How long is a tourniquet applied for arterial bleeding. Basic rules for applying a tourniquet for bleeding

Applying a tourniquet for arterial bleeding should be known to everyone. You never know when the knowledge you gain will come in handy. Arterial bleeding is dangerous for the patient's life, if timely assistance is not provided, he will die. This is the most dangerous injury. The blood from the wound is a fountain, it is impossible to confuse it with another type of bleeding.

Rules for applying a tourniquet for arterial bleeding

Even with the right medical care, a patient can die or lose a limb. The blood loss is so great that help is provided in the first 2-3 minutes after the injury. Rules for squeezing and pressing the damaged artery:

• The carotid artery is pressed against the spine - to the transverse processes of the cervical vertebrae.
• The external maxillary artery is pressed against the anterior edge of the masseter muscle.
• The temporal is compressed forward from the upper edge of the ear.
• The subclavian is pressed with fingers to the first rib.
• The brachial artery is compressed along the inner edge of the biceps muscle towards the bone.
• The femoral artery is pressed against the pubic bone with a fist. In thin victims, it can be pressed against the thigh.
• The popliteal is also pressed down with a fist in the middle of the popliteal cavity.

Finger pressure on the arteries is the first step in helping the victim. Next comes the arterial tourniquet application technique. The life of the patient depends on how correctly and quickly the tourniquet is applied. If there is no medical accessory at hand, then use a belt, scarf, rope.

Algorithm of actions for applying an arterial tourniquet:

• A tissue is applied to the wound, but it does not reach the site of bleeding.
• If the limbs are damaged, then they are in an elevated state.
• Places for applying a tourniquet for arterial bleeding depend on the site of injury, but always 2 cm above the wound from which blood is gushing.
• In case of damage to the hands, apply on the upper third of the shoulder. The application of a tourniquet on the shoulder with arterial bleeding is possible only in its upper or lower third, otherwise there is a risk of damage to the radial nerve. If the injury touched the axillary artery, then the technique is the same.
• Applying a tourniquet for bleeding of the femoral artery may require additional measures. If the blood does not stop, then you need to apply an additional tourniquet, higher than the previous one.
• The correct procedure for applying a tourniquet to the carotid artery is to carry out a soft dressing under the gum itself in order to prevent additional injuries. They don't pull tight. This will help to avoid suffocation and oxygen starvation of the brain.

The effectiveness of the tourniquet is determined by the absence of blood flow from the wound. It should stop in a couple of minutes. The maximum time for applying a tourniquet for arterial bleeding is 1.5 hours. During this time, you need to have time to deliver the patient to the hospital. If there is a situation where it is not possible to deliver the victim to a medical facility in 1.5 hours, then the twists are loosened for a few minutes, and then tightened again.

The criteria for the correct application of a tourniquet are not only to stop bleeding. A number of rules to follow during the procedure:

• A note is placed under the tightened elastic band, where you indicate the exact time of assistance and how the injury occurred.
• There should be no clothing at the site of injury. The superimposed gum should be immediately visible. This is so that the medical staff does not look for the cause, but immediately begins to provide assistance.
• If it is winter outside, then the patient is carefully wrapped up, especially the damaged area.

These rules will help to properly provide first aid. You can learn more about which one can be found here.

Danger of bleeding

The first three minutes after injury are important. Help is needed during this period. Since everything happens quickly with arterial bleeding, the body does not have time to turn on defense mechanisms and reserves. Blood is quickly lost, and circulation can be completely cut off, leading to death. It is possible to finally stop the bleeding in a medical facility. Doctors bandage or sew the vessel in the wound. If there is internal bleeding, then the victim needs urgent surgery.

After taking measures to eliminate bleeding, it is important to provide the victim with qualified medical assistance in a timely manner, otherwise, 10 hours after the assistance, a critical moment comes. The patient begins gangrene, he can only be saved by amputation of the damaged limb.

With a significant loss of blood, the patient is given a transfusion from a donor. The volume is up to 1000 cubic centimeters, but a pulsating hematoma can occur as a complication. It requires immediate surgical intervention.

Signs of incorrect tourniquet application

There are a number of common mistakes in the provision of medical care for arterial bleeding. These include:

• The procedure was carried out without indications.
• The rubber is loose. This will cause the blood flow to not stop.
• The rubber is very tight. There may be damage to muscles, fibers, nerves.
• The absence of a note with information about how the injury occurred when first aid was given.
• Masking the injury with clothing or bandages. Doctors need to see the injury right away. That is, the tourniquet should be conspicuous. Wasted time can cost the patient their life.
• Incorrect harness location. You can not install it on a naked body, and also far from work.
• Establishment in the middle third of the shoulder.
• It is impossible to allow the damaged area to freeze in winter.
• During transportation, the limb must be immobilized.

Providing first aid is the most important knowledge not only for doctors, but also for ordinary people. No one ever knows when and what knowledge will suddenly be needed. Bleeding is not only arterial, but also venous. It's worth reading about it here.

In medical institutions, for injuries of the arteries, Esmarch's hemostatic tourniquet is used. But now the 21st century, so a similar device can be purchased at any pharmacy. Such a thing in a home first aid kit may not be useful, but if you suddenly need it, it can save a life. Its price is not so high as to raise doubts about the need for such a thing in a home first aid kit. It is also important to study information on first aid, and it is better to take additional courses that will help you apply knowledge in practice. You need to read about how it is made here.

Conclusion

Any wound can become dangerous. You need to know how to be able to stop blood loss. If an artery is damaged, then there is little time, only 1-3 minutes. How to determine that the bleeding is arterial? The blood is rich scarlet, gushing like a fountain from the wound. In this case, help should be provided immediately. If there is no medical accessory at hand, then a belt, scarf, belt will do. First you need to squeeze the artery with your fingers. Then a tourniquet is placed 1.5-2 cm above the wound. Sterile gauze is applied to the wound. This will help avoid infection.

Be sure to put a note under the gum, which indicates the time of injury, how it was received, and when assistance was provided. The elastic band is superimposed over clothing, it cannot be superimposed on the head of the body.

After the procedure, there is a maximum of two hours to transport the victim to the hospital. If this is not possible, then the critical moment will come in 8-10 hours. During this time, it is necessary to deliver the patient to a medical facility, otherwise gangrene will begin and the limb will be amputated.

It is important to be able to provide first aid for any type of injury. Sometimes it can save someone's life. A medical tourniquet, which can be purchased at a pharmacy, is an indispensable component of a first-aid kit, especially if people go to rest in nature, where there are no doctors nearby.

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Arterial hemorrhage is a dangerous injury that can lead to profuse blood loss in a short time. After damage, bright scarlet blood flows in a gushing stream from the vessel. The degree of hemorrhage depends on the diameter of the artery.

Most often, it is quite difficult to stop, which is why the condition of the victim quickly worsens. Injury can lead to serious complications or even death. To prevent this from happening, it is necessary to correctly determine the signs of arterial bleeding and provide first aid to a person (PMP). This information is important for everyone!

Stop arterial bleeding

With arterial bleeding, first aid should be provided as soon as possible. First of all, you need to call an ambulance and stop the bleeding within 3 minutes.

An arterial hemorrhage can be identified by the following signs:

• A wound or fracture in the area of ​​​​the location of large arteries (the inner surface of the shoulder, forearm, thigh, etc.);
• A stream of bright scarlet blood, which pulsates in accordance with the beats of the heart;
• The pulsation of the vessels that are under the wounded area and the bleeding artery is disturbed;
• The victim is losing a lot of blood, feels weak, dizzy, turns pale, heart rhythm is disturbed, pressure decreases;
• The injured limb becomes cold.

It is important to correctly determine the type of bleeding, so as not to worsen the condition of the victim.

After an injury, a person loses a lot of blood, and the larger the artery, the higher the likelihood of coma and even death. Therefore, you should immediately begin to stop the hemorrhage.

First aid for arterial bleeding point by point:

• Stop the bleeding by clamping the artery over the injury site and call an ambulance. If the wound is on the neck and head, then pressing is carried out under the wound;
• Disinfect the wound and hands to prevent infection. To do this, the edges of the wound surface are wiped with alcohol, before bandaging the wound is covered with a sterile material;
• The injured limb is fixed with a scarf or splint;
• In case of pain shock, the patient is given an analgesic (for example, analgin, tramadol).

After providing first aid for arterial bleeding, the victim is transported to a medical facility or waiting for an ambulance.

Detailed first aid instructions

How to stop arterial bleeding? To stop the flow of blood, you need to pinch the artery with your fingers or fist.

Ways to stop arterial bleeding, depending on the location of the wound:

• If blood flows from the temple, then press the temporal artery to the bone between the eye and ear;
• If the wound is on the cheek, then press the lower jaw artery against the masticatory muscle;
• Bleeding on the face or near the mouth is stopped by pressing the carotid artery on the damaged side. The vessel is pressed with the thumb, and the remaining fingers clasp the muscles at the back of the neck. It is strictly forbidden to squeeze two carotid arteries at the same time, as the victim may lose consciousness;
• Bleeding in the shoulder girdle is stopped by pressing the subclavian artery. The vessel is pressed with the thumb, and the rest grasp the muscles above the collarbone and shoulder blade;

• If blood flows from the shoulder, then the injured limb is raised and the axillary artery is pressed against the head of the shoulder;
• Blood on the forearm is stopped by squeezing the brachial artery from the inside of the shoulder;
• To stop bleeding in the hand, press on the radial, ulnar, or brachial artery;
• When bleeding on the thigh, press on a thick artery in the groin area. To do this, they press the vessel with their thumbs, and the remaining fingers wrap around the leg from the side and back;
• The popliteal artery is squeezed with a fist in the popliteal cavity.

The artery is pressed with ten fingers to the bone for 10 minutes to stop mild bleeding.

Abundant bleeding from large vessels is stopped by bending the limbs. If the wound is located in the area of ​​the wrist or forearm, then a roller is inserted into the armpit, the arm is bent as much as possible and fixed in this position.

If the wound is above the shoulder, then both limbs are brought behind the back, pressed against each other in the area of ​​the humerus and fixed with a bandage. This compresses the artery between the clavicle and the right rib.

To stop the hemorrhage from the lower part of the legs (shin, foot), the roller is placed in the popliteal cavity, the limb is bent as much as possible and fixed. In addition, bleeding can be stopped by bending the leg at the hip joint. In this case, the roller is inserted into the inguinal fold.

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If the blood has stopped, then the victim is transported to a medical facility. But if there is a fracture, then the bending method is not suitable, in which case the damaged vessel is pressed with fingers and a tourniquet is applied.

Tourniquet technique

Already during the squeezing of the vessel, the assistant must provide improvised materials for. To do this, you need cotton wool, a bandage and cotton napkins. A bandage or tissue is applied to the damaged area over the bleeding site (at a distance of 3-10 cm). Before this, the injured limb must be lifted and wrapped with a rubber band 2 or 3 times.

The bandage must be tight to stop bleeding, but excessive pressure is dangerous to the limb. The ends of the tourniquet are tied and secured with a hook or chain.

Applying a tourniquet for arterial bleeding, depending on the site of injury:

• In case of injury to the upper limbs the tourniquet is applied to the upper third of the shoulder. It is strictly forbidden to apply a tight bandage in the middle of the shoulder, as this can damage the radial nerve;
• With severe bleeding from the femoral artery impose 2 tourniquets. In this case, the second bandage is placed slightly above the first;
• If the carotid artery is damaged or other arterial vessels on the face and head, then a soft bandage is placed under the tourniquet, which will protect against additional injury. The tourniquet must not be strongly tightened, as the likelihood of cerebrovascular accident and suffocation increases.

Consider the algorithm of actions for applying an arterial tourniquet. If you put on the bandage correctly, the bleeding stops. A note is placed under the tourniquet, which indicates information about the injury and the time the tourniquet was applied in case of arterial bleeding. The area with the tourniquet must be open so that the medical staff can immediately identify it.

After applying a pressure bandage, the patient is immediately taken to the hospital. If you are transporting a person with damage to a large artery, immobilize him first.

The tourniquet is left on the body for no longer than 1 hour 30 minutes. Otherwise, the likelihood of tissue malnutrition, necrosis and paralysis due to nerve compression increases.

If the bandage cannot be removed from the limb, then it is loosened for a while, and then tightened again. If you apply a tourniquet in the cold season, then do not forget to wrap the damaged area well. It is necessary to know and follow the rules for applying an arterial tourniquet, since the further condition of the patient as a whole depends on this.

Qualified medical assistance

The victim is taken to a medical facility and handed over to the surgeon. The plan of further actions depends on the diameter of the damaged vessel, the general condition of the patient and the nature of the injury.

Options for stopping hemorrhage from an artery todepending on the nature of the injury

• The surgeon sutures the wound in the vessel;
• The doctor bandages the damaged artery. This method is used if the diameter of the vessel is small and there are other sources of blood supply to the damaged area;
• Physicians partially or completely prosthetize the affected area of ​​the artery. The section of the vessel is replaced with a segment from one's own vein or artificial material.

After surgery, the wound is sutured and a drainage system is installed.. To make sure that arterial bleeding has stopped, infusion and restorative treatment is carried out for the "reperfusion syndrome" (resumption of blood flow in the ischemic area).

Danger of arterial hemorrhage

If a person who has bleeding from the arteries is not helped during the first minutes after it starts, then he will die from profuse blood loss. Due to the rapid loss of blood, the body does not have time to include defense mechanisms. The heart feels a lack of blood, as a result, blood circulation stops completely.

Pressing the arteries in the first minutes of injury is quite difficult, because these vessels are thicker than the veins and the blood pressure in them is much stronger. Bleeding is dangerous because even after medical intervention, serious complications can occur.

During treatment, the surgeon ligates the artery in the wound surface, if necessary, applies a vascular suture. Due to changes in the structure of tissues in the damaged area and heavy bleeding, it is not so easy to find a vessel and apply ligatures.

With internal hemorrhage, an urgent operation is performed, since a compressive bandage in this case will be ineffective.

If the victim was not provided with assistance after applying a pressure bandage, then the blood flow is disturbed and the tissues of the limb die off. The lack of blood circulation in the tissues within 8 hours after damage to the vessel becomes critical. As a result, gangrene develops. In this case, the injured limb is amputated.

Arterial hemorrhage is a dangerous injury that requires urgent and qualified assistance.

It is important in the first minutes of a hemorrhage to stop the blood by finger pressing or bending and correctly apply a tourniquet to the damaged area in case of arterial bleeding, and in the absence of first aid, a person may lose a limb or die from blood loss. It is for this reason that everyone should know the basic rules for stopping arterial hemorrhage.

Instruction

Choose an improvised material for applying a tourniquet. They can serve as gauze, bandage, piece of cloth, cord. It is also advisable to have a pencil, pen or tree branch to secure the tourniquet in place.

Determine if the artery is really damaged. This can be seen in blood. Venous blood has a rich dark red color with a hint of blue. Arterial blood, on the contrary, is bright scarlet. This is due to the specific concentration of oxygen and carbon dioxide in each type of blood. Also, the type of bleeding can be determined by its intensity. Blood will flow much more strongly from an artery than from a vein. Therefore, bleeding must be stopped with a tourniquet.

Apply a tourniquet. To do this, tighten the strip of fabric or cord so that the pulse stops below it. This will mean that the bleeding will soon stop. You can tie the cord in a knot or wind its end around at measures, on a pencil, and secure it. It will be easier at the need to relieve pressure.

Remember, or better yet, write down the exact time the tourniquet was applied. It should not be left for too long, otherwise it is a serious problem with the part of the body in which the blood flow. In summer and in heat, the tourniquet can be kept for one to two hours, and for no more than half an hour. During this time, you need to deliver the victim to the hospital for qualified medical care. As a last resort, if there is still no doctor nearby, you need to loosen the tourniquet, allow the blood flow to recover and, if blood continues to flow from the wound, tighten it back. However, it is extremely undesirable to repeat such an action more than once.

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A tourniquet is a device for stopping blood. It is a rubber band 125 cm long. Its width is 2.5 cm, thickness is 3 - 4 cm. One end of the ribbon is equipped with a hook, the other with a metal chain.

How to properly apply a tourniquet?

When applying a tourniquet, rubber gloves are first put on the hands. Then the limb affected by the injury is lifted and examined. The tourniquet is applied not on the naked body, but on top of the fabric lining. It can be a person's clothes, a towel, a bandage, cotton wool. A medical tourniquet applied in this way will not cross and will not injure the skin. Its end must be taken in one hand, and the middle in the other. Then stretch harder, and only after that circle around the arms or legs. With each subsequent turn of the winding, the bundle stretches less. The loose ends are knotted or secured with a hook and chain. Under any one turn of the tape, a note is necessarily enclosed, which indicates the time of its imposition.

A tourniquet should not be left on for more than two hours, otherwise paralysis or necrosis of the arm or leg may occur. Every hour in the warm season and half an hour in winter, the tourniquet relaxes for several minutes (at this time, the vessel is pressed with fingers), the application of the tourniquet for bleeding is done in the same way as for the first time, only a little higher. If the bleeding does not stop, then the tourniquet is applied incorrectly. Their veins could have been accidentally pulled. This will lead to the fact that the pressure in the vessels will begin to rise and bleeding will increase. With an excessively tightened tourniquet, muscles, nerves, and tissues can be damaged, which leads to paralysis of the limbs. The victim with a tourniquet applied is transported to a medical facility in the first place.

The tourniquet can be applied using a plywood tire. It is placed on the opposite side of the damaged vessel. This method has a beneficial effect. If the upper third of the thigh or shoulder is injured, a medical tourniquet is applied as a figure eight during bleeding.

A tourniquet is applied to the damaged vessels of the neck using a plank of wood or a tire in the form of a ladder. These devices are placed on the opposite side of the wound. Due to the tire, the trachea and carotid artery will not be squeezed. If there is no tire at hand, you need to put your hand on the back of your head, it will play its role. A tourniquet can be replaced with a twist, using improvised material for this: handkerchiefs, scarves, belts, ties.

Application

A hemostatic tourniquet, if necessary, is applied to the thigh, lower leg, shoulder, forearm and other parts of the body. If the place of its application is the limbs, choose a place so that it is higher than the wound, but closer to it. This is necessary so that the portion of the limb remaining without blood circulation is as short as possible.

When applying a tourniquet, remember that it must not be applied:

• On the area of ​​​​the upper third of the shoulder (it is possible to injure the radial nerve) and the lower third of the thigh (tissue is injured when the femoral artery is clamped).
• There are no muscles in the lower third of the forearm and lower leg, and if a tourniquet is applied to these places, skin necrosis may begin to develop. These areas of the body are shaped like cones, so the tourniquet can slip off when the victim is moved. It is easier, more convenient and more reliable to put the tape on the shoulder or thigh.

arterial bleeding. First aid before the doctor arrives

Loss of blood through an artery is often the cause of death of the victim, so it must be stopped quickly. In the body of an adult, the volume of blood is 4-5 liters. If the victim loses one-third of this volume, he may die. The first thing to do when treating arterial bleeding is to compress the artery so that blood does not enter the wounded area and does not flow out. To determine the place where it is located, you need to feel the pulse. Where he is, there is an artery. Confidently press this place with your fingers, but 2-3 centimeters above the wound.

If the victim needs to be transported, the application of a tourniquet for arterial bleeding is mandatory. Only this must be done correctly, as described above in the article. But if, as a result of a traffic accident, a person has lost his leg, and blood flows from the wound, the application of an arterial tourniquet must be done so that it is 5 centimeters higher than the damaged area, and not 2-3. Under no circumstances should it be weakened. Not everyone has a tourniquet handy. It can be replaced with a twist. But in no case should you use narrow ropes, cords made of inelastic material.

When the first aid is provided to the victim, it must be remembered that when a tourniquet is applied, the blood supply to all departments that are below it is stopped. It is necessary to know that the movement of blood through the arteries is carried out from the heart to all peripheral parts.

Venous bleeding. First aid

If, upon examination of the victim, it turned out that the damage to the vein is insignificant, it is enough to press the vessel with your finger below the damaged area, since this blood moves from bottom to top, and not vice versa. If this is not enough, a pressure bandage should be applied to the site of injury to stop the blood flowing from the vein. This is the first aid.

But first, the skin around the injury site is treated with iodine, the wound is closed with a sterile bandage, and a sealing roller is applied from above, along the location of the bones. Now the site of the injury must be tightly bandaged, and the injured limb should be given an elevated position. The pressure bandage is applied correctly if the bleeding stops and there are no blood stains on it. In the case when such assistance is not enough to stop the bleeding, venous tourniquets are applied, only below, and not above, the site of the vessel lesion. You just need to know that the flow of venous blood occurs in the opposite direction, that is, towards the heart.

In a hospital, first aid for arterial and venous bleeding is carried out surgically. At the site of damage to the vessel, its walls are sutured.

Car first aid kit. Her equipment

Many people believe that this kit is only needed to pass the inspection. But this is far from true. No one knows what the situation may be along the route of the car. Perhaps your humane attitude towards another person, knowledge of the rules for providing first aid to the victim and the necessary set of a motorist will save someone's life.

Currently, the first-aid kit of the automobile is produced according to new standards. It consists of: an apparatus with which you can make artificial ventilation of the lungs, bandages, a hemostatic tourniquet, rubber gloves and scissors. Disinfectants and all medicines are excluded from the first-aid kit. It does not contain analgin, aspirin, activated charcoal, validol, nitroglycerin, and even iodine with brilliant green. The complete set of the first-aid kit automobile became much poorer. What caused it to change? First of all, the European practice of providing first aid before the arrival of doctors. They believe that most drivers in Russia do not know how to use the necessary drugs. Therefore, for them, calling a doctor and stopping the blood loss of the victims will be the main task.

Depending on the type of damaged vessel:
View	What does it look like?	Characteristic
arterial bleeding		The color is bright scarlet. Blood flows out in a pulsating stream, quickly, under pressure. High rate of blood loss.
Venous bleeding		Cherry blood. Constant, uniform flow of blood without pulsations. The rate of bleeding is less than with arterial.
capillary bleeding		It occurs as a result of damage to capillaries, small veins and arteries. The wound surface bleeds. Bleeding is not as severe as with arterial or venous bleeding.
Parenchymal bleeding		Occurs due to damage to internal organs, such as: liver, spleen, lungs, kidneys. Similar to capillary bleeding, but poses a greater health risk.
Depending on the cause that led to the release of blood from the vascular bed:
1. Haemorrhagia per rhexin		Bleeding as a result of mechanical damage to the vessel wall. The most frequent.
2. Haemorrhagia per diabrosin		Bleeding due to ulceration or destruction of the vascular wall in pathological processes (inflammatory processes, tumor decay, peritonitis, etc.).
3. Haemorrhagiaperdiapedesin		Bleeding as a result of a violation of the permeability of the vascular wall. An increase in wall permeability is more common in the following conditions: a decrease in vitamin C in the body, hemorrhagic vasculitis, scarlet fever, uremia, sepsis, etc.
In relation to the external environment
external bleeding		Blood flows out of the wound into the external environment.
internal bleeding		Blood is poured into the internal cavities of the body, into the lumen of hollow organs, and tissues. Such bleeding is divided into obvious and hidden. Explicit: blood, even in an altered form, but after a certain time appears outside Example: stomach bleeding - vomiting or feces with blood (melena); Hidden: blood is poured into various cavities and is not visible to the eye (into the chest cavity, into the joint cavity, etc.).
By time of occurrence
Primary bleeding		Bleeding occurs immediately at the time of injury when the vessel is damaged.
Secondary bleeding		Allocate: early and late bleeding. Early arising from several hours to 4-5 days after damage. Causes: slippage of the thread from the vessel applied during the primary operation, washing out of the thrombus from the vessel with an increase in pressure, acceleration of blood flow or a decrease in vessel tone. Late ones occur 4-5 days or more after the injury. This is usually associated with the destruction of the vascular wall as a result of the development of infection in the wound.
With the flow
Acute bleeding		The outflow of blood occurs in a short period of time.
Chronic bleeding		The outflow of blood occurs gradually, in small portions.
By severity
Light		The volume of blood loss is 500-700 ml;
Medium		Loss of 1000-1400 ml;
heavy		Loss of 1.5-2 liters;
Massive blood loss		Loss of more than 2000 ml; A one-time blood loss of about 3-4 liters is regarded as incompatible with life.

General symptoms of bleeding

• The skin is pale, moist;
• fast heartbeat (tachycardia);
• Decreased blood pressure.

• general weakness and malaise, anxiety,
• dizziness, especially when lifting the head,
• "flies" before the eyes, "darkening" in the eyes,
• nausea,
• feeling short of breath.

• direct outflow of blood from a damaged vessel.

• Gastrointestinal bleeding: vomiting of blood that has not been altered or altered ("coffee grounds"); discoloration of feces, black stools (melena).
• Pulmonary haemorrhage: hemoptysis or foaming blood from the mouth and nose.
• Bleeding from kidneys: scarlet color of urine.
• Accumulation of blood in cavities (thoracic, abdominal, joint cavity, etc.). With bleeding into the abdominal cavity, the stomach is swollen, the motor activity of the digestive tract is reduced, pain is possible. With the accumulation of blood in the chest cavity, breathing weakens, the motor activity of the chest is reduced. When bleeding into the joint cavity, there is an increase in its volume, severe pain, dysfunction.

First aid for bleeding

1. Pressing the artery
2. Fixing a limb in a certain position
3. Elevated position of the limb
4. pressure bandage
5. Tamponade of the wound
6. Clamp on the vessel

A tourniquet for bleeding

Harness types:

Harness name	What does it look like?
Bandage tape rubber (langenbeck's tourniquet)
Esmarch's tourniquet
Dosed compression tourniquet
Harness NIISI RKKA
Atraumatic tourniquet "Alpha"

• arterial bleeding,
• Any massive bleeding in limbs.

Harness rules:

• Before applying the tourniquet, it is necessary to elevate the limb;
• It is impossible to apply a tourniquet on a bare limb, it is necessary to substitute a cloth (towel, clothes).
• If possible, a tourniquet should be applied as close as possible to the wound, from the side of the blood flow;
• When setting the tourniquet, 2-3 tours are performed, evenly stretching the tourniquet, so that the tours do not lie one on top of the other, the tourniquet should press the vessel to the bone protrusion;
• In case of bleeding from the wrist area, a tourniquet is applied to the shoulder;
• After setting the tourniquet, be sure to indicate the exact time of its setting (hour and minutes);
• The part of the body where the tourniquet is placed must be accessible for inspection. This is necessary to observe the changes that can occur in the absence of blood supply;
• The victim, to whom a tourniquet has been applied, must be transported to a medical facility and treated there in the first place;
• The tourniquet should be removed gradually, gradually loosening it, after performing anesthesia;
• The tourniquet should be held for no more than 2 hours on the lower extremities and no more than 1.5 hours on the upper ones, with the condition that every 30-40 minutes the tourniquet will be loosened for 20-30 seconds. In the cold season, the tourniquet holding time is reduced to 40-60 minutes on the lower extremities and 30-40 minutes on the upper ones. Low temperatures impair circulation in tissues, especially in the extremities, this is due to reflex vasoconstriction under the influence of cold. During long-term transportation of the victim, they burn every 30-40 minutes, regardless of the external temperature, should be removed for 20-30 seconds until the skin below the tourniquet turns pink. This can be done for several hours, the time originally recorded in the note should not be changed. This technique allows you to avoid irreversible processes in the tissues of the limb. Temporary delivery of blood to tissues will help maintain their viability.
• If, after applying the tourniquet, the limb abruptly begins to swell and turn blue, the tourniquet should be immediately removed and reapplied. At the same time, controlling the disappearance of the pulse below the application of the tourniquet.

1. The upper third of the shoulder is the place of application of the tourniquet in case of bleeding from the vessels of the upper limb, the tourniquet is applied. In case of bleeding from the vessels of the lower limb, a tourniquet is applied in the middle third of the thigh.
2. A towel or clothing of the victim should be placed under the tourniquet so as not to pinch the skin and the pressure on the vessels was uniform.
3. The limb is lifted, a tourniquet is brought under it, stretching it as much as possible. Then wrap around the limb several times. Tours should lie next to each other while not infringing on the skin. The first round is the tightest, the second is applied with less tension, the next with a minimum. The ends of the tourniquet are fixed on top of all tours. The tissues should be compressed until the bleeding stops, no more, no less. It is important to make sure that there is no pulse in the arteries below the applied tourniquet. If the disappearance of the pulse is incomplete, after 10-15 minutes the limb will swell and turn blue.
4. Apply a sterile dressing to the wound.
5. Attach a piece of paper with the exact time of applying the tourniquet (hour and minute).
6. Fix the limb using a transport splint, bandage, scarf or other available means.

The method of applying a tourniquet on the neck
In emergency situations, the application of a tourniquet to the vessels of the neck is vital and can save a life. However, the setting of the tourniquet on the vessels of the neck has some features.
The tourniquet is applied in such a way as to press the vessels only on one side of the neck and not press on the other. To do this, on the opposite side of the bleeding, use Kramer's wire splint or other improvised means, or use the victim's hand wound behind the head. This keeps blood flow to and from the brain.

Setting technique: a tissue roller is applied to the bleeding wound (a sterile bandage is better, if not, improvised means can be used). The roller is pressed with a tourniquet, then wrapped around the arm or the tire. Pulse stop monitoring is not required. You can keep the tourniquet around your neck for as long as you need.

Criteria for a correctly applied tourniquet:

• Bleeding from the damaged vessel has stopped;
• The pulse on the limb below the tourniquet is not palpable;
• The limb is pale and cold.

• A tourniquet should not be applied to the upper third of the thigh and the middle third of the shoulder, this can lead to serious damage to the nerve trunks and be ineffective in stopping bleeding.
• The wrong type of bleeding is determined, and setting a tourniquet only increases it (for example: venous bleeding);
• The tourniquet is not tightened enough or large vessels are not pressed against the bone protrusions;
• Excessive tightening of the tourniquet can cause severe damage to soft tissues (muscles, blood vessels, nerves), which can lead to paralysis of the limb.
• Exceeding the time limit for applying a tourniquet can subsequently lead to the loss of a limb;
• Putting a tourniquet on a bare leg. There is no sufficient pressing of the vessels, the skin under the tourniquet is injured.
• Apply a tourniquet away from the wound. However, with an unspecified source of bleeding in an emergency, applying a tourniquet as high as possible from the wound is a vital action. Since bleeding from the femoral artery within 2-3 minutes leads to death, therefore there is no time for long discussions and the application of a tourniquet at the base of the leg, just below the inguinal ligament, will be the best option.

Finger artery pressure

• arterial bleeding

The main pressure points of the arteries

1. Pressing the temporal artery, 2 cm up and anterior to the ear canal.
2. Pressing of the maxillary artery, 2 cm anterior to the angle of the mandible.
3. Pressing the carotid artery, the middle of the edge of the sternocleidomastoid muscle (upper edge of the thyroid cartilage).
4. Pressing the brachial artery, the inner edge of the biceps.
5. Pressing the axillary artery, the anterior border of hair growth in the armpit.
6. Compression of the femoral artery, middle of the inguinal ligament.
7. Pressing the popliteal artery, the top of the popliteal fossa.
8. Pressing the abdominal aorta, the umbilical region (pressing is done with a fist).

Fixation of a limb in a certain position

• In case of bleeding from the subclavian artery, the bent arms at the elbows are pulled back as much as possible and tightly fixed at the level of the elbow joints (Fig. b).
• In case of bleeding from the popliteal artery, the leg is fixed with maximum flexion in the knee joint (Figure D).
• When bleeding from the femoral artery, the thigh is brought to the abdomen as much as possible (Fig. e).
• When bleeding from the brachial artery, the arm is maximally bent at the elbow joint (Fig. D).

Elevated position of the limb

pressure bandage

• Moderate venous or capillary bleeding
• Bleeding from varicose veins of the lower extremities

Tamponade of the wound

• Capillary and venous bleeding from small vessels in the presence of a wound cavity.
• Often used in surgeries.

Technique:
The wound cavity is filled tightly with a swab, which is left for a while. The method allows you to buy time and prepare for a more adequate method of stopping bleeding.

Circular tug of limb

Clamping on a vessel

How to stop arterial, venous bleeding?

1. Take self-protection measures for people who care for a bleeding victim. It is necessary to wear rubber gloves, avoid getting blood on the mucous membranes and skin, especially if they are damaged. This is the prevention of various infectious diseases (viral hepatitis, HIV, etc.).
2. If the bleeding is massive, be sure to call an ambulance or take the victim to a medical facility on your own, after temporarily stopping the bleeding.
3. Stop bleeding using the methods listed above, depending on the type and location of the bleeding.
4. To prevent the development of acute anemia and to carry out the first therapeutic measures when it occurs:

capillary bleeding

Venous bleeding

arterial bleeding

For a person providing assistance, this method requires great physical strength and patience. However, the method helps to gain time for setting up a more reliable method - tourniquet. The artery is usually pressed with the thumb, palm, fist. The femoral and brachial arteries are most easily pressed.

And so, the methods used to temporarily stop arterial bleeding are as follows:

1) finger pressing of the vessel in the wound;
2) pressing the artery throughout;
3) tight tamponade;
4) application of a tourniquet;
5) circular tug-of-war
6) hemostatic clamp.

How to stop bleeding from the femoral artery?

• Signs of bleeding from the femoral artery: bleeding from a wound on the leg, in which a pool of blood increases to 1 m in a matter of seconds.
• Immediately press the arteries below the inguinal ligament with a fist, then press with a hard object (for example: a roll of a bandage), through which a tourniquet is applied to the thigh. Attach a note with the time of setting the bandage. Do not remove the tourniquet before the arrival of medical workers, even if their arrival is delayed.
• Bleeding from the femoral artery for more than 2-3 minutes leads to death.

Harness rules:

1. Before applying the tourniquet, elevate the limb.

2. The tourniquet is applied proximal to the wound, as close to it as possible.

3. Place a piece of cloth (clothing) under the tourniquet.

4. When applying a tourniquet, 2-3 rounds are made, evenly stretching it, and the tours should not lie one on top of the other.

5. After applying the tourniquet, be sure to indicate the exact time of its application.

6. The part of the body where the tourniquet is applied must be accessible for inspection.

7. Tourniquet casualties are transported and treated first.

8. Remove the tourniquet by gradually loosening it, with preliminary anesthesia.

The criteria for a correctly applied tourniquet are:

Termination of peripheral pulsation.

Pale and cold extremity.

It is extremely important that the tourniquet cannot be kept for more than 2 hours on the lower extremities and 1.5 hours on the upper ones. Otherwise, it is possible to develop necrosis on the limb due to its prolonged ischemia.

If it is necessary to transport the victim for a long time, the tourniquet is dissolved every hour for about a minute, replacing this method with another temporary way to stop bleeding (finger pressure).

Harness rules

The following signs are characteristic of arterial bleeding: pulsation during hemorrhage and the scarlet color of the blood. With venous bleeding, when the blood is poured out without pulsations and has a dark color, the application of a tourniquet is unacceptable! In this case, other methods of stopping bleeding are used - the maximum bend of the limb, pressure bandage, tamponade, etc.

Arterial bleeding is dangerous because of the rapid loss of blood. Blood loss of more than 500 ml for an adult is already a serious threat to life, especially when the loss occurs simultaneously, as in arterial bleeding.

The most effective way to stop arterial bleeding in case of damage to the limb is the application of a tourniquet. When applying a tourniquet, several rules should be impeccably followed, non-observance of which can lead to serious consequences, from amputation of the injured limb to the death of the victim.

The tourniquet is used only to stop arterial bleeding and only on the limbs!

The tourniquet is applied at the upper border of the wound 5 cm higher.

Do not apply a tourniquet directly to the skin, be sure to put a tissue under the tourniquet. Otherwise, serious damage to the skin occurs at the site of the tourniquet.

The tourniquet must not be bandaged, the tourniquet must be visible.

On the body of the victim, in two prominent places, write down clearly and legibly, and do not remember or say, the time the tourniquet was applied. Inserting pieces of paper is highly undesirable - they get lost, get wet, etc. during transportation.

The tourniquet is applied on the upper limbs up to 1.5 hours, on the lower ones up to 2 hours. In cold weather, the duration of the application of the tourniquet is reduced by 30 minutes. After the time has elapsed, remove the tourniquet for 15 seconds. Further overlay time is reduced by 2 times from the initial one. Compliance with this regime is strictly necessary. A longer application of the tourniquet threatens the development of gangrene and subsequent amputation of the limb.

When a tourniquet is applied, the patient experiences a strong pain sensation. The victim will try to loosen the tourniquet - you need to be prepared for this.

Signs of the correct application of the tourniquet: there should be no pulsation below the wound! The fingers on the limbs become white and cold.

The preservation of the pulsation below the point of application of the tourniquet, even if the bleeding is stopped, also threatens with further negative consequences for the victim.

On the forearm and on the lower leg, the tourniquet may not be effective due to the radius bones, therefore, in this case, if the first attempt is unsuccessful, the tourniquet can be applied in the lower third of the shoulder or in the lower third of the thigh.

Finger pressing of the arteries for bleeding

Submitted by admin on Sun, 23/05/:36

Finger pressure on the artery is performed in all cases of head and neck injuries if the bleeding cannot be stopped with a pressure bandage. The convenience of digital pressure on the arteries lies in the speed of this method of temporarily stopping bleeding. The main disadvantage of this method is the fact that the person providing assistance cannot move away from the victim to provide assistance to other wounded.

With proper pressure on the artery, bleeding from it should stop.

Rice. 1. Finger pressure of the artery during bleeding.

1 - pressing the radial and radial arteries when the palm is injured;

2 - pressing the temporal artery;

3 - pressing the external maxillary artery;

4 - pressing the carotid artery;

5 - pressing the brachial artery.

When bleeding from the temporal artery, the latter is pressed with two or three fingers at the level of the auricle, in front of it at a distance of 1-2 cm.

With arterial bleeding from the lower half of the face, the thumb of the external-maxillary artery is pressed at a point located between the chin and the angle of the lower jaw, somewhat closer to the latter.

With severe arterial bleeding from the upper half of the neck, the carotid artery is pressed. To do this, a person presses on the front surface of the neck of the wounded with the thumb of his hand on the side of his larynx, clasping the lateral and back surfaces of his neck with the rest of his fingers.

If the person is behind the wounded, then pressing the carotid artery is done by pressing on the front surface of the neck on the side of the larynx with four fingers, while the thumb wraps around the back of the victim's neck.

In order to stop arterial bleeding in high shoulder injuries, the axillary artery is pressed against the head of the humerus. To do this, put one hand on the shoulder joint of the victim and, holding the joint in a stationary state, with four fingers of the other hand, forcefully press on the armpit of the wounded along the line, closer to the front border of the cavity (the line of the front border of armpit hair growth, according to N. And Pirogov).

Rice. 2. Arteries and places of their pressing during bleeding.

1 - temporal artery;

2 - external maxillary artery;

3 - carotid artery;

4 - subclavian artery;

5 - axillary artery;

6 - brachial artery;

7 - radial artery;

9 - palmar artery;

10 - iliac artery;

11 - femoral artery;

12 - popliteal artery;

13 - anterior tibial artery;

14 - posterior tibial artery;

15 - artery of the foot.

In case of injuries of the shoulder, forearm and hand, finger pressing of the brachial artery is performed to stop arterial bleeding. To do this, a person, standing facing the wounded man, clasps his shoulder with his hand so that the thumb is located at the inner edge of the biceps muscle of the shoulder. When pressed with the thumb in this position, the brachial artery will inevitably be pressed against the humerus. If the caregiver is behind the victim, then he puts four fingers of his hand on the inner edge of the biceps muscle of the shoulder, and with his thumb wraps around the back and outer surface of the shoulder; while pressing the artery is produced by the pressure of four fingers.

4 - right common carotid;

5 - left common carotid;

12 - posterior tibial;

13 - artery of the rear of the foot.

With arterial bleeding from the vessels of the lower limb, digital pressing of the femoral artery is performed in the inguinal region to the pelvic bones. To this end, the nurse must press the thumbs of both hands on the inguinal region of the victim, somewhat closer to the inner edge, where the pulsation of the femoral artery is clearly felt.

Pressing the femoral artery requires considerable force, so it is also recommended to perform it with four fingers of one hand folded together while pressing on them with the other hand.

Hemostatic tourniquet. Technique of imposing a hemostatic tourniquet on a limb

A tourniquet is a device for stopping blood. It is a rubber band 125 cm long. Its width is 2.5 cm, thickness - cm. One end of the tape is equipped with a hook, the other with a metal chain. This simple device is in the first aid kit of every car for a reason. Sometimes his absence can be fatal. A person as a result of a large loss of blood can die without waiting for medical help.

How to properly apply a tourniquet?

When applying a tourniquet, rubber gloves are first put on the hands. Then the limb affected by the injury is lifted and examined. The tourniquet is applied not on the naked body, but on top of the fabric lining. It can be a person's clothes, a towel, a bandage, cotton wool. A medical tourniquet applied in this way will not cross and will not injure the skin.

Its end must be taken in one hand, and the middle in the other. Then stretch harder, and only after that circle around the arms or legs. With each subsequent turn of the winding, the bundle stretches less. The loose ends are knotted or secured with a hook and chain. Under any one turn of the tape, a note is necessarily enclosed, which indicates the time of its imposition.

Example: struck a knife on the finger

if blood continues to ooze, then we apply another bandage and press it harder

do not remove the already soaked bandage

arterial bleeding. Blood flows out in a strong pulsating stream, its color is bright red (scarlet).

What are the stopping methods?

To stop bleeding, use:

Rules for applying bandages and a tourniquet for bleeding

Capillary bleeding is not a serious

danger to the health of the victim, since the loss of blood in this case

small. It can be easily stopped by applying a pressure bandage, previously

smearing the skin around the wound with iodine and covering it with several layers of Sterile gauze

or a bandage. If there is no bandage or gauze at hand, then you can use

clean handkerchief.

When injured, the Gsiovs press the temporal (1). occipital (2),

Bleeding or wounds on the arm are stopped by pressing

In case of damage to the vessels of the legs, a fast artery is taken into

groin (10) or mid-thigh (]]), popliteal (]2), dorsalis pedis

(13) or back more tibial

The coils should lie close to each other so that folds of clothing do not fall between them. The ends of the tourniquet are securely fixed (tied or fastened with a chain and a hook). A properly tightened harness should bring it to a stop.

A note must be attached to the tourniquet indicating the time for applying the tourniquet, no more than 1.5-2 hours, and in the cold season no more than 1 hour.

- the victim has several wounds, and there is only one rescuer (for example, a simultaneous wound of an arm and leg).

1. The victim should be in such a position that the wound is above the level of the heart (if the arm is wounded, raise it; if the leg is wounded, lay the victim on his back and raise the injured leg; if the body is wounded, lay it so that the injured side is on top).

2. To stop any bleeding, the wound must be pressed!

3. A tourniquet is applied above the site of bleeding;

4. The time of applying the tourniquet is strictly fixed (recorded);

Circular tug of limb

For twisting, use a special tourniquet or rubber tube, belt, piece of cloth, scarf. The object used for twisting is loosely tied at the desired level. A plank, stick, etc. is inserted into the formed loop. Then, by rotating the inserted object, the loop is twisted until the bleeding stops completely. After that, a plank or stick is fixed to the limb. The procedure is painful, so it is better to put something under the spin knot. When twisting the dangers, the procedures and complications are similar to those when applying a tourniquet.

Clamping on a vessel

The method is indicated to stop bleeding during surgery. The Billroth clamp is used as a hemostatic forceps. Vessel clamp is used briefly to prepare for the final method of stopping bleeding, more often ligation of the vessel.

How to stop arterial, venous bleeding?

1. Take self-protection measures for people who care for a bleeding victim. It is necessary to wear rubber gloves, avoid getting blood on the mucous membranes and skin, especially if they are damaged. This is the prevention of various infectious diseases (viral hepatitis, HIV, etc.).
2. If the bleeding is massive, be sure to call an ambulance or take the victim to a medical facility on your own, after temporarily stopping the bleeding.
3. Stop bleeding using the methods listed above, depending on the type and location of the bleeding.
4. To prevent the development of acute anemia and to carry out the first therapeutic measures when it occurs:

For this, the following is required. Give the victim a horizontal position. In case of massive blood loss, fainting of the victim should be laid so that the head is lower than the body. Raise the upper and lower limbs, thereby increasing the flow to vital organs (brain, lungs, kidneys, etc.). With preserved consciousness and no damage to the abdominal organs, you can give the victim tea, mineral or ordinary water to drink, and help replenish fluid loss from the body.

When a tourniquet is applied, there is no stoppage of bleeding as such, only its delay occurs. Only professional doctors in stationary conditions can really stop arterial bleeding.

Therefore, after applying the tourniquet, urgent transportation of the victim to a medical facility is required.

• .ISBN64-0 General Surgery: A textbook for universities. - 2nd edition. - 2004. - 768 p. - Petrov S.V.

First aid for a closed fracture of the forearm

Injuries of the upper extremity in frequency occupy the first place among all other injuries. Humeral fractures are divided into fractures of the proximal and distal ends, as well as the shaft of the shoulder. In turn, fractures of the proximal and distal ends of the humerus are divided into intra-articular and extra-articular.

WHAT TO DO WITH A WOUND

Do not smear the wound yourself with anything, no brilliant green or iodine.

washed with peroxide, no gauze napkins (

• The cut is carefully examined to determine how severe the injury is.
• After examination, the wound is well washed with running water. If it is not possible to do this, you can use bottled water, which is sold in every kiosk.
• To prevent the spread of infection in the wound, you should not touch it with your hands. If necessary, you can wash the cut with soapy foam, which should be washed off immediately after treating the wound. Do not use laundry soap. For this purpose, children's is better suited.
• Next, you need to blot the wound with a bandage. If it is not at hand, you can use any clean cloth, including a handkerchief.

Why You Shouldn't Drink Water When You're Wounded

Wounds in the abdomen are divided into open and closed. First aid methods for such abdominal injuries have fundamental differences.

to the lessons of life safety on the topic "Wounds"

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First aid for arterial bleeding

Bleeding is a severe traumatic injury. Among all its types, arterial is considered the most dangerous. After all, untimely or incorrectly provided first aid for arterial bleeding can result in unpleasant consequences for the patient, including death.

There is an opinion that knowledge, as well as practical skills in first aid, should be owned only by medical workers, because this is their direct responsibility. In fact, the duty of every person is to know and be able to apply elementary medical skills in practice. After all, one day it can help save a human life.

Distinctive signs of arterial bleeding

The classification of bleeding implies its division into three main types:

With extensive traumatic injuries, mixed bleeding can be observed, for example, venous and arterial. In addition, any bleeding with respect to where the blood is poured is divided into internal (in the body cavity) and external (into the external environment). First aid for internal bleeding, as well as its diagnosis itself, is carried out exclusively by medical staff. External bleeding is easier to diagnose and can be treated by anyone.

Arterial bleeding occurs due to damage to the arterial trunks - vessels that carry oxygenated blood from the heart cavities to all body tissues. Venous bleeding develops when the integrity of the veins that collect blood saturated with carbon dioxide and carry it to the heart is disrupted. Capillary bleeding occurs due to traumatization of capillaries - small vessels that are directly involved in tissue gas exchange.

External differences in the types of bleeding

With arterial bleeding, the color of the outflowing blood is bright red or scarlet, in contrast to venous bleeding, in which the blood is dark red and it comes out slowly. In the case of arterial injury, blood is released rapidly in a gushing stream. The jet of blood at the same time pulsates, each portion of it comes out synchronously with the pulse and heartbeat. This is due to the high pressure in the arterial vessels that come directly from the heart.

With arterial bleeding, if help is not provided in time, the phenomena of hemorrhagic shock quickly increase - a pathological condition due to significant blood loss. It has these symptoms:

• drop in blood pressure;
• increased heart rate;
• pallor and marbling of the skin;
• cyanosis of the extremities;
• respiratory disorders;
• decrease in diuresis;
• severe weakness;
• dizziness;
• cold extremities;
• loss of consciousness.

First aid

The most important role in emergency care for bleeding of arterial origin is played by the time factor: for maximum effectiveness, it should be provided no later than 2-3 minutes from the moment of injury. If the matter concerns the main arterial trunks, then it is necessary to stop bleeding from them no later than 1-2 minutes after the injury. Otherwise, the chances of a successful outcome will decrease every second with every milliliter of blood lost.

The algorithm for stopping any arterial bleeding is as follows:

1. Assessment of the type of bleeding.
2. Finger pressure on an artery that is damaged.
3. Applying a tourniquet, applying maximum limb flexion or pressure bandage.
4. The imposition of an aseptic bandage on the wound.

This sequence of actions may vary slightly depending on the characteristics of the damaged anatomical region.

Methods to stop bleeding are temporary and definitive. Temporary arrest of arterial bleeding is used at the stage of first medical and medical care. The final one is carried out in a hospital and is part of the hospital stage of care. It is worth noting that in some cases, temporary stop measures are enough to completely stop the bleeding.

Finger pressure

This technique should be used as a starting point in helping the wounded. The basic principles of digital compression depend on the anatomical region in which the artery is damaged. The general rule is to press the vessel above the site of injury. But if bleeding occurs in the neck or head area, then the vessels are pinched downward from the wound. This is because the arteries in this area go up from the heart.

Attention! Applying any methods to stop bleeding, you need to raise the affected limb up to reduce blood flow to it.

Damaged arterial vessels must be pressed against the bony prominences, as they can slip out, and then the bleeding will resume.

Pressure points for arteries during bleeding

To better remember the method, you can use the 3D mnemonic rule:

It means that you need to press the artery by pressing ten fingers of both hands for 10 minutes, after which it is recommended to check if the bleeding has stopped. If it is stopped, and this happens if it is not the main arterial vessel that is damaged, then you can limit yourself to applying a pressure aseptic bandage to the wound.

Since the blood pressure in the arteries is very high, it will take a lot of effort to press the vessel and stop the bleeding. Finger pressure is a method of temporarily stopping bleeding, so while one person is pressing the artery, the second should already be looking for a tourniquet and dressing. Time should not be wasted in removing clothing or freeing limbs from it. In parallel, one of the eyewitnesses should immediately call an ambulance to provide first aid and transport the victim to a hospital.

The biggest disadvantages of the finger pressure technique are:

• significant pain for the injured;
• physical fatigue of the one who provides emergency assistance.

The speed of execution is considered the most important advantage of temporarily stopping external arterial bleeding using finger pressure.

Maximum fixed limb flexion

In some cases, you can use the maximum flexion of the limbs as a method of temporarily stopping the bleeding from the artery. It should be performed, making sure that the victim does not have a fracture of the injured limb.

A dense roller should be placed in the place of the bend of the limb (popliteal, ulnar and inguinal regions) to compress the damaged artery at maximum flexion

After inserting the roller, the bent arm or leg is fixed to the patient's torso. Such actions are aimed at a temporary cessation of bleeding, and if they are ineffective, one should prepare for the imposition of an arterial tourniquet. The same technique, even when performed correctly, has questionable effectiveness.

Applying a tourniquet for arterial bleeding

Stopping bleeding from an artery by applying a tourniquet refers to a temporary method of stopping bleeding. The task of everyone who helps the victim is to correctly perform the tourniquet technique and ensure the delivery of the wounded to a medical facility.

A tourniquet should be applied only with severe arterial bleeding. In all other cases, you should try to stop the bleeding with digital compression or a pressure bandage. A pressure bandage is made with arterial bleeding from a whole roll of a sterile bandage, which is tightly fixed to the wound surface.

If the rules for applying a tourniquet are violated, sad consequences may occur: necrosis, gangrene, damage to the nerve trunks

This is especially true of the shoulder region, because the radial nerve is located superficially there. A tourniquet is applied to the middle third of the shoulder only as a last resort. It is better to choose a place higher or lower. One of the available tools can be used as a tourniquet: a wide rope, belt or scarf.

So how to apply a tourniquet for arterial bleeding, so as not to harm the patient in the future? By remembering a few basic rules, you can avoid a lot of mistakes.

The harness overlay algorithm looks like this:

1. Choose a place for applying a tourniquet. It is located above the injury site, but as close as possible to it (the optimal distance is 2-3 cm). We should not forget about injuries to the neck and head - there a tourniquet is used below the wound. In case of damage, the femoral artery is clamped at the level of the middle third of the thigh, and in case of bleeding from the arm, in the upper or lower third of the shoulder.
2. Wrap the selected area with a cloth, gauze or bandage.
3. The limb must be in an elevated position.
4. The tourniquet is stretched and several turns are made around the limb. At the same time, its first turn is done with more, and all subsequent ones - with less effort. In case of damage to large arterial trunks, for example, the femoral artery, it makes sense to apply two tourniquets - one above, the other below.
5. Its ends are tied into a knot or fixed with a special chain or hook.
6. The correct application of the tourniquet is checked: the pulsation of the injured artery below the damage is not palpable, and the bleeding from the wound stops.
7. The exact time the tourniquet was applied is recorded. This can be done on a piece of paper that is inserted under the tourniquet itself, directly on the patient's body near the site of injury or on clothing.
8. An aseptic bandage is applied to the wound.

In case of injuries of the carotid artery, the tourniquet is applied below the injury, while it should not pinch the artery of the same name on the other side. To do this, a tight roller is applied on the side of the injury, while the tourniquet is fixed on the opposite side through the raised arm of the patient and the attached flat board.

Correct application of a tourniquet according to Mikulich in case of injury to the carotid artery

The tourniquet should not be applied too tight, as properly applying a tourniquet means applying minimal pressure to stop bleeding. In this case, the blood supply should be carried out at the expense of the deep arteries and veins, and in no case should it completely stop.

If the tourniquet is applied too tightly, it can lead to necrosis of the limb, followed by amputation.

The time factor is also important here. The maximum tourniquet application time varies depending on the ambient temperature:

If a longer time interval is required to transport the victim to the nearest hospital, the tourniquet is temporarily removed, switching to a 10-minute finger pressure. Then again you need to apply a tourniquet according to the above rules.

Twist-twist

In the absence of a special tourniquet, you can use an impromptu twist tourniquet. To form it, you need to take a wide ribbon, scarf or piece of fabric and wrap it around the limb above the wound. The fabric is then tied with a double knot. A small stick is inserted into the gap between the resulting nodes and twisted with rotational movements until the bleeding stops.

Rope and wire cannot be used for twisting.

The stick is fixed with a rope above the place of application of the tourniquet to the limb also with double knots. A note is inserted under the tourniquet indicating the exact time the twist was applied.

Thus, due to the direct threat to life that occurs with arterial bleeding, you need to act very quickly. Briefly described first aid rules will help not to panic, and in an extreme situation, save someone's life.

How to apply a tourniquet for arterial bleeding?

Before you apply a tourniquet for arterial bleeding, you should remember an important rule - the tourniquet is always applied above the site of damage to the artery. This is done due to the anatomical features of the blood supply to the limb, which occurs from the center to the periphery. Therefore, it is advisable to stop the blood flow in the area that is closer to the center, that is, above the injury site. It must be remembered that in addition to stopping bleeding, there is a violation or complete cessation of blood flow in the peripheral part of the limb.

Now you can proceed directly to the application of the tourniquet. First, you need to raise the injured limb in order to cause the outflow of venous blood. It is strictly forbidden to apply a tourniquet directly to human skin - this can cause damage to it. It is necessary to put a thin, but dense matter under the tourniquet, or simply lower the edge of the clothes. Then, Esmarch's tourniquet is stretched and a very tight first tour around the limb is performed. Subsequent rounds are performed with less tension, but it should still be present. Tours must not be crossed, as a fold of skin can be pinched between them.

In order to verify the correct application of the tourniquet, there are three mandatory conditions that must be met: bleeding from the wound must stop; Pulsation of the peripheral artery below the tourniquet should be absent; the skin below the tourniquet should be ivory. If all these signs are present, then the tourniquet is applied correctly, and the first medical aid is provided with high quality. Without fail, a note is attached to the imposed tourniquet with the exact indication of the time of its application. A note is needed to accurately determine the duration of the stay of the tourniquet on the limb.

It is important to remember that the tourniquet should be applied for no more than 2 hours, because after this time, without blood flow, the tissues begin to die. Therefore, if for some reason the transportation of the victim to the hospital is delayed, the tourniquet is removed for a minute to normalize blood flow, stopping the bleeding by pressing the artery with a finger. Then, a tourniquet is applied again according to all the rules, above or below the previous place of application, again for a period of no more than 2 hours. In the cold season, the time of arrival of the tourniquet on the limbs is reduced to 1.5 hours, since in cold weather the process of tissue necrosis develops faster than in warm weather and this should not be neglected.

If, when assisting with an injury, the Esmarch tourniquet was not at hand, you can use a home-made twist tourniquet. To do this, a dense cloth fabric is folded in the form of a strip, and tightly tied to the limbs, above the site of bleeding, and the free ends are tied together so that a loop is formed. A stick is inserted into this loop and twisted with rotational movements until the bleeding stops. One who has mastered the skill of applying a tourniquet will never remain unarmed in a situation where only his knowledge and skills can stop the bleeding and save someone's life.

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Correct application of a tourniquet for arterial bleeding

Correct application of a tourniquet for arterial bleeding will save the life of a person who has received a serious injury. It will be useful for each person to know how to properly apply a tourniquet.

Arterial bleeding is one of the most dangerous types of bleeding. Blood from the damaged artery flows in a fountain or strong stream, pulsing in the rhythm of the beating of the heart muscle. The blood flowing through the arteries is bright red. Arterial bleeding is extremely dangerous, so if the blood is not stopped quickly, the person will die. Arterial bleeding can cause complications and limb amputation if first aid is not provided correctly or too late.

With this type of bleeding, first aid should be provided quickly. It is important to remember that due to blood pressure, an injured person can lose consciousness or even fall into a coma.

There is no way to waste time, the people around the injured person have a couple of minutes to apply a tourniquet to the wound and begin to provide first aid. First of all, with the help of the fingers, try to close the place of the rupture of the artery, thereby temporarily stopping the fountain of blood. Experts recommend considering the following rules for each individual type of artery:

1. 1. If the carotid artery is damaged, it is pressed against the transverse vertebral processes on the neck.
2. 2. If the jaw artery is damaged, then it must be pressed against the jaw muscle.
3. 3. The artery of the temporal region should be pressed slightly, in front of the edge of the auricle from above.
4. 4. Subclavian arterial blood loss is stopped by the pressing action of the fist on the outer edges of the clavicle from the back side towards the rib.
5. 5. The brachial artery should be pressed against the inside of the bone muscle.
6. 6. The artery on the thigh must be pressed against the pubic bone.
7. 7. The artery under the knee joint should be pressed against the middle of the patella.

It is clear that remembering these rules is not so easy. In the event of an unforeseen emergency, few people will be able to apply them in practice. But even if you just read the rules, then there is already a high probability that they will pop up in your memory when a person in trouble needs help.

After pressing the artery, it is necessary to apply a rubber tourniquet. A medical tourniquet made of rubber can be replaced with a belt, rope, rag weave. To prevent infection from getting into the injured place, a sterile bandage should be applied to the wound. If there is no fracture of the limb, then fixation of the artery can be done by bending the injured arm or leg. The limb must be bent, in this state, bandaged with a bandage or other clean suitable material.

It is important to work together when providing first aid. While one person is applying a tourniquet, the second should prepare cotton wool, gauze, bandage, a clean non-synthetic cloth, a roller. A tourniquet is applied only when the lower or upper limbs are injured. When the wound is on the carotid artery, a splint should be placed on the back of the neck. If there is no tire, then you can put the hand of the injured person. Thanks to the tire or the hand of the victim, the carotid artery should be transferred directly to the site of injury.

Next, a roller must be applied to the place below the injury, and a tourniquet must be applied through the splint or arm. Do not apply a tourniquet to a bare wound. Be sure to put a gasket under the harness. It should not have a crease, should be soft, not synthetic, cotton is best.

The injured limb should be elevated. The tourniquet should be twisted as close as possible to the injured area. It is superimposed above the wound. If it is a hand, then it is necessary to impose in the shoulder area. In no case should a tourniquet be applied in the middle of the shoulder, since the radial nerve passes there.

If bleeding of the lower limb occurs, then it is better to apply the tourniquet on the upper third of the thigh. The very first turn of the tourniquet should be tightening, all the rest are done exclusively for fixation. It is impossible to prevent pinching of the skin. In order to choose what the tension of the tourniquet should be, it is necessary to feel the pulse below the wound, if it is absent, the tension is normal.

When the tourniquet has been properly applied, the affected person should receive pain medication. It can be analgin or other strong medication. In the event that the artery is severely damaged, the person must be immobilized. The tourniquet should not be hidden under clothing, it should be visible. If a person was injured in autumn or winter, then the injury site must be insulated to avoid frostbite of the limb.

It is important to remember that in the cold season, the tourniquet can be on the limb for no more than half an hour. If it is warm outside, then the tourniquet should be removed no later than an hour later. A note can be inserted into the tourniquet, on which the time the tourniquet will be applied will be written. If the victim does not have time to be delivered to the hospital, and it is already dangerous to hold the tourniquet, then the following actions should be taken:

1. 1. It is necessary to press the artery in the area above the applied tourniquet.
2. 2. The tourniquet must be loosened for half an hour. This will restore blood circulation.
3. 3. As soon as 30 minutes have passed, the tourniquet must be applied again, but the place should be slightly higher or lower than the previous one.

The procedure is repeated again, if necessary, the main thing is to perform all actions according to the rules. It is important to deliver the victim to the hospital as quickly as possible, not to miss time.

After the tourniquet is applied, the injured person must be transported as quickly as possible to the nearest medical facility. Only a professional team of doctors will be able to provide the injured person with qualified medical care. If the doctor's help is not provided within a maximum of 10 hours after the tourniquet is applied, then this can cause catastrophic consequences. Up to death.

Tragic consequences can be the most terrible, for example, tissue may die, which will lead to amputation of a limb. As a result of gangrene, the limb is removed slightly above the place it touched. If the victim has lost a lot of blood, then he must be given a blood transfusion and other medical measures to provide emergency medical care.

In addition to bleeding from an artery, there are cases of blood loss from a vein. Blood in this case flows out in a stream, has the color of ripe cherries.

It is important to know that if blood is lost from a vein, the bandage must be applied a few centimeters below the injury area.

Any bleeding poses a danger to human life, so the people around the victim must react quickly in an extraordinary situation for them. The main thing is not to panic, but responsibly perform the tourniquet in accordance with the rules.

In case of injury, the place of tissue rupture is very painful, therefore, after applying a tourniquet, the injured person must definitely be given an analgesic. Today, there are many inexpensive medicines on sale that are highly effective and non-toxic.

An excellent remedy is Diclofenac. The drug is produced both in tablet form and in injections. In case of tissue injuries, in no case should you use anesthetic ointments, gels for topical application. The well-known analgin also anesthetizes well. Of the tablet medicines, Ketorol, Nise, Ibuprofen, Ketanov and others will help well.

It is important to study the instructions and make sure that the drug does not thin the blood and increase bleeding.

Before giving an affected person this or that drug, you should ask the victim if he has any allergies to medications. With the right approach, you can save a person's life, most importantly, never remain indifferent to someone else's misfortune, you should always remember that none of us is immune from an accident, when emergency help from surrounding strangers may also be required, but at the same time not indifferent people.

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