Rendering of the first emergency medical aid at bleedings. How to determine what kind of bleeding and what methods are there to stop bleeding Help with internal bleeding at a glance

Bleeding is an outpouring of blood (that is, its outflow) through blood vessels as a result of a violation of the integrity in their walls. The nature of bleeding can be traumatic, which is caused by damage to blood vessels, as well as non-traumatic, which is caused by the destruction of blood vessels when exposed to one or another disease process. The types of lesions determine, respectively, the types of bleeding, the first aid in which is decisive in the efficiency of its provision, which is reflected in the consequences of the influence of the pathological process on the entire body.

Types of bleeding

As we have already indicated, damage to a particular type of vessel determines the corresponding type of bleeding.

• arterial bleeding. The pouring blood is bright red in color, a distinctive feature lies in the intensity of the pulsation of the jet.
• Venous bleeding. In this case, the blood is darker in color, it is released abundantly and continuously.
• capillary bleeding. The release of blood occurs evenly, along the entire surface of the lesion.
• Mixed bleeding. It is characterized by a combination of the above types of bleeding, which is important for deep lesions.

Symptoms of acute blood loss

With acute blood loss, the victim has an extremely pale appearance, while his body is covered with cold and sticky sweat. There is lethargy, dizziness. The victim is thirsty, dry mouth. His pulse is characterized by a frequency with a small filling at the same time.

First aid for arterial bleeding

The main thing that is necessary to save the life of the victim, regardless of the type of bleeding, is first aid, which consists in temporarily stopping the discharge and loss of blood.

The easiest way is to digitally press the artery, not near the lesion itself, but above it, that is, in the accessible area near the bone or under the lesion. In the given example of the figure, points are indicated in the area of ​​\u200b\u200bwhich should be finger pressed. It should be noted that it is precisely due to finger pressure that it becomes possible to almost instantly and completely stop bleeding. Meanwhile, even a strong person manages to hold the required point for more than 15 minutes, because the hands experience a certain fatigue because of this, and therefore the degree of pressing also weakens. Considering this, it can be noted that this technique is important because it allows you to win a certain time, which is necessary to search for and implement other measures to stop bleeding.

Next, a tourniquet is applied to the damaged limb, which is also done in the area above the damage to the vessel. The maximum time specified for applying a tourniquet for adults is about two hours, for children - up to 50 minutes. Holding the tourniquet for a longer time period can lead to tissue necrosis. During this period, the victim should be taken to the hospital.

First aid for venous bleeding

In considering the types of bleeding and first aid for them, in addition to arterial bleeding, which is the most dangerous of the possible options, venous bleeding should not be overlooked. The danger of this bleeding, in addition to significant blood loss, lies in the possibility of absorption through damaged areas into the air vessels. The air trapped in the vessel can subsequently enter the heart, resulting in a fatal condition known as an air embolism.

Stopping venous bleeding is best done with a pressure bandage. So, clean gauze is applied to the damaged area, on top of which a bandage is placed (or, again, gauze folded several times). In the absence of these materials, a clean handkerchief will do. In the absence of any type of pressure bandage and with severe bleeding, it is necessary to press the bleeding area with your fingers. Bleeding of a vein in the upper limb can be stopped by raising the arm up.

First aid for capillary bleeding

Capillary bleeding, unlike other types of bleeding and the first aid necessary for them, is characterized by relatively small blood loss. Moreover, it can be stopped quickly enough using clean gauze applied to the affected area. Cotton wool is placed on top of this gauze, after which the wound is bandaged. In the absence of these materials, a bandage can be used.

Most often, bleeding occurs as a result of damage to blood vessels. The most common cause is trauma (strike, injection, cut, crush, sprain). Vessels are much easier to damage and bleeding occurs in atherosclerosis, hypertension. Bleeding can also occur when the vessel is corroded by a painful focus (pathological process) - tuberculous, cancerous, ulcerative.

Types of bleeding. Bleeding is of varying strength and depends on the type and caliber of the damaged vessel. Bleeding, in which blood flows out of a wound or natural openings, is called outdoor. Bleeding in which blood accumulates in body cavities is called internal. Especially dangerous are internal bleeding into closed cavities - into the pleural, abdominal, heart shirt, cranial cavity. These bleedings are imperceptible, their diagnosis is extremely difficult, and they can remain unrecognized.

Internal bleeding occurs with penetrating wounds, closed injuries (ruptures of internal organs without damage to the skin as a result of a strong blow, fall from a height, squeezing), as well as diseases of internal organs (ulcer, cancer, tuberculosis, blood vessel aneurysm).

With a decrease in the amount of circulating blood, the activity of the heart worsens, the supply of oxygen to vital organs - the brain, kidneys, and liver - is disrupted. This causes a sharp disruption of all metabolic processes in the body and can lead to death.

There are arterial, venous, capillary and parenchymal bleeding.

arterial bleeding the most dangerous: in a short time, a person loses a large amount of blood flowing out under high pressure. Blood of bright red (scarlet) color beats with a pulsating jet. This type of bleeding occurs with deep chopped, stab wounds. If large arteries, the aorta, are damaged, blood loss that is incompatible with life can occur within a few minutes.

Venous bleeding occurs when the veins are damaged, in which the blood pressure is much lower than in the arteries, and the blood (it is dark cherry in color) flows out more slowly, evenly and continuously. Venous bleeding is less intense than arterial bleeding and is therefore rarely life-threatening. However, when the veins of the neck and chest are injured, air can be drawn into the lumen of the veins at the time of a deep breath. Air bubbles, penetrating with blood flow into the heart, can cause blockage of its vessels and cause lightning death.

capillary bleeding occurs when the smallest blood vessels (capillaries) are damaged. It happens, for example, with superficial wounds, shallow skin cuts, abrasions. Blood flows out of the wound slowly, drop by drop, and if the blood clotting is normal, the bleeding stops on its own.

Parenchymal bleeding associated with damage to internal organs that have a very developed network of blood vessels (liver, spleen, kidneys).

Stop bleeding. First aid for bleeding at the scene aims to temporarily stop the bleeding, in order to then deliver the victim to a medical facility, where the bleeding will be completely stopped. First aid in case of bleeding is carried out by applying a bandage or tourniquet, maximum flexion of the damaged limb in the joints.

capillary bleeding easily stopped by applying a conventional bandage to the wound. To reduce bleeding during the preparation of the dressing, it is enough to raise the injured limb above the level of the body. After applying a bandage to the area of ​​the injured surface, it is useful to put an ice pack.

Stop venous bleeding done with a pressure bandage

(Fig. 69). To do this, several layers of gauze are applied over the wound, a tight ball of cotton wool and tightly bandaged. The blood vessels squeezed by the bandage quickly close with clotted blood, so this method of stopping bleeding can be final. With severe venous bleeding during the preparation of a pressure bandage, bleeding can be temporarily stopped by pressing the bleeding vessel with your fingers below the wound.

To stop arterial bleeding vigorous and swift action is needed. If the blood flows from a small artery, good effect Rice. 69. Applying a pressure bandage gives a pressure bandage.

Rice. 70. Places of clamping of the arteries: 1 - femoral, 2 - axillary, 3 - subclavian, 4 - sleepy 5 - shoulder

To stop bleeding from a large arterial vessel, the technique of pressing the artery above the injury site is used. This method is simple and based on the fact that a number of arteries can be completely blocked by pressing them to the underlying bone formations in typical places (Fig. 70, 71).

Prolonged stopping of bleeding with the help of finger pressing of the artery is impossible, since this requires great physical strength, is tiring and practically excludes the possibility of transportation.

A reliable way to stop severe bleeding from the artery of the limb is the imposition of a hemostatic tourniquet (standard or impromptu).

The tourniquet is applied over the sleeve or trousers, but not on the naked body: the skin can be damaged. Hold a tourniquet in an adult not more than 2 hours (in winter - no more than 1 hour), longer

Rice. 74. Twist overlay

Rice. 71. Finger clamping of the arteries Rice. 72. Correct tourniquet application

pressure on blood vessels can lead to necrosis of the limb. A note must be placed under the tourniquet with an exact (up to a minute) indication of the time of its application (Fig. 72).

If the tourniquet is applied correctly (Fig. 73), the bleeding stops immediately, the limb turns pale, and the pulsation of the vessels below the tourniquet disappears. Excessive tightening of the tourniquet can cause crushing of muscles, nerves, blood vessels and cause limb paralysis. With a loose tourniquet, conditions are created for venous stasis and increased bleeding.

If there is no special tourniquet, you can use improvised means: a belt, a scarf, a piece of cloth, a scarf, etc. A tourniquet made from auxiliary materials is called a twist. To apply a twist, it is necessary to freely tie the object used for this at the required level. A stick should be passed under the knot and, rotating it, twist until the bleeding stops completely, then fix the stick to the limb (Fig. 74). The application of the twist is painful, so it is necessary to put cotton wool, a towel or a piece of cloth folded 2-3 times under it. All errors, dangers and complications noted during the application of the tourniquet fully apply to twisting.

Rice. 73. Places for applying a tourniquet for bleeding from the arteries:

1 - shins, 2 - lower leg and knee joint, 3 - brushes, 4 - forearm and elbow joint, 5 - shoulder, 6 - hips

To stop bleeding during transportation, pressure on the arteries is used by fixing the limbs in a certain position. In case of injury to the subclavian ar-

Rice. 75. Fixation of limbs

terii, bleeding can be stopped by the maximum abduction of the arms back with their fixation at the level of the elbow joints (Fig. 75, a). Compression of the popliteal and femoral arteries is shown in Fig. 75, b, c.

Stopping bleeding from wounds on the forearm (shoulder, thigh or lower leg), in the elbow (armpit, inguinal fold or popliteal fossa) put a roller of cotton wool or tightly folded tissue, bend the arm to failure in the elbow joint (or, respectively, in the shoulder, pressing it to the body, and the leg - in the hip or knee joint) and fix it in this position with a bandage, scarf, belt, towel (Fig. 76). You can leave the limb in this position, like a tourniquet, for no more than 2 hours.

This method is not suitable for broken bones or severe bruises.

Rice. 76. Stop bleeding from a wound on the forearm

Bleeding from the nose. When the nose is bruised, and sometimes for no apparent reason, with certain infectious diseases, high blood pressure, anemia, etc., nosebleeds often occur.

First aid. First of all, it is necessary to stop washing the nose, blowing your nose, coughing up blood that enters the nasopharynx, sitting with your head down, etc., since these measures only increase the bleeding. The patient should be seated or laid down with his head raised, his neck and chest should be freed from restrictive clothing, and fresh air should be given access. sick Rice. 77. Stopping the nasal is recommended to breathe through an open mouth. Most but-

bleeding of owl bleeding when the patient is in a calm position

stops. You can put cold (blister or plastic bag with ice, cold lotions) on the bridge of the nose. Stopping the bleeding in most cases helps to compress the nose for 15-20 minutes (Fig. 77), especially after the introduction of a lump of cotton wool into the nostril (you can moisten it with a solution of hydrogen peroxide or a vasoconstrictor, such as a solution of naphthyzinum). If the bleeding does not stop soon, it is necessary to call a doctor or refer the patient to a medical facility.

Bleeding after tooth extraction. After a tooth is removed or after it is damaged (knocked out teeth), bleeding from the dental bed (hole) is possible, especially when the victim sucks blood from the hole, rinses the mouth, and sometimes with insufficient blood clotting. If the bleeding that occurs during the extraction of a tooth does not stop, becomes more abundant or resumes, measures should be taken to stop it.

First aid. It is necessary to make a small roller of sterile cotton wool or gauze, put it between the upper and lower teeth, respectively, to the place of the extracted tooth, after which the patient tightly clenched his teeth. The thickness of the roller should correspond to the gap between the teeth and, when the jaws are closed, will press on the place of bleeding.

Hemoptysis, or pulmonary hemorrhage. In patients with tuberculosis and some other lung diseases, as well as heart defects, sputum with streaks of blood (hemoptysis) is separated, blood is coughed up in a significant amount or profuse (pulmonary) bleeding occurs. Blood in the mouth may also be from the gums or mucous membranes, with vomiting due to gastric bleeding. Pulmonary bleeding is usually not life threatening, but makes a painful impression on the patient and others.

It is necessary to reassure the patient, pointing out the absence of danger to life. Then you should put him in bed with a raised upper body. To facilitate breathing, unfasten or remove squeezing clothing, open the window. The patient is forbidden to speak and drink hot, he should not cough, if possible, they are given cough-soothing medicines from the home medicine cabinet. Place on the patient's chest

an ice pack, to the feet - heating pads or mustard plasters. When thirsty, you should give small sips of cold water or a concentrated solution of table salt (1 tablespoon of salt per 1 glass of water).

A doctor is called for first aid. Only a doctor, having determined the severity of bleeding and the nature of the disease, can dictate further actions.

Hematemesis. With a stomach ulcer, duodenal ulcer and some other diseases of the stomach, as well as with varicose veins of the esophagus, vomiting often occurs with dark clots of the color of coffee grounds, and sometimes with unclotting bright blood. Vomiting blood can be single, a small amount and multiple, profuse, life-threatening patient.

Symptoms. With gastric bleeding, blood is released with vomit. In some cases, blood from the stomach and duodenum enters the intestine and is detected only by the presence of black stools. With heavy bleeding, there are signs of acute anemia: dizziness, weakness, pallor, fainting, weakening and increased heart rate.

First aid. The patient is subject to immediate hospitalization (in the surgical department). Before transportation, the patient needs complete rest, giving a lying position, prohibition of any movements, placing an ice pack on the epigastric region. You should not feed the patient, but you can give teaspoons of cold jelly. Transportation is carried out in a supine position on a stretcher with great care, even if hematemesis has stopped; in case of collapse, measures are taken at the scene until the patient exits a serious condition.

Intestinal bleeding. With ulcers of the intestine and some of its diseases, significant bleeding into the intestinal lumen may occur. It is accompanied by general signs of blood loss, and later - the appearance of black stools.

From the dilated veins of the anus with hemorrhoids and other diseases of the rectum, it is possible with a bowel movement to excrete unchanged or mixed with feces blood. Such bleeding is usually not heavy, but often repeated many times.

First aid. With intestinal bleeding, complete rest, giving a lying position, placing ice on the stomach are necessary. You should not feed the patient, give him laxatives and put enemas.

With significant bleeding from the anus, it is recommended to put an ice pack on the sacral region.

Blood in the urine (hematuria). Damage to the kidney and urinary tract (ruptures), tuberculosis of the kidney and bladder, stones in the urinary tract, tumors and a number of other diseases may be accompanied by the appearance of blood in the urine or its excretion through the urinary tract in significant quantities, sometimes in the form of clots or even pure blood .

First aid. Requires bed rest, ice on the lower abdomen and lumbar region. In view of the fact that blood in the urine is often a sign of a serious illness, the patient is subject, even after stopping the bleeding, to hospitalization for a special examination.

21 Order No. 84

Uterine bleeding. Many diseases of the female genital organs (miscarriages, menstrual irregularities, inflammatory processes, tumors of the uterus) are accompanied by uterine bleeding during menstruation or in between.

First aid. The patient should be given a horizontal position or, even better, raise the foot end of the bed, put an ice pack on the lower abdomen. On the bed you need to put an oilcloth and on top of it - to absorb blood - a towel folded several times. The patient should be given a cold drink. The issue of placement in a hospital (maternity hospital, gynecological department of the hospital) is decided by the doctor. With heavy and prolonged bleeding, referral to the hospital should be urgent.

Internal bleeding during ectopic pregnancy. Life-threatening internal (into the abdominal cavity) bleeding occurs during pregnancy that has developed not in the uterus, but in the fallopian tube, which happens most often after inflammatory diseases of the tubes and abortions. An ectopic pregnancy is complicated by rupture of the tube and bleeding.

Symptoms. Internal bleeding occurs suddenly, at 2-3 months of pregnancy. It is accompanied by scanty bloody discharge from the genital tract, cramping pains in the lower abdomen; dizziness, cold sweat, pallor, rapid breathing, weak pulse, sometimes vomiting and fainting. The presence of pregnancy is confirmed by a preliminary delay in menstruation, pigmentation of the nipples and swelling of the mammary glands.

First aid. The patient should lie with ice on the stomach. It is necessary to ensure the most urgent delivery to the surgical department.

The human body contains many vessels filled with blood. In the life of any person, there has always been a situation when the skin was injured and blood flow occurred. It is important at this moment to provide assistance correctly and in time, because sometimes human life depends on it. And for this you need to know what kind of bleeding happens and its types, because it depends on what your independent actions will be in providing first aid before the ambulance arrives, as well as what first aid for bleeding consists of.

Kinds

What is bleeding in medical terms? Bleeding refers to the release of blood from the walls of injured hematopoietic vessels. This may be due to injury or have another cause. What types of bleeding are there? Bleeding types of bleeding first aid are very interconnected with each other. Separation into different types in bleeding is necessary, since when providing first aid for bleeding, it will be easy to determine the algorithm of actions that any physician clearly knows. This allows you to quickly help with bleeding and minimize blood loss. But a person who is far from medicine must also have an idea about the types of bleeding in order to know the rules of first aid in difficult times and be able to put them into practice, thereby saving the life of his friends, relatives and himself.

What types of bleeding exist:

1. For the correct provision of first aid for bleeding, a table will help, which presents the definitions of injured vessels due to what type of vessel is damaged.

2. In addition, the classification of bleeding includes dividing them according to the place of blood flow and there are:

• internal, when internal organs or vessels are injured, the location of which is inside the body. Signs of bleeding become visible over time, so this blood flow is considered dangerous. First aid for bleeding of this type should be provided as soon as possible. Signs of this bleeding are indirect;
• external bleeding when the skin surface of the body, mucous membranes or soft tissues located near the surface is damaged. Wounds, cuts and other injuries are expressed by the external flow of blood. The strength of the current depends on the damaged vessel. In addition, the external blood flows are divided, in addition to skin, into uterine, pulmonary, gastric, intestinal, urinary system bleeding. In this regard, they are divided into hidden (detected after some time) and explicit. Blood clots can be attributed to the latent external blood flow, as well as to the internal one, if blood is retained inside the human body.

3. The type of bleeding is also classified according to its intensity and happens:

• acute, when a large loss of blood occurs within a short time period. As a rule, this situation is associated with injuries. This leads to anemia;
• chronic, when blood loss occurs in small portions over a long period of time, which gradually causes chronic anemia in a person.

4. From what causes bleeding it happens:

• traumatic;
• pathological;

5. Depending on the intensity of the blood flow, it is classified as follows:

• if the blood loss is up to 0.5 liters, then such a blood flow is called light;
• with an average loss of up to one liter;
• with severe - up to one and a half liters;
• with a massive - up to two and a half liters;
• with fatal - up to three liters;
• Absolutely deadly - up to three and a half liters.

In a child, this figure should not exceed 0.25 liters, otherwise it becomes dangerous for their health.

Symptoms

From which vessel is damaged, the symptoms of bleeding are different.

1. The symptoms of capillary are as follows:

• red blood;
• her losses are small;
• stops flowing.

2. Symptoms of venous blood flow:

• it is dark red, may have a burgundy color;
• characterized by a fast flow in the form of strips;
• if you press down from the injury, then the blood flow decreases;
• poses a danger without providing first aid on time;
• it rarely stops flowing.

3. Symptoms of arterial blood flow:

• she is bright red;
• the peculiarities of this species are that the blood flows in the form of pulsating shocks quickly;
• if you press higher and lower than the injury, the flow continues in the same way;
• very dangerous because of its intensity, it can lead to a state of shock. First aid for them should be provided immediately.

4. Symptoms of internal blood flow:

• a person is drawn to sleep, from being exhausted;
• the stomach starts to hurt;
• blood pressure decreases;
• there is an increase in heart rate;
• the skin takes on a pale shade;
• a person has a painful sensation on the right or left in the cervical region. If he lies down, the pain increases;
• are very insidious due to the fact that they manifest themselves when a large loss of blood has already occurred, and in the initial period it is difficult to detect the flow of blood. A person can suddenly become ill a few days after the onset of the injury.

5. Symptoms of latent blood flows:

• with the appearance of foamy blood of a bright red color, accompanied by a cough, one can suspect the flow of blood in the lungs;
• with gastric blood brown, it happens in the form of clots. At the same time, the person is exhausted, his pulse rate increases, blood pressure decreases, the skin color becomes pale, vomiting begins with a brown blood admixture, black or bloody liquid feces;
• with intestinal in the feces, a change in their color to dark, brown or black is detected;
• if the blood flow occurs in the kidneys or from the urinary system, then the color of the urine changes to red;
• when flowing from the reproductive system, its color is red with pieces of mucus;
• the scarlet color of blood in the form of drops on the feces indicates bleeding in the rectum;
• a person can suddenly become ill a few days after the onset of the injury. Calling emergency care for bleeding in this case is mandatory.

About the reasons

Why is there blood? With different types of causes of bleeding are different. With a traumatic form of bleeding, the causes are as follows:

• thermal effects can cause bleeding;
• mechanical impact. Why is there blood in this situation? For example, fractures, bruises that occur in traffic accidents, during air travel, a fight, this can also include household and work injuries, can cause blood flow.

With a pathological form, the reasons are as follows:

• vascular diseases;
• diseases associated with the coagulation of the circulatory system;
• diseases that can be classified as common. Why is blood flowing? It is related to illness. These include diseases of the endocrine system, for example, diabetes mellitus, diseases associated with a viral infection, and various diseases of internal organs.

Help before doctors arrive

What to do with bleeding, if it happens, how to stop the bleeding at home? What is first aid for bleeding? First aid for bleeding requires speed. Types of bleeding and first aid are interrelated.

The following describes the types of bleeding and how to stop them:

1. If the bleeding looks like a mild capillary, then the first first aid to stop the bleeding at home is as follows:

• treat the affected area with iodine solution, after washing it with clean water;
• ways to stop bleeding are to bandage the damaged area with a pressure gauze bandage, you can use any clean cloth;
• methods to stop bleeding in case of damage to the limb are to raise the injured limb slightly up.

2. How to quickly stop the blood if it is venous bleeding:

• the first first aid in this case will be to apply a tight tight bandage. If the limb is damaged, then it must be raised.

3. How to stop the arterial blood flow:

• you can stop it by applying a bandage, which should compress the wound;
• if a large artery is damaged, methods to stop bleeding in this case are to press the vessels against the bones. As a result, blood stops flowing to the site of injury. But we must remember that these are methods of temporarily stopping bleeding;
• how to stop heavy bleeding, which is possible with this form? Ways to temporarily stop bleeding include the method of applying a tourniquet. It can be any thing like a belt, tie, which is at hand. This method is applicable if there is profuse bleeding in the extremities. At the same time, one must remember and know that it is necessary to apply a tourniquet in a place that is above the injured area, it is tightly knitted into a knot, while for a greater effect of constriction, a stick or something like it is placed under the improvised remedy. This achieves a temporary stop of bleeding. It is necessary to note the exact time of applying the tourniquet and, upon the arrival of the doctors, be sure to tell them or put the sheet with the time of applying the bandage under the tissue;
• ways to stop the flow of blood, consisting in bending the arm or leg at the joint, will help with wounds under the knee or at the elbow. In this case, it is necessary to apply a tight bandage in order to fix the arm or leg. If the femoral artery is damaged, the thigh should be pulled up to the stomach as much as possible and squeezed. Blood will not be able to go in this state;
• if there is severe bleeding and how to stop it if there is nothing at hand? In such a situation, you can be anywhere. First aid here is simply to press down the damaged vessel above the area of ​​injury with your hand, fingers, fist. Thus, the flow of blood is stopped for a short period of time, while you can orient yourself and find another way. If the brachial or femoral artery is injured, then this method is applicable. How to call an ambulance, everyone should know this.

4. With the internal form of the blood flow, you need to know its symptoms:

• the skin has a pale appearance;
• the pulse quickens, it is barely audible;
• lips turn blue;
• the patient complains that he is dizzy, dark before his eyes;
• the patient breathes often and superficially;
• may be fainting;
• the patient is in a retarded state.

How to provide first aid for this type of bleeding? It is impossible to provide first aid for bleeding at home. With this type of bleeding, the treatment will consist of resting and applying cold to the injured area, if it is determined. In such a situation, support for the victim is also important.

In this case, do not forget about such an important matter as calling the doctors of the ambulance.

5. I would especially like to talk about the flow of blood from the nose. How to stop bleeding in this case. Why is there blood? These cases can occur with various ailments, with overheating in the sun, etc. These bleedings in children are not uncommon. It stops like this:

• breathing should be carried out only through the nose;
• swallowing blood is strictly prohibited;
• close the nasal openings for about ten minutes, no more;
• apply cold to the back of the head and nose;
• put cotton swabs into the nasal openings;
• the head, when applying cold and using tampons, should be slightly thrown back, otherwise it is necessary to lean slightly down. There is nothing left but to call PMP if the blood has not stopped within a quarter of an hour.

In contact with

Blood provides organs and tissues with the necessary nutrients, protects them from foreign agents, and removes metabolic end products. The stability of its transport activity contributes to the coordinated work of all body systems. If the integrity of the vascular bed is violated and bleeding occurs, malfunctions in the functioning of organs appear. Massive blood loss (more than 50% of blood volume) poses a serious danger to human life and health, so you need to know the basics of first aid in this situation.

Blood loss occurs as a result of damaging effects on the vascular system of various factors: injuries, diseases of internal organs, disorders of coagulation processes. As a result, bleeding of varying severity occurs. The choice of method of assistance directly depends on the type of blood loss.

Depending on the area of ​​bleeding, it can be:

• outdoor- blood flows from the vascular bed into the external environment. Its outpouring occurs on the surface of the skin from wounds, which are of various types, based on the damaging factor: cut, torn, stabbed, bruised, chopped, gunshot, bitten, crushed;
• internal- when blood flows into the body. The causes of its appearance are strokes, diseases of internal organs (parenchymal bleeding), stab and gunshot wounds, fractures, falls. It can be overt and covert.

The first variant is characterized by bloody discharge from natural openings: ears, nose, vagina, anus, oral cavity, urethra. With a latent form, blood accumulates in a certain cavity (abdominal, pelvic, pleural).

Depending on the type of damaged vessel, bleeding is classified:

• capillary- appears as a result of a superficial wound, deep tissues are not affected, the blood is bright red in color. Blood loss in this case is small, there is a danger of infection entering the affected area;
• venous- occurs with deeper damage. Blood loss can be quite abundant, especially when a large vein is traumatized. This condition can be fatal. The outpouring of blood occurs at a measured pace, continuously, without spouting;
• arterial- the most dangerous type of bleeding, especially when large arteries are injured. Blood loss develops at a rapid pace, often massive, which is a mortal danger. The ejection of blood of a scarlet color occurs in pulsating shocks (gushing), since it is under great pressure in the vessel, moving in the direction from the heart;
• mixed- characteristic of a deep wound, appears when blood loss of various types is combined.

Symptoms

To determine the necessary measures to help the victim, it is sometimes necessary to know the clinical manifestations of blood loss. At outdoor the form of bleeding diagnosis of difficulties does not cause. There are pallor, dizziness, fainting, a feeling of thirst and dryness in the oral cavity, blood pressure drops, the pulse quickens, but its filling is weak, there may be difficulty in breathing, a state of shock.

At internal blood loss evaluation of symptoms is important to confirm the fact of bleeding. In this case, the same symptoms are present as in the external form. However, hemoptysis, respiratory failure (with pulmonary hemorrhage), painful, hard abdomen, coffee-colored vomiting, melena (with blood loss in the abdominal cavity) can be added in addition. The patient's condition deteriorates sharply up to shock and cardiac arrest.

First aid for bleeding

In the event of a situation that threatens a person’s life, in particular with blood loss, you need to know the basics and some of the nuances of first aid. This will save precious minutes before the arrival of doctors, help preserve the health and life of a person.

The table shows general methods for stopping and reducing blood loss in various types of bleeding.

To put into practice these methods of stopping and reducing blood loss, you need to know their detailed technique, take into account some of the nuances and possible consequences.

With capillary bleeding

With minor damage, a regular sterile dressing made from a bandage or napkin is often sufficient. The wound must be washed, treated with an antiseptic agent (iodine, brilliant green, alcohol). A pressure bandage may be applied if blood continues to ooze. At the same time, a sterile napkin with an antiseptic is placed on the wound, tightly bandaged, a cotton roll is applied on top and again tightly fixed with a bandage.

For venous bleeding

With this type of blood loss, the use of a pressure bandage is most justified. Its purpose is to accelerate thrombosis of the vessel, often such a technique is enough to stop blood loss. If it is saturated with blood, it is not necessary to change it, it is necessary to bandage an additional one on top.

ATTENTION! In the absence of means for making a bandage, it is possible to press the wound with your fingers or palm.

Elevation of the limb helps to reduce or stop blood loss.

The mortal danger of such bleeding may lie in the possible occurrence of an air embolism, due to the suction of air bubbles through damage in the venous bed and their entry into the heart.

ATTENTION! It is forbidden to remove blood clots from the wound, this can provoke massive blood loss!

For arterial bleeding

With this type of blood loss, every minute is valuable, so clamping an artery, usually the brachial or femoral, is a priority technique. This is done above the injury site with significant use of force. Pressing is carried out with a finger or palm, fist (in case of damage to large vessels). This method is designed for a short period of time, since it requires a lot of effort, but it makes it possible to prepare a tourniquet and seek medical help during this period.

ATTENTION! If blood loss does not stop when pressing the artery for ten minutes, you should take a break for a few seconds to avoid the formation of a blood clot in the vascular bed!

Flexion of the limbs can help stop bleeding. If the popliteal artery is damaged, it is necessary to bend the leg to the stop at the knee joint, if the femoral artery is damaged, bring the thigh to the stomach as much as possible. The subclavian artery is clamped with the help of arms bent at the elbows, wound behind the back and securely fixed. When the brachial artery is injured, the arm is bent all the way at the elbow joint.

The use of a tourniquet is advisable in extreme situations, with the failure of other methods, since its prolonged use leads to nerve atrophy and tissue necrosis. The tourniquet is stretched and the leg or arm is wrapped several times above the site of the lesion like a bandage, the first wrap (tour) is the tightest that needs to be fixed, the subsequent rounds (3-4) are weaker. It is superimposed exclusively on clothing or any material at hand in order to avoid infringement of tissues. You can make a tourniquet yourself from a rope, belt, twisted fabric (twist). In this case, the arm or leg is tightly bandaged, a stick or other similar objects (pen, spoon) are inserted into the knot, fixed with an additional knot and wrapped several times until the blood loss stops. The correct use of the tourniquet is determined by the pronounced pallor of the limb and the absence of a pulse. Be sure to specify the time of application of the tourniquet.

IMPORTANT! The time of its exposure should not exceed two hours in summer and half an hour in winter (for children - no more than fifty minutes). With a delay, the tourniquet is loosened for a quarter of an hour, using the method of pressing the vessel, then again applied slightly above or below the original location.

For internal bleeding

The main thing in this state is to completely immobilize the patient, giving him a certain pose:

• with blood loss in the chest, in the stomach, with a miscarriage, the patient takes a semi-sitting position;
• with damage to the abdominal cavity, pelvic organs give the legs an elevated position;
• in case of traumatic brain injury, a pose with a slightly raised head is used.

It is forbidden to feed, drink, anesthetize the patient, cold is applied to the affected area, the victim must be covered.

IMPORTANT! It is necessary to monitor the condition of the person and be ready to carry out resuscitation measures! Transportation is carried out in a sitting position!

First aid in special cases

In some cases of bleeding, a special approach to first aid is required, subject to certain rules.

1. It is forbidden to remove anything from the wound on your own, whether it be glass, sand, or a protruding object. This is done exclusively by a doctor. With a protruding object (or part of a bone), it is recommended to apply a bandage near it. Self-removal can provoke increased blood loss.

   

2. When bleeding from the nose, cold is applied to this area, the head is slightly forward. If after a quarter of an hour the blood loss has not stopped, this is a reason to seek medical help.

   

3. With ear bleeding, an examination should be carried out for superficial wounds that can be treated with an antiseptic. If there are no injuries, it is necessary to urgently seek medical help, this may be a symptom of a fracture of the base of the skull.

   

4. In case of damage to the peritoneum (penetrating), assistance is provided in the same way as with internal blood loss. If there are internal organs that have fallen out, they are placed in a bag and bandaged or glued with a plaster. In this case, the intestines must be constantly moistened.

   

5. In case of traumatic amputation, together with measures to stop blood loss, the amputated limb should be placed in a bag, then in another one with cold water or ice. At the same time, you need to keep it on weight.

   

In the event of serious bleeding, you should immediately seek medical help. The danger of blood loss lies in the fact that the deterioration of the condition increases sharply and without the provision of high-quality first aid, the prognosis in most cases is disappointing. Proper and quick application of methods to stop bleeding can save the health and life of the injured person.

Bleeding is the most dangerous post-traumatic complications that threaten the life of the injured person. The degree of possible risk depends on the specific characteristics and location of the damaged vessels.

There is the following classification of types of bleeding:

• capillary bleeding. This type of bleeding occurs when the smallest vessels located in the mucous membranes, muscle tissues, and skin are injured. Signs of bleeding from the capillaries are: dark red blood, bleeding in a small trickle (with superficial cuts) or uniform bleeding over the entire surface of the wound (with abrasions). Capillary bleeding rarely threatens the life and health of the affected person (if there is no hemophilia and problems with blood clotting) and, as a rule, stops on its own.
• Venous bleeding. The main sign of bleeding from the veins is a slow but continuous outflow of blood from the wound. The blood is dark red. In case of significant venous bleeding, in order to prevent the loss of a large amount of blood, it is urgent to clamp the damaged vessel with any available means (you can even use your finger).
• Parenchymal bleeding. Refers to internal bleeding. It is typical for wounds and injuries of the lungs, liver, spleen and other internal organs. With this type, bleeding of various colors is possible (depending on which internal organ is damaged) - dark red and bright scarlet. When blood comes out, it acts evenly over the entire wound surface. The greatest danger is the option when parenchymal bleeding is hidden. The patient runs the risk of losing a lot of blood without waiting for first aid, because. diagnosis of internal bleeding is extremely difficult.
• arterial bleeding. A characteristic sign of bleeding from the arteries is a pulsating jet outflow of blood from the wound, the color of the blood has a bright scarlet hue. This species poses a particular danger to the life of the victim, because. rapidly leads to the onset of complete bleeding of the body. The development of acute anemia in arterial bleeding is accompanied by the following most obvious signs: a drop in heart rate and blood pressure, progressive pallor of the skin and mucous membranes, nausea, vomiting, darkening of the eyes, dizziness, loss of consciousness.
• Mixed (combined) bleeding - occurs with extensive injuries and combines various types of bleeding described in the previous paragraphs.

Treatment of bleeding

First aid measures for bleeding should be started as soon as possible after injury. They consist primarily in stopping bleeding and preventing significant blood loss. If we are talking about arterial bleeding, the necessary measures to stop the bleeding must be taken immediately, because with this type of bleeding, a significant amount of blood flows out of the wound in a short period of time. Rapid and sudden loss of blood (more than two liters) can lead to death of the victim, especially if the bleeding is combined with combined traumatic injuries.

For obvious reasons, first aid for bleeding, as a rule, is performed outside the walls of a medical institution. Therefore, this procedure is temporary, and consists in stopping bleeding for the speedy transportation of an injured person to a medical hospital.

Ways to temporarily stop bleeding:

• Pressure bandage. Used to press the immediate site of bleeding. A sterile gauze bandage is applied to the wound surface (in the absence of a piece of any clean natural tissue) and bandaged tightly (in the absence of material for bandaging, simply press the bandage to the wound with your hand). Applied with capillary, venous and mixed bleeding of moderate intensity.
• With minor bleeding in case of wound injuries of the feet, lower leg, fingers, etc. use the method of giving the injured limb an elevated position. It is good to combine this method with the application of a pressure bandage.
• In the case of arterial bleeding and the need to immediately stop the bleeding (when there is no time to look for suitable means), the method of pressing the bleeding artery with a finger is used. The arteries are pressed at certain anatomical points where they can be pressed tightly against the bones and thereby temporarily stop the bleeding.

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