First aid. Providing first aid for bleeding First aid for bleeding briefly

Since trauma, and therefore bleeding due to it, can happen anywhere and anytime, every adult should know how to provide first aid for bleeding.

Types of bleeding and their features

Depending on the type of injured vessel, the following types of bleeding are distinguished:

arterial;
Venous;
Capillary.

Also, bleeding is distinguished by location. The hands are most often injured - bleeding of the upper extremities is the most common type. In second place are leg injuries, and nosebleeds are in third place. The most dangerous type is bleeding of internal organs, since it is difficult to notice them in time, it is even more difficult to keep the situation under control. Below we will consider the principles of first aid for arterial, venous, nasal and internal bleeding.

First aid for arterial and venous bleeding

Many people vaguely remember that first aid for arterial bleeding consists in applying a tourniquet to the vessel, but few people know how to do it correctly. Doctors warn: the application of a tourniquet can be no less dangerous than the loss of blood, an ineptly applied tourniquet can lead to the need for amputation of a limb, and alas, it often does. How to provide first aid for arterial bleeding without causing harm? Remember, with an injury to a large artery, there is not much time left, only 3-5 minutes. The algorithm of actions is as follows:

Do not wash or in any other way try to decontaminate the wound, do not remove small fragments that have got there;
Apply a pressure bandage as follows: directly on the wound, apply a sterile bandage or a clean cloth folded in several layers (it is desirable that the dressing be sterile, if one is not at hand, use any). Put another roller made of fabric on top. Then bandage everything tightly, after which the limb must be placed above the level of the body. If done correctly, the bleeding should stop;
If there was nothing at hand that could serve as a dressing, you can try to stop the bleeding by maximum flexion of the joint located above the wound;

First aid for bleeding and wounds with a tourniquet. This method is resorted to if it was not possible to stop the blood in another way. The rules are as follows:

A tourniquet (or any long piece of rubber, such as a rubber hose) is applied 5-7 cm above the wound, but not on bare skin, but on the fabric that should be wrapped around the limb, it can be on a sleeve or trouser leg;
After stretching the tourniquet, lay it in several turns without gaps between them, the first is not too tight, each subsequent turn is tighter. A sign of a correctly applied tourniquet is to stop bleeding;
The tourniquet should not be applied too tightly so as not to injure the nerves. If severe pain occurs from the tourniquet, the injured vessel must be pressed with a finger, and the tourniquet removed, give the victim a break from the tourniquet, then apply again;
Be sure to record the time of applying the tourniquet! This is an extremely important condition that can save a person from possible disability. It is advisable to write the time of applying the tourniquet with a pen directly on the skin or clothing of the victim. The maximum time for which a tourniquet can be applied is one and a half to two hours in summer and one hour in winter. During this time, the patient should be taken to the hospital, if this is not possible, and the time has elapsed, the tourniquet must be removed very carefully and slowly, if the bleeding has resumed, press the vessel with your finger above the wound.

First aid for venous bleeding occurs according to a similar algorithm, the only difference is that the vessel should be pressed below the wound.

First aid for nosebleeds

As a rule, nosebleeds are not life-threatening, although they look frightening. However, blood loss can be significant. To prevent this, you must take the following actions:

In the nostril from which the blood comes, you need to insert a small swab of cotton, bandage, napkin or handkerchief. The tampon should not cause pain;
The person must be seated with his head slightly tilted down. A common mistake is made by people who, as first aid for nosebleeds, lay a person on his back or make him throw his head back. This can cause blood to drain down the back of the throat;
Put a cold compress or any cold object on the nose area;
Slightly squeeze the wings of the nose.

First aid for internal bleeding

Internal bleeding is difficult to recognize on its own. An indirect sign of it after an injury that has occurred is a deterioration in a person’s condition, blanching of the skin, cold sweat that has come through, darkening in the eyes. In this case, blood may be excreted with vomiting or with feces, but not necessarily. If you notice these signs, the following should be done as first aid for internal bleeding:

In case of a chest injury, give the person a semi-sitting position, in case of an abdominal cavity injury - lying down;
Provide fresh air supply;
Apply cold to the abdomen or chest;
Forbid the victim to eat, drink, move and talk;
Take the person to the hospital immediately.

The last point is relevant not only for injuries of internal organs. In case of massive blood loss, the main point of first aid for bleeding of any kind will be the delivery of the victim to the clinic for the provision of qualified medical care.

Bleeding is the outflow of blood from soft tissues, mucous membranes with various injuries. Injury to large vessels is dangerous by the rapid death of the victim.

The most abundant bleeding is observed in those places where there is good vascularization, a small amount of fat lobules.

Click on the picture to enlarge

Classification of bleeding

There are three types of bleeding. This classification takes into account the type of vessel that has been damaged:

Capillary. Characteristic of musculoskeletal injuries. Blood is released from the injured surface is not very intense. This type of bleeding may stop on its own.
. The discharge of dark blood is noted from the wound, which flows out in a plentiful continuous uniform stream.
. This type of bleeding is characterized by the release of scarlet blood from the injured area of the vessel, a pulsating jet.
Mixed.
Parenchymal. Internal bleeding that occurs when the vessels supplying blood to the internal organs are injured.

Signs of acute blood loss are:

If blood flows very rapidly from the wound, the victim may develop hemorrhagic shock.

First aid for bleeding is performed immediately after injury. If arterial bleeding is localized on the upper limbs, lower limbs (their stumps), stopping bleeding consists in performing two stages:

Pressing the artery against the bone, which is performed in a place above the injury to the vessel. Thus, the flow of blood to the affected vessel is stopped.
The imposition of a sterile bandage, tourniquet. Under the tourniquet, it is necessary to put a note with the time of its application.

The most dangerous arterial bleeding is the outflow of blood from the femoral, carotid, and brachial arteries. If they are injured, death can occur in just a few minutes. For this reason, you need to be able to use first aid skills for bleeding from an artery. On such a site as the thigh, it is recommended to use finger pressure on the artery, the use of a tourniquet. The tourniquet is suitable for stopping arterial bleeding on the thigh, shoulder.

The main signs of this type of bleeding are:

bright scarlet color of blood;
bleeding in a pulsating stream;
blood pulsation corresponds to the pulse rate.

Finger pressing of the artery is performed in this way:

Press the artery slightly above the injury.
The artery must be pressed hard enough to stop the bleeding.
It is forbidden to relieve pressure on the artery until a tourniquet is applied.

Finger pressure is enough to stop bleeding from a superficial artery. To stop bleeding from a large artery, you must use your palm, fist.

A tourniquet is used for injury to large arteries. To do this, you must perform the following steps:

To the place of bleeding, it is necessary to wrap a part of the limb. To do this, use a towel, gauze.
The injured limb must be elevated.
Before applying the tourniquet, you need to stretch it slightly. Then it is necessary to make 2 - 3 turns around the injured limb.
The ends of the harness should be secured with a hook with a chain. If the tourniquet is homemade, it is necessary to tie its ends.
It is necessary to leave a note about the time the tourniquet was applied.
Apply a sterile bandage.

If the tourniquet is applied correctly, bleeding from the wound should stop.

If arterial bleeding is concentrated on a small artery (hand, forearm, foot), you can stop the bleeding without applying a tourniquet. To do this, it is enough to apply a sterile bandage, apply a pressure bandage.

If arterial bleeding is located in the scalp, on the torso, neck, then tight wound tamponade is used. Over cotton swabs, an unfolded bandage, tightly wrap the bandage. In cases where an injured artery is visible in the wound, hemostatic clamps can be applied.

Venous bleeding often occurs when deep wounds are applied. A characteristic feature of this type of bleeding is the flow of blood from the wound in a uniform stream, while the blood has a dark red color.

The danger of venous bleeding is that the pressure inside the veins is below atmospheric pressure. For this reason, air can be sucked into the veins, and the vessels of the heart, brain, and various organs become blocked.

A fatal condition that develops when air enters the blood vessels is called an air embolism. First aid should be given immediately after an injury.

First aid for venous bleeding should use the imposition of a pressure bandage on the injured area. The imposition of a pressure bandage consists in applying a sterile bandage to the bleeding site, which is put together in several layers. An unfolded bandage is placed on top, which is bandaged very tightly. If blood continues to seep through the bandage, it is necessary to put a few more napkins on top of it, then bandage it tightly again.

An injured limb with venous bleeding must be kept in an elevated position.

Stop capillary bleeding

Usually capillary bleeding is characterized by insignificant blood loss. This type of bleeding can be stopped very quickly. For this, clean gauze is applied to the injured area, a layer of cotton wool is placed on top, which is rewound with a bandage.

In the absence of cotton wool, gauze, bandage, you can use any clean material at hand (handkerchief, scarf, scarf). Shaggy tissue should not be applied over the wound. Fluffy fabrics carry more germs than smooth fabrics. Fleecy tissue provokes infection of the wound. Due to the large number of microbes, cotton can not be applied directly to the wound.

internal bleeding

Usually occurs due to a blow to the stomach. With internal bleeding, it is forbidden to give the victim to drink, eat. He should be given a semi-sitting position, legs at the knees should be bent. Cold should be applied to the stomach of the victim. If internal bleeding is detected, the victim should be sent to the hospital.

It is also necessary to stop, which may occur as a result of a blow to the nose.

It also occurs when sneezing, blowing your nose, traumatizing the skull.

It is forbidden to tilt your head back to avoid getting blood into the respiratory tract.

The wings of the nose should be squeezed with fingers, cotton swabs are placed in the nostrils, which are moistened with hydrogen peroxide (if available), water.

The most common cause of bleeding is glass cuts on the hands. More severe injuries can occur, but they are not typical for chemical laboratories.

Depending on which blood vessels are damaged during injury, bleeding is distinguished:

capillary
venous
arterial

With capillary and venous bleeding, the blood is dark, flows out in drops or a continuous stream. A way to stop capillary and venous bleeding is to apply a pressure bandage to the wound. With arterial bleeding, blood is scarlet in color, flows out in a pulsating stream. Arterial bleeding is stopped by applying a tourniquet or complete flexion of the limb in the joint and fixing it in this position with a belt or bandage.

When providing first aid, the following rules must be observed:

it is possible to wash the wound only if caustic or toxic substances get into it
if sand, rust, etc. got into the wound. it cannot be washed with water and solutions of medicines
you can not lubricate the wound with ointments or cover it with powder - this prevents it from healing;
when the wound is contaminated, carefully remove dirt from the skin around the wound in the direction from the edges of the wound outward; the cleaned area before applying the bandage is smeared with iodine tincture
do not allow iodine to enter the wound;
do not touch the wound with your hands, even if they are cleanly washed; do not remove blood clots from the wound, as this can cause severe bleeding;
only a doctor can remove small glass fragments from the wound;
after first aid, when the bleeding is stopped, if the loss of blood is significant, the victim should be urgently referred to a doctor;

Applying a pressure bandage.

A sterile bandage, gauze or clean cloth is applied directly to the bleeding wound. If a non-sterile dressing is used, it is recommended to drop a little tincture of iodine onto the fabric to make a spot larger than the wound. A dense roller of bandage, cotton wool or a clean handkerchief is applied over the fabric. The roller is tightly bandaged and, if necessary, continue to press on it with your hand. If possible, the bleeding limb should be elevated above the body. When the pressure bandage is in the correct position, bleeding stops and the bandage does not get wet.

Stop bleeding from a limb by flexing the joints.

To stop bleeding, it is necessary to bend the limb to the limit in the joint located above the wound.

The imposition of a tourniquet or twist.

An unskilled tourniquet is in itself a serious danger; this operation should be resorted to only as a last resort in case of very severe bleeding that cannot be stopped otherwise. Don't waste time! Severe bleeding can lead to the death of the victim in 3-5 minutes.

If the tourniquet cannot be applied immediately, in order to temporarily stop the bleeding, it is necessary to press the fingers on the vessel above the wound (Fig. 1).

Bleeding stops:

from the lower part of the face - by pressing the maxillary artery to the edge of the lower jaw (1);
on the temple and forehead - by pressing the temporal artery in front of the ear tragus (2);
on the head and neck - by pressing the carotid artery against the cervical vertebrae (3);
on the armpit and shoulder - by pressing the subclavian artery against the bone in the subclavian fossa (4);
on the forearm - by pressing the brachial artery in the middle of the shoulder from the inside (5);
on the hand and fingers - by pressing two arteries (radial and ulnar) to the lower third of the forearm near the hand (6);
from the lower leg - by pressing the popliteal artery (7),
on the thigh - by pressing the femoral artery to the pelvic bones (8);
on the foot - by pressing the artery on the back of the foot (9)

If a special rubber band is not at hand, the most suitable material for its manufacture is a soft rubber hose. At the place where the tourniquet was applied (5-7 cm above the wound), in order not to pinch the skin, it is necessary to first put a dense cloth or wrap the limb with several layers of bandage. You can apply a tourniquet over a sleeve or trousers. The limb is wrapped several times with a pre-stretched tourniquet. The coils should fit tightly, without gaps and overlaps. The first turn is wound not too tight, each next - all with great tension. The imposition of coils is continued only until the bleeding stops, after which the tourniquet is tied. The tourniquet should not be overstretched, as this may damage the nerve fibers.

The maximum time during which you can not remove the tourniquet in the warm season is 1.5-2 hours, in the cold season - 1 hour. Exceeding the specified time can lead to necrosis of the bloodless limb. After applying the tourniquet, it is necessary to take all measures for the speedy delivery of the victim to the nearest medical facility.

If the tourniquet causes severe pain, it is allowed to remove it for a while to give the victim a rest from the pain. Before this, it is necessary to firmly press the vessel through which blood flows to the wound with your fingers. Dissolve the tourniquet should be very carefully and slowly.

Instead of a tourniquet, you can use a twist made of soft non-stretching material - a bandage, towel, tie, belt, etc. A strong loop with a circle one and a half to two times the circumference of the limb is put on with a knot upwards 5-7 cm above the wound. The skin is also as in the application of a tourniquet, they protect against pinching by the tissue. A short stick or any suitable object is threaded into or under the knot, with the help of which winding is performed. As soon as the bleeding stops, the stick is fixed so that it cannot unwind spontaneously, and the wound is closed with an aseptic bandage.

Under the twist or tourniquet, you must enclose a note indicating the exact time of their application.

Help with internal bleeding is based on creating conditions that help reduce the intensity of bleeding or stop it; fast, but "sparing" transportation; maintenance of compensatory reactions in the body.

First aid for internal bleeding

1) the creation of absolute rest for the patient;

2) the imposition of cold on the area of the source of bleeding. Cold water, frozen food, ice or snow can be used as cold;

3) the introduction of substances that help stop the bleeding, if conditions allow it. Such substances include hemophobin, calcium chloride, vitamin C, vikasol, gelatin, epsilon-aminocaproic acid;

4) the fastest possible transportation of the victim to a medical facility.

A person after a significant loss of blood can be saved by taking urgent measures to stop internal bleeding. Even if the bleeding has stopped, it is still recommended to apply a pressure bandage to the wound. After that, you need to unbutton the collar, the dress of the victim. If he is conscious and there are no injuries to the digestive tract, then you can give the patient tea to drink. It is not recommended to give black coffee. Then the victim needs to be put on his back, head down a little, raise his arms and legs, or even hang them. Being in this position, the brain is filled with blood, therefore, its activity is supported. After carrying out such events, the victim must be taken to a medical facility.

First aid for pulmonary bleeding

Pulmonary bleeding can occur due to injury or in the presence of diseases of the lungs (tuberculosis, tumor lesion, abscess, etc.) and the heart. Signs of this type of internal bleeding include coughing up foamy blood, which is stained with sputum blood, shortness of breath, shortness of breath. If the bleeding is severe, then the blood is coughed up in clots and there are signs of acute blood loss: dizziness, pallor, lowering blood pressure. In case of pulmonary bleeding, the patient should be given a half-sitting position; for support, you can use a roller placed under the back to free the chest. The patient is not allowed to talk, cough, move. The patient should be transported to a hospital as soon as possible.

First aid for intrathoracic bleeding

Intrathoracic bleeding can occur due to a chest injury and damage to internal organs: lungs, heart, large vessels. Internal bleeding into the pleural cavity, as a rule, does not stop spontaneously. The patient needs to be given a half-sitting position, bend the lower limbs, attach an ice pack to the chest, unfasten the trouser belt, shirt collar.

First aid for bleeding into the lumen of the gastrointestinal tract

The cause of such bleeding is peptic ulcer, stomach cancer and other diseases. Signs of internal bleeding into the lumen of the gastrointestinal tract are the appearance of vomiting, which has the color of coffee grounds, tarry feces and the presence of general signs of acute anemia: tachycardia, pallor, weakness, lowering blood pressure, loss of consciousness. First aid for internal bleeding into the lumen of the gastrointestinal tract is providing the patient with complete rest and a horizontal position. An ice pack should be placed on the epigastric region, and very small pieces of ice can also be given to the patient so that he swallows them. You need to be transported to the hospital in the supine position on a stretcher.

First aid for intra-abdominal bleeding

The causes of intra-abdominal bleeding, most often, are abdominal trauma, in which internal organs are damaged. In women, intra-abdominal bleeding may accompany a disturbed tubal pregnancy. Signs of intra-abdominal bleeding are large blood loss (up to 2-3 liters), the threat of peritonitis, the impossibility of spontaneous stop.

The only help for such internal bleeding is an immediate operation aimed at the final stop of the bleeding. The victim should not eat or drink. Transportation should be carried out in a supine position, with a cold compress or ice pack applied to the abdomen. During transportation, the victim must be accompanied by a person providing assistance.

First aid is the urgent implementation of complex therapeutic and prophylactic manipulations. They are necessary in case of accidents, sudden illnesses or exacerbation of an existing disease. First aid is provided before the arrival of medical personnel or before the victim is admitted to a medical facility. One of the possible pathological symptoms that needs first aid is bleeding. What you need to know about blood loss, how to properly stop the bleeding and transport the victim to the hospital?

What you need to know about bleeding?

Bleeding is the release of blood outside the vascular bed into the body cavity / organ lumen (internal blood loss) or into the environment (external blood loss). After any bleeding, regardless of location and intensity, the amount of circulating blood in the body decreases. As a result, the work of the heart worsens, providing tissues with vital fluid and oxygen. This is especially true of the brain, liver and kidneys. This condition is extremely dangerous for patients of younger and older age categories. Their body adapts worse to changes in the amount of circulating blood, which is fraught with irreversible consequences.

The degree of damage to the body depends on the size of the vessel in which blood loss occurs. For example, if small blood vessels are damaged, the body gives the command to produce blood clots. These are blood clots that close the lumen of the wound, stop the flow of blood on their own and help the skin recover. It is impossible to stop the integrity of large vessels on their own. The victim may temporarily cut off blood flow, but not fix the underlying problem. Therein lies the whole danger of the situation. For example, when an artery is injured, the blood flow is so intense that after three minutes it can lead to the death of the victim.

What happens to the body during/after blood loss?

The consequences of bleeding are conditionally divided into two groups - general and local. Let's analyze each of them in more detail. General changes refer to the body's attempts to replace lost blood. The heart begins to contract with minimal activity, edema develops in the lungs, and filtration in the kidneys decreases. Urine stops flowing to the bladder, and necrosis develops in the liver.

What are the local changes? When bleeding from the lung, blood begins to come out of the mouth. It is painted in a scarlet hue and foams intensively. Blood loss from the esophagus is accompanied by similar symptoms. Gastric bleeding makes itself felt with a dark brown tint of liquid (due to interaction with hydrochloric acid). Intestinal hemorrhage is dark in color and dense tar-like consistency. With renal blood loss, the victim may observe blood impurities in the urine or its color in scarlet.

With latent internal bleeding, shortness of breath, respiratory failure, abdominal distension, swelling of the joints, and redness of the skin are recorded. A cerebral hemorrhage is fraught with disorders of the nervous system, and the ingress of fluid into the pericardial cavity can lead to cardiac arrest. In general, the symptoms depend on the individual characteristics of the body, the localization of blood loss and the size of the vessel. In some cases, a person does not even understand what is happening inside and does not have time to ask for help or get to a medical facility. If you notice a victim with blood loss, call an ambulance as soon as possible and try to stop the bleeding yourself.

How to stop the bleeding?

During the stop of bleeding, it is necessary to act quickly, calmly and purposefully. Only in this way will it be possible to alleviate the condition or save the life of the victim. Timely first aid will facilitate further treatment of the wound, shorten the rehabilitation period and minimize complications/injuries/injuries. There are only two ways to stop blood loss - temporary and final. Temporary manipulations help save the life of the victim until the arrival of the ambulance. The final stop is carried out only by a qualified doctor in the operating room.

The first thing a person should do is to analyze the volume / intensity of blood loss and the condition of the victim. Rationally assess your own strengths. In case of intracavitary bleeding or trauma to the main vessels, it is better to refuse squeezing, bandaging and other manipulations. They can only aggravate the condition of the victim, cause him additional pain and complicate the work of specialists. The only sure option is to call an ambulance or take the person to the hospital as soon as possible.

First aid is provided for capillary bleeding, when the loss of blood is relatively small. It can be quickly stopped by applying clean gauze to the bleeding area. Several layers of cotton wool are applied over the gauze, after which the wound is bandaged. If neither gauze nor cotton wool was at hand, you can use a clean handkerchief. Cloth with fluff that can be easily separated should not be used. These villi accumulate a huge amount of bacteria. It is impossible to accurately study their nature and effects on the body. Some bacteria can cause wound infection and make the situation worse. For the same reason, it is impossible to treat the affected areas with cotton wool or cotton pads.

First aid principle:

squeezing the wound using a pressure bandage and tight packing;
selection of the optimal position of the wounded limb (elevated and motionless);
applying a bandage or tourniquet;
thermal stop of bleeding mainly with high temperatures (try to warm the body of the victim and the area that has undergone hemorrhage as much as possible).

The first thing to do when stopping the bleeding is to strongly squeeze the wound with your hands. To do this, you need to use the "3D" rule (press / ten / ten). Press on the wound with both hands for 10 minutes. If the intensity of bleeding is insignificant, you can press only a few fingers, but the time (10 minutes) does not change.

Hemostatic preparations are freely available in pharmacies. These are topical substances that can stop blood loss. Medicines can be used for capillary bleeding or blood loss from small vessels. It has been proven that hemostatic drugs can stop up to 80% of even intense hemorrhages, regardless of location. Before using a hemostatic powder / granule or wipe, it is necessary to compress the wound (squeezing time is reduced from 10 to 3 minutes), and then apply a pressure bandage.

The pressure bandage can be applied with or without hemostatic agents. As a bandage, it is permissible to use napkins, a dressing bag, an elastic bandage (subject to tight bandaging). The main thing is that the tissue is dense and does not exfoliate on the wound. A tourniquet is an extreme measure of first aid. Most bleeding can be stopped without the use of a tourniquet. It is applied only for amputations, complete / partial destruction of the limb or gushing bleeding (in case of injury to the artery).

Incorrect tourniquet application in 50% of cases leads to limb amputation. If you do not have a specialized education, try to stop the bleeding by squeezing and bandaging.

The use of ice and cold is one of the most common bleeding myths. With massive blood loss, blood coagulates much faster under the influence of high rather than low temperatures. To help the victim as much as possible, warm the wound rather than applying ice or anything cold to it. To keep the person warm while being transported or waiting for medical staff, use your own clothing or the victim's belongings.

Providing first aid for bleeding can save a life or, conversely, aggravate the situation. Proceed to manipulation only if you are confident in your own strengths and actions. Rationally evaluate what is happening, call an ambulance and try to maximize the comfort of the victim. With heavy blood loss, it is better to wait for the ambulance to arrive or transport the person to the hospital as soon as possible.