.

Fig. 13. Spiral bandage on the abdomen, reinforced on the thigh with rounds of a spike-shaped bandage

Spike-shaped bandage on the area of ​​the hip joint. Superimposed with injuries in the hip joint and adjacent areas. Bandaging is carried out with a wide bandage. The line of crossing of the tours of the bandage corresponds to that part of the dressing, which most securely fixes the dressing covering the wound. According to the location of the line of crossing of the bandage tours, the following types of spike-shaped bandages are distinguished: anterior, lateral, posterior, bilateral. There are also ascending and descending spike-shaped bandages. - the head of the bandage is in the left hand and bandaging is performed from right to left.

Descending anterior spica bandage (Fig. 14 a). It starts with fixing circular tours in the pelvic area. Then the bandage is led to the front surface of the thigh and along the inner side surface around the thigh go to its outer side surface. From here the bandage is lifted obliquely through groin, where it intersects with the previous move, to the lateral surface of the torso. Having made a move around the back, they again lead the bandage to the stomach. Then repeat the previous moves. Each round passes below the previous one, covering it by half or 2/3 of the width of the bandage. The bandage is finished with circular moves around the abdomen.

Fig.14. Anterior spica bandage of the hip joint area: a - descending; b - ascending

Ascending anterior spica bandage (Fig. 14b). Superimposed in reverse order in contrast to the descending bandage. Firming circular tours are superimposed in the upper third of the thigh. Then the bandage is led from the outer lateral surface of the thigh through the inguinal region to the stomach, the lateral surface of the body and around the body along the front surface of the thigh pass to its inner surface. Then the bandage moves are repeated, with each subsequent round shifting upwards from the previous one. General view of the anterior ascending spica bandage is shown in Fig.15.

Fig.15. General view of the ascending anterior spica bandage on the hip joint

Lateral spike bandage. Superimposed similarly to the front, however, the crossing of the bandage moves is carried out along the lateral surface of the hip joint.

Back spica bandage. Bandaging begins with firming circular tours around the abdomen. Next, the bandage is led through the buttock of the diseased side to the inner surface of the thigh, bypassed in front and obliquely lifted again on the body, crossing the previous course of the bandage along the back surface.

Bilateral spike-shaped bandage on the pelvic area (Fig. 16). It starts with firming circular tours around the abdomen. On the right side of the abdomen, the bandage is led obliquely down to the front of the left thigh, bypassing the thigh around until it intersects with the previous move on the front of the thigh. From here, a bandage is lifted on the torso. Circle it around the back again to the right side. Next, they lead the bandage down to the right thigh, go around it with inside and cross the previous round along the front surface. Then again obliquely return the bandage along the front surface of the abdomen to the body, make a semicircular move around the back and lead the bandage back to the left thigh, repeating the previous rounds. Each subsequent round shifts upwards from the previous one. The bandage is finished with a fixing circular tour around the abdomen.

Rice. 16. Bilateral spike-shaped bandage on the pelvic area.

Spike bandage on the perineum (Fig. 17). After the fixing tour around the abdomen, the bandage is led obliquely from the right lateral surface of the abdomen along its anterior surface to the perineum, and from the inner surface of the left thigh, a semicircular move is made along the posterior surface with the transition to the anterior surface of the left thigh. Then the course of the bandage is led obliquely along the front surface of the abdomen to the beginning of this course, that is, to the right lateral surface of the abdomen. They make a move around the back, and already on the left the bandage is directed obliquely through the stomach to the perineum, go around the back surface of the left thigh in a semicircular move and again return to the side surface of the body, after which the already known tours are repeated.

Fig.17. Spike perineal bandage

T-shaped crotch bandage. If necessary, the bandage can be quickly applied and removed. The bandage is easy to manufacture (Fig. 18). A horizontal bandage is applied around the waist and tied in the abdomen. Vertical bands passing through the perineum and holding the dressing are fixed to horizontal strip in the abdomen.

Fig.18. T-shaped crotch bandage

Kerchief bandage on the hip joint and gluteal region (Fig. 19). The middle of the scarf covers the outer surface of the buttocks, placing the base of the scarf in the upper third of the thigh. The top of the kerchief is fastened to the belt or to the second kerchief folded along the length and drawn around the body. Then the ends of the scarf are circled around the thigh and tied on its outer surface.

Fig.19. Bandage on the hip joint and gluteal region

Kerchief bandage on both buttocks and perineum (Fig. 20). The scarf is laid so that the base runs along the lower back. The ends of the kerchief are tied in front on the stomach, and the top is passed, covering the buttocks, through the perineum anteriorly and fastened to the knot from the ends of the kerchief. Similarly, but in front, a kerchief bandage is applied, covering the front of the perineum and external genitalia.

Rice. 20. Bandage on the perineum and both buttocks

Bandage on the scrotum (Fig. 21). The suspensory belt is carried around the waist and fixed with a buckle or knot. The scrotum is placed in a suspensory bag, the penis is brought out through a special hole in the supporting bag. Two ribbons attached to the bottom edge of the pouch are passed through the crotch and attached to the back of the belt.

Rice. 21. Bandage on the scrotum

Bandages on the upper limb.

Reversible finger bandage. It is used for injuries and diseases of the finger, when it is necessary to close the end of the finger (Fig. 22). The width of the bandage is 5 cm. Bandaging starts along the palmar surface from the base of the finger, goes around the end of the finger and along the back side the bandage is moved to the base of the finger. After the bend, the bandage is led in a creeping motion to the end of the finger and bandaged in spiral tours towards its base, where it is fixed.

Rice. 22. Reversible finger bandage

Spiral bandage on the finger (Fig. 23). Most hand wraps begin with circular fixing strokes in the lower third of the forearm just above the wrist. The bandage is led obliquely along the back of the hand to the end of the finger and, leaving the tip of the finger open, the finger is bandaged in spiral moves to the base. Then again, through the rear of the hand, the bandage is returned to the forearm. Bandaging ends with circular tours in the lower third of the forearm.

Fig.23. Spiral finger bandage

Spiral bandage on all fingers ("glove") (Fig. 24). It is superimposed on each finger in the same way as on one finger. Bandaging on the right hand begins with the thumb, on the left hand - with the little finger.

Fig.24. Spiral bandage on all fingers of the hand ("glove")

Spike bandage on the thumb (Fig. 25). Used to close the area of ​​the metacarpophalangeal joint and the elevation of the thumb.

Rice. 25. Spike bandage on the thumb

After fixing the moves above the wrist, the bandage is led along the back of the hand to the fingertip, wrapped around it and again led along the back surface to the forearm. With such moves they reach the base of the finger and the end of the bandage is fixed on the wrist. To cover the entire thumb, the bandage is supplemented with returning tours.

Cruciform bandage on the hand (Fig. 26). Closes the back and palmar surfaces of the hand, except for the fingers, fixes the wrist joint, limiting the range of motion. The width of the bandage is 10 cm. Bandaging begins with fixing circular tours on the forearm. Then the bandage is led along the back of the hand to the palm, around the hand to the base of the second finger. From here, along the back of the hand, the bandage is obliquely returned to the forearm. For a more reliable retention of the dressing material on the hand, cross-shaped passages are supplemented with circular bandage moves on the hand. The bandage is completed with circular tours over the wrist.

Rice. 26. Cross-shaped (eight-shaped) bandage on the brush

Returning bandage on the brush (Fig. 27). Used to hold the dressing in case of damage to all fingers or all parts of the hand. When applying cotton-gauze pads or gauze pads to wounds or burn surfaces, it is necessary to leave layers of dressing material between the fingers. The width of the bandage is 10 cm. Bandaging begins with fixing tours above the wrist, then the bandage is led along the back surface of the hand to the fingers and the fingers and hand are covered with returning moves from the back and palm. forearm, where the bandage is completed with circular tours over the wrist.

Rice. 27. Returning bandage on the brush

Kerchief bandage on the brush (Fig. 28). The scarf is laid so that its base is located in the lower third of the forearm above the area wrist joint. The brush is placed with the palm on the kerchief and the top of the kerchief is bent over the back of the hand. The ends of the scarf are circled several times around the forearm above the wrist and tied.

Fig.28. Bandage on the brush

Spiral bandage on the forearm (Fig. 29). To apply a bandage, a bandage 10 cm wide is used. Bandaging begins with circular strengthening tours in the lower third of the forearm and several ascending spiral tours. Since the forearm has a conical shape, a tight fit of the bandage to the surface of the body is ensured by bandaging in the form of spiral tours with kinks to the level of the upper third of the forearm. To perform the bend, hold the lower edge of the bandage with the first finger of the left hand, and with the right hand make a bend towards you by 180 degrees. The upper edge of the bandage becomes the lower one, the lower one becomes the upper one. At the next round, the bending of the bandage is repeated. The bandage is fixed with circular tours of the bandage in the upper third of the forearm.

Fig.29. Spiral ascending bandage with kinks on the forearm (technique for performing kinks of the bandage)

Turtle bandage on the area of ​​the elbow joint. In case of damage, a converging turtle bandage is applied directly in the area of ​​the elbow joint. If the damage is located above or below the joint, apply divergent tortoise bandage. Bandage width - 10 cm.

Converging tortoiseshell bandage (Fig. 30). The arm is bent at the elbow joint at an angle of 90 degrees. Bandaging begins with circular strengthening rounds either in the lower third of the shoulder above the elbow joint, or in the upper third of the forearm. Then the dressing material in the area of ​​damage is closed with eight-shaped tours. Bandage moves cross only in the area of ​​the elbow bend. Eight-shaped tours of the bandage are gradually shifted to the center of the joint. Finish the bandage with circular tours along the line of the joint.

Fig.30. Converging tortoiseshell elbow bandage

Diverging turtle bandage (Fig. 31). Bandaging begins with circular fixing rounds directly along the line of the joint, then the bandage is alternately carried out above and below the elbow bend, covering two thirds of the previous rounds. All moves intersect along the flexion surface of the elbow joint. Thus, they cover the entire area of ​​​​the joint. The bandage is finished with circular moves on the shoulder or forearm.

Rice. 31. Diverging tortoise bandage on the elbow joint

A kerchief bandage on the area of ​​the elbow joint (Fig. 32). The scarf is brought under the back surface of the elbow joint so that the base of the scarf is under the forearm, and the top is under the lower third of the shoulder. The ends of the headscarf are passed to the front surface of the elbow joint, where they are crossed, circled around the lower third of the shoulder and tied. The top is attached to the crossed ends of the scarf on the back of the shoulder.

Rice. 32. Kerchief bandage on the area of ​​the elbow joint

Spiral bandage on the shoulder (Fig. 33.). The shoulder area is closed with a conventional spiral bandage or a spiral bandage with kinks. A bandage with a width of 10-14 cm is used. In the upper parts of the shoulder, in order to prevent the bandage from slipping, bandaging can be completed with rounds of a spike-shaped bandage.

Fig. 33. Spiral bandage on the shoulder

Kerchief bandage on the shoulder (Fig. 34). The scarf is placed on the outer side surface of the shoulder. The top of the scarf is directed towards the neck. The ends of the scarf are circled around the shoulder, crossed, brought to the outer surface of the shoulder and tied. To prevent the bandage from slipping, the top of the kerchief is fixed with a loop of cord, bandage or a second kerchief, passed through the opposite armpit.

Rice. 34. Shoulder kerchief

Spike bandage on the area of ​​the shoulder joint. Used to hold dressings on wounds in the area of ​​the shoulder joint and adjacent areas. The cross of the bandage tours is performed directly above the dressing covering the wound. The width of the bandage is 10-14 cm. On the left shoulder joint, the bandage is bandaged from left to right, on the right - from right to left, that is, the bandage of the spike-shaped bandage is carried out in the direction of the side of the injury. There are ascending and descending spike-shaped bandages on the area of ​​the shoulder joint. Ascending spike-shaped bandage (Fig. 35 a, b). Bandaging begins with circular fixing rounds in the upper part of the shoulder, then the bandage is led to the shoulder girdle and along the back to the axillary region opposite side. Then the bandage goes along the front side of the chest to the front surface of the shoulder, along the outer surface around the shoulder to the armpit, with the transition to the outer surface of the shoulder joint and shoulder girdle. Then the tours of the bandage are repeated with an upward shift of one third or half of the width of the bandage. Bandaging ends with circular tours around the chest.

Rice. 35. Spica bandage on the area of ​​the shoulder joint: a, b - ascending; c, d - descending

Descending spica bandage (Fig. 35 c, d). Apply in reverse order. The end of the bandage is fixed with circular passages around the chest, then from the axillary region healthy side lift the bandage along the anterior surface of the chest to the shoulder girdle on the side of the injury, go around it along the back surface and through axillary region brought to the front surface of the shoulder girdle. After that, the course of the bandage along the back is returned to the axillary region of the healthy side. Each subsequent eight-shaped move is repeated slightly lower than the previous one. Bandaging ends with circular tours around the chest.

Spike bandage on the axillary region (Fig. 36). To securely hold the dressing on the wound in the axillary region, the spike-shaped bandage is supplemented with special tours of the bandage through a healthy shoulder girdle. It is recommended to cover the dressing material in the area of ​​damage from above with a layer of cotton wool, which extends beyond the armpit and partially covers upper part chest. The width of the bandage is 10-14cm. The bandage is started with two circular tours in the lower third of the shoulder, then several moves of the ascending spica bandage are made and an additional oblique move is made along the back through the shoulder girdle of the healthy side and chest to the damaged axillary region. Then make a circular move, covering the chest and holding a layer of cotton wool. Additional oblique and circular moves of the bandage alternate several times. Bandaging is completed with rounds of a spike-shaped bandage and circular rounds on the chest.

Rice. 36. Spica bandage on the armpit

A kerchief bandage on the area of ​​the shoulder joint (Fig. 37). The medical scarf is folded with a tie and its middle is brought into the axillary fossa, the ends of the bandage are crossed over the shoulder joint, passed along the front and back surfaces of the chest and tied in the axillary region of the healthy side.

Fig.37. Bandage on the area of ​​the shoulder joint

Kerchief bandage for hanging the upper limb (Fig. 38). It is used to support the injured upper limb after applying a soft bandage or transport immobilization bandage. The injured arm is bent at the elbow joint at a right angle. An unfolded kerchief is brought under the forearm so that the base of the kerchief runs along the axis of the body, its middle is slightly higher than the forearm, and the top is behind and above the elbow joint. The upper end of the scarf is carried out on a healthy shoulder girdle. The lower end is wound on the shoulder girdle of the damaged side, closing the forearm in front with the lower, smaller part of the scarf. The ends of the scarf are tied in a knot over the shoulder girdle. The top of the scarf is circled around the elbow joint and fixed with a pin to the front of the bandage.

Fig.38. Bandage for hanging the upper limb

Bandage Deso (Fig. 39). It is used for temporary immobilization of the injured arm in case of clavicle fractures by bandaging to the body. Bandage width - 10-14 cm. Bandaging is always carried out towards the injured arm. If the bandage is applied to the left hand, they are bandaged from left to right (bandage head in the right hand), on the right hand - from right to left (bandage head in the left hand).

Fig.39. Bandage Deso In the armpit of the damaged side, before bandaging, put a roller of compress gray non-absorbent cotton wool wrapped in a piece of wide bandage or gauze. The roller is inserted to eliminate the displacement of fragments of the clavicle along the length. The injured arm is bent at the elbow joint at a right angle, pressed against the body, and the shoulder is bandaged to the chest in circular tours (1), which are applied below the level of the roller located in the axillary region on the side of the injury. Further, from the axillary region of the healthy side, the bandage is led obliquely upward along the anterior surface of the chest to the shoulder girdle of the injured side (2), where the tour of the bandage should pass through the central fragment of the clavicle closer to the lateral surface of the neck. Then the bandage is led down along the back of the shoulder under the middle third of the forearm. Covering the forearm, the bandage continues along the chest to the axillary region of the healthy side (3) and along the back obliquely upwards to the shoulder girdle of the injured side, where the bandage tour is again carried out through the central fragment of the clavicle closer to the lateral surface of the neck, after which the bandage is moved down the front surface shoulder under the elbow (4). From under the elbow, the bandage is led in an oblique direction through the back to the axillary region of the intact side. The described moves of the bandage are repeated several times, forming a bandage that provides reliable immobilization of the upper limb. The bandage is fixed in a circular motion through the shoulder and chest.

Bandages on the lower limb.

Return bandage on the toes. Used for diseases and injuries of the toes. The width of the bandage is 3-5 cm. The bandage is usually used to hold the dressing on the wounds of 1 toe and rarely to cover other fingers, which are usually bandaged along with the entire foot. The bandage starts from the plantar surface of the base of the finger, closes the tip of the finger and leads the bandage along it back surface to base. They make a kink and creep the bandage to the fingertip. Then it is bandaged with spiral tours to the base, where the bandage is fixed.

Spiral bandage on the first toe (Fig. 40). The width of the bandage is 3-5 cm. Separately, only one thumb is usually bandaged. Bandaging is recommended to start with firming circular tours in the lower third of the lower leg above the ankles. Then, through the back surface of the foot, a bandage is led to the nail phalanx of 1 finger. From here, the entire finger is closed with spiral tours to the base and again, through the rear of the foot, the bandage is returned to the lower leg, where the bandage is completed with fixing circular tours.

Fig.40. Spiral bandage on the big toe

Spike bandage on the first toe (Fig. 41). The width of the bandage is 3-5 cm. Like all spica bandages, the spike bandage on the first toe is bandaged in the direction of the injury. On the left foot, the bandage is carried out from left to right, on the right foot - from right to left. Bandaging begins with strengthening circular tours in the lower third of the lower leg above the ankles. Then the bandage is led from the inner ankle to the back of the foot to its outer surface and along the plantar surface to the inner edge of the nail phalanx of the first toe. After a circular turn on the first finger, the bandage is moved along the dorsal surface of the foot to its outer edge, and a circular turn through the plantar surface leads the bandage to the outer ankle.

Fig.41. Spica bandage on the big toe

Each subsequent tour of the bandage on the first toe shifts upwards in relation to the previous one, thus forming an ascending spiky bandage. Returning bandage on the peripheral parts of the foot. Used for diseases and injuries peripheral departments feet and toes. The width of the bandage is 10 cm. Each finger is covered with dressing material separately, or all fingers together with gauze pads between them. Then proceed to bandaging the foot. Circular strengthening tours are applied in the middle sections of the foot. After that, with longitudinal return tours from the plantar surface of the foot through the fingertips to the back surface and back, the foot is closed across the entire width. In a creeping motion, the bandage is led to the fingertips, from where the foot is bandaged in spiral tours to the middle. The bandage on the foot is usually poorly held, so it is recommended to finish the bandage with strengthening eight-shaped tours around the ankle joint with fixing circular tours above the ankles.

The returning bandage on all foot (fig. 42). It is used for foot injuries when it is necessary to cover the entire foot, including the toes. Bandage width - 10 cm.

Rice. 42.Return bandage on the whole foot

Bandaging begins with circular fixing tours in the lower third of the lower leg above the ankles. Then the bandage is transferred to the foot, from the side of the inner ankle on the right foot and from the side of the outer ankle on the left, and several circular moves are applied along the lateral surface of the foot to the first toe, from it back along the opposite lateral surface of the foot to the heel. From the heel, in a creeping move, the bandage is led to the fingertips and the foot is bandaged in spiral moves towards the lower third of the lower leg. In the area of ​​the ankle joint, the technique of applying a bandage to the heel region is applied (Fig. 44). Finish the bandage with circular tours over the ankles.

Cruciform (eight-shaped) bandage on the foot (Fig. 43). Allows you to securely fix the ankle joint in case of damage to the ligaments and some diseases of the joint. The width of the bandage is 10 cm. The foot is set in a position at a right angle with respect to the lower leg. Bandaging begins with circular fixing tours in the lower third of the lower leg above the ankles. Then the bandage is moved obliquely along the back surface of the ankle joint to the lateral surface of the foot (to the outer on the left foot and to the inner on the right foot). Perform a circular motion around the foot. Further, from the opposite lateral surface of the foot along its rear, the previous course of the bandage is crossed obliquely upwards and returned to the lower leg. Again perform a circular motion over the ankles and repeat the eight-shaped bandage moves 5-6 times to create secure fixation ankle joint. The bandage is finished with circular tours on the lower legs above the ankles.

Rice. 43. Cross-shaped (eight-shaped) bandage on the foot

Bandage on the heel region (like a tortoise) (Fig. 44). It is used to completely cover the heel area like a divergent tortoiseshell bandage. The width of the bandage is 10 cm. Bandaging begins with circular fixing rounds on the shins above the ankles. Then obliquely down the dorsal surface lead the bandage to the ankle joint. Impose the first circular tour through the most protruding part of the heel and the back surface of the ankle joint and add to it circular moves above and below the first. However, in this case, there is a loose fit of the tours of the bandage to the surface of the foot. To avoid this, the tours of the bandage are strengthened with an additional oblique bandage running from the back of the ankle joint down and anteriorly to the outer side surface of the foot. Then, along the plantar surface, the course of the bandage leads to the inner edge of the foot and continues to impose divergent tours of the tortoise bandage. The bandage ends with circular tours in the lower third of the lower leg above the ankles.

Fig.44. Heel bandage

Spike-shaped ascending bandage on the foot (Fig. 45). It is used to securely hold the dressing on the dorsal and plantar surfaces in case of injuries and diseases of the foot. The toes remain uncovered. The width of the bandage is 10 cm. Bandaging begins with circular fixing tours through the most protruding part of the heel and the back surface of the ankle joint. Then, from the heel, the bandage is moved along the outer surface on the right foot (on the left foot - along the inner surface), obliquely along the back surface to the base of the first finger (on the left foot - to the base of the fifth finger). Make a full circular motion around the foot and return the bandage to the back surface at the base of the fifth toe (on the left foot - at the base of the first toe). On the rear, the feet cross the previous round and return to the heel region from the opposite side. Having bypassed the heel from behind, the described eight-shaped tours of the bandage are repeated, gradually shifting them towards the ankle joint. The bandage ends with circular tours in the lower third of the lower leg above the ankles.

Fig.45. Spike bandage on the foot

Bandages on the foot. There are kerchief bandages covering the entire foot, heel region and ankle joint.

A kerchief bandage on the entire foot (Fig. 46 a, b). The plantar region is closed with the middle of the scarf, the top of the scarf is wrapped, covering the fingers and the back of the foot. The ends are brought to the rear of the foot, crossed, and then wrapped around the lower leg above the ankles and tied with a knot on the front surface.

Fig.46. Kerchief bandages on the foot: a b - on the entire foot; c - on the calcaneal region and the region of the ankle joint

A kerchief bandage on the heel region and ankle joint (Fig. 46 c). The scarf is placed on the plantar surface of the foot. The base of the scarf is located across the foot. The top is located on the back surface of the ankle joint. The ends of the kerchief are crossed first on the back of the foot, and then over the top of the ankle joint and the lower third of the lower leg. Tie the ends on the front surface of the lower leg above the ankles.

Spiral bandage with folds on the lower leg (Fig. 47). Allows you to keep the dressing on wounds and other injuries of the lower leg, which has a cone shape. The width of the bandage is 10 cm. Bandaging begins with fixing circular tours in the lower third of the lower leg above the ankles. Then several circular spiral tours are made and on the cone-shaped section of the lower leg they switch to bandaging with spiral tours with kinks, similar to a spiral bandage on the forearm. The bandage is finished with circular rounds in the upper third of the lower leg below the knee joint.

Rice. 47. Spiral bandage on the lower leg (general view)

Kerchief bandage on the shin (Fig. 48). The base of the scarf is helically circled around the lower leg. The lower end of the scarf is led over the ankle area and directed slightly upward, where it is fixed with a pin. The other end of the scarf is covered from above in a circular motion with the upper part of the lower leg and the end is also fixed with a pin.

Fig.48. kerchief bandage on the shin

Turtle bandage on the area of ​​the knee joint. Allows you to securely hold the dressing in the area of ​​the knee joint and immediately adjacent areas, while the movements in the joint are slightly limited. In case of damage directly in the area of ​​the knee joint, a converging turtle bandage is applied, in case of damage near the knee joint, a diverging bandage is applied. The bandage is applied in the position of slight flexion in the joint. Bandage width - 10 cm.

Converging turtle bandage on the area of ​​the knee joint (Fig. 49 a, b). Bandaging begins with fixing circular tours in the lower third of the thigh above the knee joint or in the upper third of the lower leg under the knee joint, depending on where the wound or other damage is located. Then, converging eight-shaped bandage tours are applied, crossing in the popliteal region. The bandage ends with circular tours in the upper third of the lower leg under the knee joint.

Fig.49. Turtle bandage on the knee joint: a, b - converging; c - divergent

Divergent turtle bandage on the area of ​​the knee joint (Fig. 49 c). Bandaging begins with fixing circular tours through the most protruding part of the patella. Then, eight-shaped divergent moves are performed, crossing in the popliteal region. The bandage is finished with circular tours in the upper third of the lower leg or lower third of the thigh, depending on where the damage is located. The bandage begins with circular passages in the upper third of the lower leg and ends with fixation tours in the lower third of the thigh. Spiral bandage with folds on the thigh. It is used to hold dressings on wounds and other injuries of the thigh, which, like the lower leg, has a conical shape. The width of the bandage is 10-14 cm. Bandaging begins with fixing circular tours in the lower third of the thigh above the knee joint. Then, with spiral moves of the bandage with kinks, they cover the entire surface of the thigh from the bottom up. As a rule, such bandages on the thigh are held poorly and slip off easily. Therefore, it is recommended to complete the bandage with rounds of a spike-shaped bandage on the area of ​​the hip joint.

Bandages on the stump of the limbs.

Superimposed in case of separation of various parts of the upper and lower extremities, diseases and injuries of the stumps of the shoulder and forearm, thigh and lower leg. When bandaging the stump of the limb, the technique of the returning bandage is used. The stumps of the limbs are usually cone-shaped, so the bandages are poorly held and require additional strengthening. Bandage width - 10-14 cm.

The technique of applying a returning bandage (Fig. 50). Bandaging begins with fixing circular tours in the upper third of the affected limb segment. Then hold the bandage with the first finger of the left hand and make a kink on the front surface of the stump. The course of the bandage is carried out in the longitudinal direction through the end part of the stump to the back surface. Each longitudinal stroke of the bandage is fixed in a circular motion. The bandage is bent on the back surface of the stump closer to the end part and the bandage is returned to the front surface. Each returning tour is fixed with spiral bandage moves from the end part of the stump. If the stump has a pronounced conical shape, then the bandage is more durable when the second returning bandage runs perpendicular to the first and intersects at the end of the stump with the first returning tour at a right angle. The third returning move should be carried out in the interval between the first and second. The returning moves of the bandage are repeated until the stump is securely bandaged.

Fig.50. Returning bandage on the stump of the thigh

Returning bandage on the stump of the forearm (Fig. 51). The bandage begins with circular rounds in the lower third of the shoulder, to prevent slipping of the bandage. Then the course of the bandage is led to the stump of the forearm and a returning bandage is applied. Bandaging is completed with circular tours in the lower third of the shoulder.

Fig.51. Returning bandage on the stump of the forearm

Returning bandage on the shoulder stump (Fig. 52). The bandage begins with circular tours in the upper third of the shoulder stump. Then a returning bandage is applied, which, before completion, is strengthened with the moves of a spike-shaped bandage on the shoulder joint. The bandage is completed with circular tours in the upper third of the shoulder.

Fig.52. Returning bandage on the shoulder stump

The returning bandage on a stump of a shin. The bandage begins with circular tours in the upper third of the lower leg. Then a returning bandage is applied, which is strengthened with eight-shaped bandage moves on the knee joint. The bandage is completed with circular tours in the upper third of the lower leg.

Returning bandage on the stump of the thigh. The bandage begins with circular rounds in the upper third of the thigh. Then a returning bandage is applied, which is strengthened by the passages of a spike-shaped bandage on the hip joint. The bandage is completed with circular rounds in the pelvic area.

A kerchief bandage on the stump of the thigh (Fig. 53). The middle of the scarf is placed on the end of the stump, the top is wrapped on the front surface of the stump, and the base and ends of the scarf are on the back surface. The ends of the scarf are wrapped around the upper third of the thigh, forming a bandage, tied on the front surface and fixed to the top of the knot.

Fig.53. Bandage on the stump of the thigh

Similarly, kerchief bandages are applied to the stumps of the shoulder, forearm and lower leg.

3. Types of bleeding and their consequences

Bleeding can be arterial, venous, capillary and parenchymal. In the case of arterial bleeding, blood is bright red (scarlet) in color, beats from a damaged vessel in an intermittent stream. Such bleeding is very dangerous due to rapid blood loss. With venous bleeding, the blood is dark red in color, it flows out in a continuous stream. In the case of capillary bleeding, blood oozes from the wound in drops. Parenchymal bleeding is observed when internal organs (liver, kidneys, etc.) .Bleeding that occurs from an open wound is called external. Bleeding, in which blood flows from the vessel into the tissues and cavities of the body (thoracic, abdominal, etc.), is called internal. It is customary to distinguish between primary and secondary bleeding. The primary occurs immediately after injury. Secondary bleeding begins after certain time after it, due to the expulsion of a thrombus that clogged the vessel, or as a result of injury to the vessel by sharp bone fragments or foreign bodies. The cause of secondary bleeding can be careless first aid, poor immobilization of the limb, shaking of the victim during transportation, development of suppuration in the wound. an adult is life-threatening blood loss of 1.5-2 liters. Bleeding is the main cause of death on the battlefield, and therefore the main first aid measure for the wounded is to temporarily stop bleeding. In acute blood loss, the victims experience blackouts, shortness of breath, dizziness, tinnitus, thirst, nausea (sometimes vomiting), blanching of the skin , especially limbs, and lips. The pulse is frequent, weak or almost imperceptible, the extremities are cold. Sometimes fainting is observed. In case of damage to the lungs, gastrointestinal tract or genitourinary organs, blood can be respectively in sputum, vomit, feces and urine. Large blood loss leads to loss of consciousness by the victims. Blood loss, as already noted, is the main cause of death on the battlefield. In acute blood loss, after bleeding stops, a large amount of fluid should be introduced into the body to compensate for the lack of circulating blood. The wounded are given strong tea, coffee, and water to drink. It should be remembered that if the internal organs of the abdomen are injured, the victim should not be given drink. In order to improve the blood supply to the brain and other vital organs, the victim's legs should be raised. The wounded should be warmed. Blood loss is replenished by transfusing the wounded with blood, blood plasma, blood-substituting fluids. They are shown giving oxygen. In case of injury to capillaries, venous vessels and small arteries, bleeding can stop spontaneously as a result of blockage of the vessel by a blood clot.

4. Ways to temporarily stop bleeding

A temporary stop of bleeding is achieved by applying a pressure bandage, tourniquet or twist (Fig. 54), pressing the artery to the bone throughout.

Rice. 54. Ways to temporarily stop bleeding: a - with a pressure bandage, b - with a tourniquet, c - with a twist. The final stop of bleeding is carried out when surgeons treat wounds in the dressing room and operating room. In case of any bleeding, especially with damage to the limb, the injured area should be given an elevated position and rest. This helps to lower blood pressure in the blood vessels, reduce blood flow in them and form a blood clot. Bleeding from small wounds and capillaries can be stopped by applying a pressure sterile bandage. In order to better compress the vessels, a PPI cotton-gauze pad or a sterile dressing is applied to a bleeding wound in the form of a tampon. For a temporary stop of bleeding on the body, only this method is suitable, since others are unacceptable.

Pressing the artery along, i.e., along the bloodstream, closer to the heart is a simple and affordable way to temporarily stop arterial bleeding in various settings. To do this, the vessel is pressed in a place where one or another artery is not very deep and it can be pressed against the bone. At these points, you can determine the pulsation of the arteries when feeling with your fingers (Fig. 55).

Rice. 55. Ways of pressing the arteries of the head

In case of bleeding in the face and scalp, the submandibular and temporal arteries should be pressed. In case of bleeding on the neck, the carotid artery is pressed against the spine at the inner edge of the sternocleidomastoid muscle.

A pressure bandage in the neck area is applied in such a way that blood circulation is maintained on the uninjured side (Fig. 56).

Rice. 56. The imposition of a pressure bandage in the neck

Bleeding at the base of the upper limb is stopped by pressing the subclavian artery in the supraclavicular region (Fig. 57).

Rice. 57. Pressing the artery in the supraclavicular region

The brachial artery is pressed against the shoulder bone along the edge of the biceps muscle (Fig. 58).

Rice. 58. Pressing the brachial artery.

Bleeding in the area of ​​the forearm and hand can be stopped by inserting a roller into the elbow bend and maximum bending of the arm in the elbow joint.

The arteries of the lower leg are pressed in the popliteal fossa, after placing a soft roller into it and bending the leg at the knee joint as much as possible. In case of arterial bleeding in the region of the lower limb, the femoral artery is pressed in the groin or at the inner edge of the quadriceps muscle (Fig. 59).

Rice. 59. Compression of the femoral artery

To successfully stop bleeding, the arterial vessel must be squeezed with the pulp of two to four fingers. This method of stopping bleeding is used as a short-term measure. It must be supplemented with a quick application of a tourniquet. The application of a tourniquet is the main way to temporarily stop bleeding on the battlefield when large arterial vessels of the limb are injured. For this, a rubber band is used. It consists of a rubber band 1–1.5 m long, with a metal chain attached to one end and a hook to the other. The ends of the tourniquet are fixed with a chain and hook or tied in a knot (Fig. 60).

Rice. 60. Method of applying a tourniquet

The tourniquet is applied above the wound (closer to the heart) directly on the clothes, or the place of the forthcoming application of the tourniquet is wrapped with several layers of a bandage or other material. It is important that the tourniquet is not applied too loosely or too tight. If the tourniquet is applied too loosely, the arteries are not completely occluded and bleeding continues. Due to the fact that the veins are clamped with a tourniquet, the limb is filled with blood, its skin becomes cyanotic and bleeding may increase. In case of severe compression of the limb with a tourniquet, the nerves are injured, which can lead to paralysis of the limb. Proper application of the tourniquet stops bleeding and pales the skin of the limb. The degree of compression of the limb with a tourniquet is determined by the pulse on the artery below the place of its application. If the pulse disappeared, then the artery was squeezed by the tourniquet. The limb, on which the tourniquet is applied, should be wrapped warmly. The tourniquet, which is applied, cannot be kept for a long time. It should not exceed 2 hours, otherwise necrosis of the limb may occur. Therefore, an inscription is made on the bandage or on the skin with an indelible pencil indicating the time the tourniquet is applied. A note can be used for this purpose. If after 2 hours the wounded person is not taken to the dressing room or operating room for final stop bleeding, you should temporarily loosen the tourniquet. To do this, press the artery with your fingers above the place where the tourniquet is applied, then slowly so that the blood flow does not push out the formed thrombus, the tourniquet is dissolved for 5-10 minutes and tightened again. Temporary loosening of the tourniquet in this way is repeated every hour until the victim receives surgical care. A casualty with a tourniquet should be monitored, as the tourniquet may loosen, leading to renewed bleeding.

In the absence of a tourniquet, to temporarily stop the bleeding, you can use improvised materials - a rope, a belt, a twisted handkerchief, etc. Using improvised means, the limb is pulled in the same way as with a rubber tourniquet, or a twist is made, the end of which is bandaged to the limb (Fig. 61).

Fig.61. How to apply twist

A wound is damage to the tissues of the human body - its skin and tissues, mucous membranes, deeper located biological structures and organs.

The causes of injury are various physical or mechanical influences.

Wounds are superficial, deep and penetrating into body cavities. There are also stab, cut, bruised, chopped, torn, bitten and gunshot wounds.

stab wounds are the result of penetration into the body of piercing objects - a needle, a nail, an awl, a knife, a sharp chip, etc.

cut wounds applied with sharp objects - a razor, a knife, glass, iron fragments. They differ in smooth edges, heavy bleeding.

Bruised wounds come from the action of blunt objects - a blow with a stone, a hammer, parts of moving machines, as a result of a fall from a height. These are severe and dangerous wounds, often associated with significant tissue damage and fraying.

Chopped wounds are a combination of cut and contusion wounds. Often they are accompanied by severe trauma to the muscles and bones.

Lacerations are characterized by crushing of damaged tissues, tearing and crushing of the affected parts of the body.

Bite wounds are inflicted by the teeth of cats, dogs, other domestic and wild animals, and snakes. Their main danger is the possibility of extremely serious consequences (rabies, tetanus).

gunshot wounds- this is special kind damage. They are the result of intentional or careless use. firearms and can be bullet, fragmentation, shot, ball, plastic. Gunshot wounds usually have a large area of ​​damage, affecting internal organs, blood vessels and nerves. Most wounds bleed due to damage to the blood vessels, but there are also so-called bloodless wounds.

First aid in case of injury aims to stop bleeding, protect the wound from contamination, and create rest for the injured limb.

Protecting the wound from contamination and infection with germs is best achieved by applying a dressing.

Severe bleeding is stopped by applying a pressure bandage or a hemostatic tourniquet (on the limbs).

When applying a bandage, the following rules must be observed:

You should never wash the wound yourself, especially with water, as microbes can be introduced into it;

When pieces of wood, scraps of clothing, earth, etc. get into the wound. you can take them out only if they are on the surface of the wound;

You can not touch the surface of the wound (burn surface) with your hands, since there are especially many microbes on the skin of the hands; bandaging should be done only with cleanly washed hands, if possible wiped with cologne or alcohol;

The dressing material used to close the wound must be sterile;

In the absence of a sterile dressing, it is permissible to use a cleanly laundered handkerchief or piece of cloth, preferably white color, pre-ironed with a hot iron;

Before applying a bandage, the skin around the wound should be wiped with vodka (alcohol, cologne), and it should be wiped in the direction from the wound, after which the skin should be lubricated with iodine tincture;

Before applying a bandage, gauze pads are applied to the wound.

Wound bandaging is usually performed from left to right, in a circle. The bandage is taken in the right hand, the free end is captured with the thumb and forefinger of the left hand.

Specific cases are penetrating wounds of the chest and abdominal cavity, skull.

With a penetrating wound in the chest cavity, there is a threat of respiratory arrest and lethal outcome due to asphyxia (suffocation). The latter is explained by the fact that the external atmospheric and intra-abdominal pressure are aligned. When the victim tries to inhale, air enters the chest cavity, and the lungs do not straighten out. If the victim is conscious, he urgently needs to exhale, clamp the wound with his hand and seal it with any material at hand (adhesive tape, packaging from a sterile bag, plastic bag). If the victim is unconscious, you should sharply press on his chest to simulate exhalation and also seal the wound. Artificial respiration is performed according to the circumstances.

In case of a penetrating wound in the abdominal cavity, it is necessary to close the wound with a sterile bandage. If the internal organs have fallen out, in no case do not fill them into the abdominal cavity, but simply gently bandage them to the body.

Victims with penetrating wounds of the chest and especially the abdominal cavity should not be allowed to drink.

In case of a penetrating wound of the skull, fragments of protruding bones or foreign objects should be removed, and the wound should be tightly bandaged. As a dressing, it is best to use standard dressing bags (Fig. 35). To open the package, they take it in the left hand, grab the notched edge of the shell with the right hand and tear off the gluing with a jerk. A pin is taken out of a fold of paper and fastened to their clothes. Then, having unfolded the paper shell, they take the end of the bandage, to which the cotton-gauze pad is sewn, in the left hand, and in the right hand - the rolled bandage and spread their arms. When the bandage is tightened, a second pad will be visible, which can move along the bandage. This pad is used if the wound is through: one pad closes the inlet, and the second - the outlet; pads for this move apart to the desired distance. The pads can only be touched by hand from the side marked with colored thread. The reverse (unmarked) side of the pads is applied to the wound and fixed with a circular bandage. The end of the bandage is stabbed with a pin. In the case when the wound is one, the pads are placed side by side, and for small wounds they are superimposed on each other.

There are rules for applying different types of bandages.

The simplest bandage is circular. It is superimposed on the wrist, lower leg, forehead, etc. The bandage with a circular bandage is superimposed so that each subsequent turn completely covers the previous one.

A spiral bandage is used for bandaging limbs. They start it in the same way as a circular one, making two or three turns of the bandage in one place in order to fix it; bandaging should begin with the thinnest part of the limb. Then bandaged in a spiral upwards. In order for the bandage to fit snugly without forming pockets, it is twisted after one or two turns. At the end of bandaging, the bandage is fixed with an elastic mesh or its end is cut along the length and tied.

When bandaging the area of ​​​​the joints of the feet, hands, eight-shaped bandages are used, so called because when they are applied, the bandage all the time, as it were, forms the number "8".

Bandages on the parietal and occipital regions are made in the form of a "bridle" (Fig. 36). After two or three fixing turns of the bandage around the head through the back of the head, they lead it to the neck and chin, then make several vertical contours through the chin and crown, after which the bandage is sent to the back of the head and fixed in a circular motion. An eight-shaped bandage can also be applied to the back of the head.

A bandage in the form of a "cap" is applied to the scalp (Fig. 37). A piece of bandage about 1.5 meters long is placed on the crown, its ends (ties) are lowered down in front auricles. Then make two or three fixing turns with a bandage (other) around the head. Next, the ends of the ties are pulled down and somewhat to the side, the bandage is wrapped around them on the right and left alternately and lead it through the occipital, frontal and parietal regions until the entire scalp is covered. The ends of the ties are tied with a knot under the chin.

The bandage on the right eye begins with the fixing turns of the bandage counterclockwise around the head, then through the back of the head the bandage is led under the right ear to the right eye. Then the moves alternate: one through the eye, the other around the head.

When applying a bandage to the left eye, fixing moves around the head are made clockwise, then through the back of the head under the left ear and on the eye (Fig. 38).

When applying a bandage to both eyes, after fixing moves, alternate moves through the back of the head to the right eye, and then to the left.

It is convenient to apply a sling-like bandage on the nose, lips, chin, and also on the entire face (Fig. 39). To prepare it, they take a piece of a wide bandage about a meter long and cut it along the length from each end, leaving the middle part intact.

For small wounds, a sticker can be used instead of a bandage. A sterile napkin is applied to the wound, then the uncut part of the bandage (see above) is applied to the napkin, the ends of which are crossed and tied at the back.

Also, with small wounds and abrasions, it is quick and convenient to use adhesive bandages. A napkin is applied to the wound and fixed with strips of adhesive tape. A bactericidal adhesive plaster, on which there is an antiseptic tampon, after removing the protective coating, is applied to the wound and glued to the surrounding skin.

Fig. 39. Sling bandage

When bandaging a wound located on the chest or on the back, a so-called cruciform bandage is made (Fig. 40).

When the shoulder joint is injured, a spike-shaped bandage is used.

A kerchief bandage is applied for wounds to the head, elbow joint and buttocks.

When applying a bandage, the victim should be seated or laid down, because even with minor injuries under the influence of nervous excitement or pain, a short-term loss of consciousness can occur - fainting.

The injured part of the body should be given the most comfortable position. If the casualty is thirsty, give him water (except as noted above), hot strong sweet tea or coffee to drink.

Questions for self-control

1. What types of wounds do you know?

2. What is first aid for injury?

3. What rules should be observed when applying a bandage?

4. What is the specificity of providing first aid for a penetrating wound in the chest cavity?

5. What assistance is provided for a penetrating wound in the abdominal cavity?

6. What kind of assistance should be provided in case of a penetrating wound of the skull?

7. Name the main types of dressings.

8. Explain the technology of applying such types of dressings as circular, spiral and eight-shaped.

9. How are bandages in the form of a "bridle" and "cap" applied?

10. What kind of bandage can be applied to the nose, lips, chin, as well as the entire face?

11. For what kind of wounds are cruciform and spike-shaped dressings used?

12. When injuring which parts of the body is a scarf bandage used?