First aid for internal bleeding. First aid for bleeding of various types Help with severe bleeding

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 stopped completely. 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 bleeding in most cases is facilitated by compression of the nose for 15-20 minutes (Fig. 77), especially after a lump of cotton wool is introduced into the nostril (you can moisten it with a solution of hydrogen peroxide or a vasoconstrictor, for example, 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 uncurled 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 intestinal ulcers and some of its diseases, significant bleeding into the intestinal lumen may occur. It is accompanied by general signs of blood loss, and later - the appearance of black stools.

From the dilated veins of the 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 mild, 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 the bleeding has stopped, to hospitalization for a special examination.

21 Order No. 84

Uterine bleeding. Many diseases of the female genital organs (miscarriages, menstrual disorders, 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.

First aid for heavy external bleeding can reduce the risk of complications and death. With intense blood loss, you should immediately call an ambulance. Before the arrival of doctors, the bleeding should be stopped. In this case, you should know what to do and what is strictly prohibited.

Despite the fact that you can only temporarily stop the bleeding on your own, the life and health of a person can depend on the correctness of first aid.

What can cause external bleeding?

Depending on the area of ​​damage, venous, arterial and capillary bleeding is distinguished. But they all have almost the same causes. All provoking factors are divided into pathological and mechanical.

External bleeding can occur due to the following reasons:

1. Mechanical damage to veins, arteries, capillaries and soft tissues. Injury to the walls of blood vessels can occur under the influence of high temperatures (thermal), as a result of a fracture, bruise and injury (mechanical). External bleeding is most often observed in traffic accidents, falls from a height, fights using piercing and cutting objects, gunshot wounds, and plane crashes. There are also domestic and industrial injuries, the consequence of which may be external bleeding.
2. Vascular pathologies. These include neoplasms of a different nature of the course, purulent lesions of soft tissues,.
3. Diseases characterized by a violation of the process. These can be diseases such as hemophilia, cirrhosis, hepatitis, fibrinogen deficiency.
4. General diseases. The causes of external bleeding can be such diseases as type 1 or 2 diabetes, infectious and viral lesions, sepsis, vitamin deficiency, food poisoning, heavy metals, drugs
5. Diseases of the internal organs. External bleeding can occur against the background of hemorrhoids, tumors, cracks, ulcers, polyps, inflammation of various types, tuberculosis.

There are a lot of causes of external bleeding, but most often hemorrhage is observed with mechanical damage to the walls of blood vessels.

What symptoms does it manifest?

Clinical manifestations of bleeding are divided into local and general. The first group of symptoms include:

• Feeling short of breath.
• Weakness.
• Drowsiness.
• Thirst.
• and severe dizziness.

External signs of external bleeding are also quite pronounced. The victim has pallor of the skin, cold sweat appears, the heartbeat quickens, but the pulse is poorly palpable.Also, the victim may lose consciousness against the background of severe pain and great blood loss.

In some cases, the process of urination is disturbed, the level of blood pressure decreases.

Local symptoms are also intense. The main symptom is the presence of a wound on the surface of the skin or mucous membrane.

But the nature of the hemorrhage depends on the type of vessel that was damaged:

• With capillary bleeding, the blood first collects in large drops and exits from the entire surface of the wound. The color of the blood is always red and its loss is not high enough.
• Venous bleeding is dangerous because the blood comes out of the wound quickly enough and in large portions, which can cause fainting. With significant blood loss, death is possible. Venous blood is dark red or burgundy in color. In some cases, it comes out intermittently, depending on the frequency of breathing.
• Arterial bleeding can be established by the way the blood flows out in pulsating shocks, the rhythm and frequency of which depends on the pulse and heartbeat. Arterial blood has a bright red color. For a certain unit of time, blood loss is fast and voluminous.

For more information on how to help with bleeding, see the video:

Help with arterial bleeding

In cases where arterial external bleeding is observed, assistance to the victim should be provided immediately. But at home, in the absence of a specialist, it is not always possible to stop the blood as accurately as possible.

The place where damage is observed must be lifted and a tight bandage applied 5-10 centimeters higher from the wound. You need to use an elastic bandage. Be sure to indicate the time of applying the bandage. To do this, you can write it on paper and put it between the sections of the bandage.

First aid for venous bleeding

Venous bleeding is quite difficult to stop, due to a strong loss of blood. The wound at the same time has sufficient depth. First of all, the injured person must apply a pressure bandage to the injury site. However, it should not be tight or too loose.

Within 10 minutes, you need to observe the site of damage. With a weak dressing, the blood may begin to flow more intensely. If this happens, the bandage needs to be tightened a little.

In the event that a limb is injured, a pressure bandage should be applied slightly higher, to the level of the heart muscle. This will help slow down the bleeding a little.Apply a cold compress to the wound for 40 minutes. For this, a cold heating pad or ice wrapped in a cloth is suitable. As it warms up, it should be replaced.

The pressure bandage must be applied correctly. First of all, you should not try to wash the wound or remove various particles from it. In the case when the pollution is strong enough, you need to quickly wipe the skin around the damage with a damp cloth and treat it with an antiseptic solution with outward movements. Then the pressure bandage is applied according to the following algorithm:

1. Place a sterile bandage folded several times or a napkin in the wound area. In their absence, you can use any material previously impregnated with an antiseptic solution.
2. Fix the napkin with several layers of bandage.
3. The third layer is made from a dense roll of fabric. You can use cotton. It puts pressure on the wound and does not allow blood to flow out in large quantities. The roller is fixed with several layers of bandage.
4. In cases where the bandage is quickly saturated with blood, it should not be changed. On top of it you need to apply a few more layers of bandage.

In order to achieve maximum effect, you should lift the injured limb up so that it is above the level of the heart muscle.

Help with capillary bleeding

Capillary bleeding, unlike venous and arterial, is not so dangerous. First aid also consists in stopping the hemorrhage. This should:

• First of all, treat the injury site with an antiseptic and bandage the wound.
• The bandage should not be tightened too tightly, as the area of ​​\u200b\u200bthe skin may turn blue.
• In order to stop the hemorrhage as quickly as possible, you need to apply cold to the injury site. But you should be aware that the use of plain ice can cause infection.

What can not be done with bleeding?

First aid, especially for venous and arterial bleeding, must be provided correctly. Even a minor mistake can lead to serious consequences, including death.

With external bleeding, regardless of its type, it is strictly prohibited:

1. Remove large objects from the wound. This can lead to additional damage to blood vessels and soft tissues, resulting in increased bleeding.
2. Use antiseptic solutions, such as brilliant green and iodine, to treat the surface of the wound. Their use leads to severe burns of already damaged tissues.
3. Remove blood clots and blood clots from the wound. Thus, the body itself tries to stop the bleeding. Their removal can lead to increased hemorrhage and large blood loss.
4. Touch the wound with your hands. This should not be done, even if the hands are washed and treated with an antiseptic.
5. Remove the pressure bandage that is soaked with blood. A few more layers of bandage should be applied. Only a doctor in a hospital can change the bandage.
6. Use a tourniquet when not needed. It needs to be applied correctly. With the help of a tourniquet, veins and arteries are pulled in case of severe damage, when it is impossible to stop the blood with a pressure bandage.
7. Apply a tourniquet under clothing or cover it with a bandage. Upon arrival, the doctors may not immediately notice him. The tourniquet should be removed 2 hours after application. That is why it is imperative to indicate the time when it was installed.
8. If internal bleeding is suspected, the victim should not be fed or watered. There is also no need to give painkillers.

After the blood has stopped, it is urgent to call an ambulance, since every minute of delay can cost a person life.

When is a doctor needed?

When external bleeding occurs, it is not always possible to consult a doctor. If there is no violation of blood clotting and capillary hemorrhage was stopped on its own, you can do without medical help.

You should urgently consult a doctor in the following cases:

• Excessive bleeding that cannot be stopped on its own.
• The victim lost consciousness.
• Significant injury.
• Suspicion of fracture and internal bleeding.
• Weak pulse.
• There is a stoppage of breathing or heartbeat.

An ambulance must be called for heavy venous or arterial bleeding, as they are considered a fairly serious injury.

But in any case, even if the blood was stopped on its own, it is recommended to contact a medical institution for help. Specialists will properly treat the wound, apply a bandage, and, if necessary, provide additional assistance, which will help reduce the risk of complications.

External bleeding, especially in cases where arteries and veins are damaged, can be dangerous to life and health. It is important to properly provide first aid to the victim and inform the ambulance. You also need to carefully follow all the steps, as improper assistance can lead to serious consequences. Every minute of delay can cost a person a life.

When bleeding, the rate of blood loss can be dangerous, so in many cases you need to act quickly. First aid measures depend on the type of bleeding, its location, the nature of the injury, and some other factors. In the article we will talk about ways to deal with in different situations.

Types of bleeding

There is also parenchymal bleeding that cannot be seen. It occurs when the integrity of the liver, pancreas, kidneys is violated. The nature of parenchymal bleeding is similar to capillary, but is a great danger to life. With deep penetrating wounds or violation of the integrity of internal organs, bleeding can be mixed.

In the direction of the blood outlet, internal and external bleeding is also distinguished. In the first case, blood accumulates in the cavities of the body, in the second, it comes out through.

Harness rules

A tourniquet is applied only to stop arterial bleeding, and also if an arm or leg has been amputated as a result of an injury. In other cases, the use of a tourniquet is impractical due to the high degree of injury to the skin and soft tissues. To temporarily stop bleeding, you can use Esmarch's tourniquet or improvised rubber material.

Basic rules and sequence for applying a tourniquet:

1. If possible, raise the arm or leg for a few seconds and fix it in a comfortable position - this will lead to the outflow of venous blood.
2. The tourniquet is superimposed over clothing or a piece of fabric is placed under it. This is necessary to protect the skin.
3. The first two turns must be made as tight as possible, it is they who stop the blood, while the crosshair is superimposed on the back of the artery.
4. The maximum duration of applying a tourniquet in the warm season should not exceed 90 minutes, in the cold - 60 minutes. If during this time the victim cannot be taken to the hospital, the tourniquet must be loosened for 10-15 minutes, and the artery should be pinched with a finger. Then the tourniquet is applied again, 1-2 cm above or below the previous place. The duration of the tourniquet for children should not exceed an hour.
5. The time of application of the tourniquet must be recorded and attached to a conspicuous place. In reality, due to problems with compiling (search for paper and pens in field or combat conditions, while there are more urgent tasks to save the life of the victim) and preservation (paper soaks in blood and spreads or is simply lost) notes, in modern In practice, it is customary to write the time of applying the tourniquet with a marker directly in a prominent place on the body, for example, it can be the forehead, it is recommended to indicate the name of the rescuer or the person who made the tourniquet.

Indications:

• traumatic amputation of a limb;
• inability to stop bleeding by other known means.

Advantages:

• fast enough and the most effective way to stop bleeding from the arteries of the limb.

Flaws:

• the use of a tourniquet leads to complete bleeding of the distal extremities due to compression of not only damaged great vessels, but also collaterals, which can lead to gangrene for more than 2 hours;
• nerve trunks are compressed, which is the cause of post-traumatic plexitis with subsequent pain and orthopedic syndrome;
• cessation of blood circulation in the limb reduces the resistance of infection tissues and reduces their regenerative abilities;
• the use of a tourniquet can cause severe angiospasm and lead to thrombosis of the operated artery;
• restoration of blood circulation after the application of the tourniquet contributes to the development of tourniquet shock and acute renal failure;
• the use of a tourniquet is not possible on the trunk or is limited in anatomically difficult areas.

Errors:

• its use without indications, that is, with venous and capillary bleeding;
• overlay on the naked body;
• away from the wound;
• weak or excessive tightening;
• poor fixing of the ends of the tourniquet;
• absence of a cover note;
• use for more than 2 hours;
• closing the tourniquet with a bandage or clothing.

A tourniquet is applied in case of severe bleeding on the upper third of the shoulder or the middle third of the thigh. In these areas, the anatomical location of the humerus and femur allows you to stop the blood with maximum efficiency. Applying a tourniquet in other places will not give the desired result. If the limb is torn off, the application of a tourniquet is mandatory even in the absence of bleeding.

If the tourniquet is applied correctly, characteristic signs will appear after a while. The limb below the site of application will turn pale and become cold, bleeding will stop, and the peripheral pulse will not be palpable. The junction of the tourniquet should be located on the outside of the arm or leg, since the artery is located on the axillary side.

First aid

For arterial bleeding

When an artery is damaged, bleeding is rapid, so you can not hesitate. Having briefly assessed the condition of the victim, measures must be taken to temporarily stop the bleeding. First, the artery is pinched with a finger, for this, certain points are used:

1. For bleeding in the face area, press the corner of the lower jaw with your thumb.
2. In case of bleeding from the head, press on the area of ​​the temporal bone in front of the ear.
3. In case of arterial bleeding in the area of ​​the shoulder joint, press the subclavian artery against the rib.
4. If the hand is damaged, press the brachial artery against the bone from the side of the shoulder.
5. If the integrity of the femoral artery is broken, press the fist on the pubic bone in the groin area.

First aid for arterial bleeding

After finger pressing, a tourniquet is applied in compliance with the rules described above. If there is no tourniquet and similar material at hand, you can apply a twist. To do this, use a piece of twine or fabric. A loop is made of the material and applied to the desired area of ​​\u200b\u200bthe limb. A metal or wooden rod is inserted into the loop, with which the bandage is twisted. Further actions are the same as when stopping bleeding with a tourniquet.

For venous bleeding

In most cases, bleeding from a vein is easier to stop than from an artery, so neither a tourniquet nor a twist is practically used.

The algorithm for providing first aid is as follows:

1. The wound is closed with several layers of bandage, napkins or any clean piece of cloth.
2. Sterile cotton wool is placed on top.
3. Tightly fix everything with a bandage, scarf or piece of fabric of the desired width.

To consolidate the effect, the injured limb is raised so that it is higher than the body and fixed. If it is not possible to apply a bandage, the wound is tamponed with a tightly twisted bandage. Sometimes this is enough to stop the bleeding.

If the vein is bleeding heavily, a pressure bandage may be useless. In this case, you need to apply a tourniquet, and attach an ice pack to the wound. After that, the victim must be taken to the nearest hospital.

With capillary bleeding

In most cases, capillary bleeding does not pose a threat to the life of the victim and, if the first aid measures were correct, does not cause complications.

To stop bleeding with external bleeding, you must adhere to the following sequence:

1. Treat the area of ​​\u200b\u200bthe skin with any antiseptic.
2. Apply a napkin and fix it with a bandage;
3. If the limb is damaged, raise it relative to the body.

With various injuries or diseases, nosebleeds can begin. It occurs in case of damage to the blood vessels located in the mucous membrane, it can stop on its own, but in severe cases, first aid will be required.

First of all, you need to press the wing of the nose to the nasal septum. With minor damage to blood vessels, the blood should stop after 10 minutes. If this does not happen, a nasal tamponade is done. With nosebleeds, you need to monitor the well-being of the victim and warn him that you need to breathe through your mouth.

First aid for types of bleeding

For internal bleeding

It is quite difficult to detect internal bleeding. Symptoms largely depend on the type of damage and its location, most often there is a rapid pulse (up to 140 / min), a decrease in blood pressure and pallor of the skin.

First aid for internal bleeding is as follows:

1. Help the person lie down in a certain position.
2. Restrict movement.
3. Monitor physiological indicators - pulse, respiration, pressure.

If internal bleeding is suspected, the victim should be taken to a medical facility as soon as possible.

If there is a suspicion that the bleeding is localized in the chest or stomach, the victim should be provided with a “reclining” position, if localized in the abdominal or pelvic cavity, raise the legs up.

Sources:

• Zavyalov V.N., Gogolev M.I., Mordvinov V.S. "Health education of students" 1988.
• D. V. Marchenko - "First aid for injuries and accidents" 2009.
• General surgery: textbook / Petrov S.V. - 3rd ed., revised. and additional – 2010.

Bleeding is divided into traumatic and non-traumatic. The cause of traumatic bleeding is mechanical damage to the vessel, accompanied by a rupture of its wall.
Non-traumatic bleeding is not preceded by mechanical trauma to the vessel. This type of bleeding develops as a result of various diseases and pathological conditions (such as tumor processes, chronic and acute inflammatory diseases, blood diseases, beriberi, atherosclerosis, etc.). The blood volume of an adult is 5 liters. Loss of 2 liters of blood is almost always fatal.

Clinical manifestations of massive blood loss

With blood loss of more than 200 ml, the general well-being of the victim is almost always disturbed. The following clinical manifestations are noted: a drop in blood pressure, increased heart rate, general weakness, fainting. Maybe thirst.
Thus, almost all bleeding creates a potential danger to the life of the patient.

First aid

It is necessary, if possible, to stop the bleeding, and then urgently hospitalize the victim in a hospital on a stretcher. Their head end descends, the foot end rises. To stop bleeding, tourniquets, pressure bandages, and cold are used. An urgent replacement of the volume of lost blood is needed.

Nosebleeds

Nosebleeds are also divided into traumatic and non-traumatic. The causes of traumatic nosebleeds can be a blow to the nose, damage to its mucous membrane when picking the nose.
Non-traumatic bleeding is a consequence of the following pathological conditions: diseases accompanied by an increase in blood pressure (hypertension, pathologies of the kidneys, heart, atherosclerosis); diseases accompanied by a violation of the structure of the vascular wall (hemorrhagic diathesis, atherosclerosis, connective tissue diseases); liver pathologies; viral diseases (ARI, influenza); malignant and benign tumors in the nasal cavity.

Clinical manifestations
Blood during nosebleeds can be released out through the nasal openings or drain down the back of the throat and enter the digestive tract (the so-called hidden bleeding). When blood is released to the outside, this is the main symptom of nosebleeds. The blood is bright, the intensity of bleeding is different - from insignificant (a few drops) to abundant. Prolonged ingestion of blood can lead to hematemesis. With prolonged bleeding that does not stop, leading to large blood loss and a drop in blood pressure, fainting may develop.

First aid
The victim must be seated, his head thrown back, in the nasal passage from the side of the injury, place a cotton turunda soaked in a 3% hydrogen peroxide solution, and pinch the nostrils; apply cold to the bridge of the nose and the back of the head for 20-30 minutes (until the bleeding stops completely).

To stop prolonged massive bleeding from the nose in otorhinolaryngology, anterior or posterior tamponade of its cavity is performed.

With high blood pressure, measures are taken to normalize it (the use of antihypertensive drugs). Non-abundant nosebleeds after these events completely stop. If the bleeding is heavy, the measures taken did not give results within 30 minutes, the victim must be urgently hospitalized in a hospital. Also, hospitalization is necessary if the bleeding is caused by the presence of a serious illness in the victim (blood diseases, neoplasms, hemorrhagic diathesis, liver pathologies, severe infectious diseases).

Bleeding from the mouth

The causes of bleeding from the oral cavity may be the following: traumatization of the soft tissues of the oral cavity (tongue, palate, gums, cheeks) with sharp objects; removal of a tooth; malignant or benign tumors; the presence of diseases accompanied by a violation of blood coagulation.

Clinical manifestations
The intensity of bleeding and the appearance of blood depend on the type (artery, vein or capillary) and caliber (small or large) of the damaged vessel. With massive bleeding, blood can enter the respiratory tract with respiratory arrest, as well as the development of a shock state as a result of blood loss.

First aid
The patient must be laid on his side or seated on a chair, lower his head, remove liquid blood and its clots from his mouth. In case of bleeding after tooth extraction, the tooth socket is tamponade with cotton wool soaked in a 3% hydrogen peroxide solution. If, after the extraction of a tooth, the blood cannot be stopped within an hour, you should be examined for the presence of diseases of the blood coagulation system. When bleeding from the cheek or gums, a cotton swab dipped in a 3% hydrogen peroxide solution is placed between the cheek and teeth. If the bleeding is profuse and does not stop after applying the described methods, the patient must be hospitalized in a hospital. Also, hospitalization is needed for persons whose bleeding is caused by diseases accompanied by a violation of blood clotting, tumors.

Pulmonary bleeding

Depending on the amount of blood lost, pulmonary hemorrhages are divided into proper pulmonary hemorrhages and hemoptysis.
Hemoptysis is the appearance in the sputum of a small amount of blood in the form of streaks or its uniform bright red staining. Isolation with sputum of a large amount of blood and the presence of sputum in each portion indicate the presence of pulmonary hemorrhage.

There are many reasons for its occurrence:

• lung diseases: malignant and some benign tumors, tuberculosis, connective tissue pathologies, abscess, cysts, pneumonia;
• diseases of the cardiovascular system: aneurysms of the vessels of the lungs and aorta, myocardial infarction, heart defects;
• chest and lung injuries;
• common infectious diseases, accompanied by increased fragility of blood vessels (flu, etc.).

Clinical manifestations
The appearance of a cough with bright red sputum, foamy. The blood in the sputum does not clot. Sometimes with rapidly developing pulmonary bleeding, cough may be absent. Massive pulmonary bleeding quickly leads to the development of respiratory failure in the patient due to the filling of the respiratory tract with blood, which causes loss of consciousness, and then death. With gradually developed and not very abundant pulmonary bleeding, the most common complication is pneumonia (pneumonia).

First aid
The patient must be seated, given to drink cold water in small sips and swallow pieces of ice. With a strong cough, it is recommended to give him any antitussive drug containing codeine, and try to take the patient to the hospital as soon as possible.

Bleeding from the digestive tract

Causes of bleeding from the gastrointestinal tract:

• diseases of the esophagus: cancer, injury by sharp foreign bodies, rupture of varicose veins;
• diseases of the stomach: ulcer, erosive gastritis, cancer, rupture of the mucous membrane;
• bowel diseases: duodenal ulcer, cancer, ulcerative colitis, dysentery;
• diseases of the rectum: hemorrhoids, cancer.

Clinical manifestations
Bleeding from the gastrointestinal tract has 2 main manifestations: hematemesis and tarry stools. The vomit may be bright red or dark brown in color. Bright red vomit indicates an acute onset of heavy bleeding; while the blood quickly accumulates in the stomach, stretches it and causes vomiting. Dark brown vomit appears when the bleeding is not very profuse and the blood has been in the stomach for some time, where it was exposed to gastric juice before vomiting began. Blood that is not removed from the digestive tract with vomit enters the intestine and after 15-20 hours is excreted with feces, giving it a black color (tarry stool) and a specific smell of decomposed blood. In addition to these manifestations, bleeding from the digestive tract is accompanied by general weakness, a drop in blood pressure, increased heart rate, and the occurrence of fainting. The onset of bleeding from a stomach or duodenal ulcer, bleeding from a rupture of the gastric mucosa is often accompanied by pain in the abdomen of varying severity.

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First aid
A patient with suspected gastrointestinal bleeding must be urgently delivered to the hospital. Hospitalization should be carried out on a stretcher, the patient is laid on his back, with his head lowered below the body, a heating pad with cold water or an ice pack is placed on his stomach, he is given to drink cold water in small portions or swallow pieces of ice.
With continued bloody vomiting, the patient's head must be turned to the side so that the vomit does not enter the respiratory tract and does not lead to respiratory arrest and, subsequently, to the development of severe pneumonia.

External bleeding

Bleeding can occur from arteries, veins and small vessels - capillaries. Bleeding from the capillaries, as a rule, is not life-threatening and soon stops on its own.
An exception is capillary bleeding if the victim has diseases accompanied by a violation of blood clotting. These include hemophilia, thrombocytopenia, thrombocytopathies. In this case, damage to even a very small vessel can lead to large blood loss, since the bleeding is almost impossible to stop.

Clinical manifestations
When bleeding from an artery, the blood has a scarlet color, pours out under high pressure, abundantly, in jolts. With arterial bleeding from large vessels (aorta and arteries extending from it), there is a rapid loss of a large volume of blood, which leads to the death of the patient. When the carotid artery ruptures, blood loss becomes fatal after 1 minute. When bleeding from venous vessels, dark blood flows slowly, in a trickle. When small veins are damaged, blood loss usually does not reach large volumes.

First aid
At the prehospital stage, the main thing in providing first aid to a patient with external bleeding is his temporary stop.
It is performed in 2 stages. First, the damaged vessel is pressed against the underlying bone, then a tourniquet is applied to the affected limb. With bleeding from a vein, the vessel is clamped below the injury site, with bleeding from an artery - above.

Danger to the life of the patient can occur if the large veins of the neck, subclavian veins are damaged, since as a result of the suction action of the chest, negative pressure is created in them. This leads to the suction of air through the damaged wall of the vein and the development of a deadly complication - an air embolism.

First aid for bleeding from the arteries of the upper and lower extremities

Wound of the arteries of the shoulder. To press the vessel into the armpit, a hand clenched into a fist is placed (a towel folded several times, several folded packs of bandages, etc.), the hand on the side of the lesion is straightened and pressed to the body.
Injury to the arteries of the hand. A rolled bandage is applied to the bleeding vessel and it is tightly bandaged with another bandage, after which the hand is given an elevated position. As a rule, this event is sufficient to stop bleeding from the arteries of the hand.
Injury to the femoral arteries. A hand clenched into a fist is pressed on the surface of the thigh from the side of the lesion so that the fist is located immediately under the inguinal fold, perpendicular to it.
Wound of vessels of a shin. A towel folded with a roller or 2 folded packs of bandages is placed under the knee, after which the leg is bent as much as possible at the knee joint.
Injury to the arteries of the foot. The same manipulations are performed as for wounding the vessels of the lower leg. Another way to stop bleeding from the arteries of the foot is to tightly bandage a rolled bandage or a roll of sterile wipes to the wound site, after which the leg is given an elevated position. As a rule, after these measures, the bleeding stops, the application of a tourniquet is not required.
After stopping the bleeding by pressing the vessel to the bone protrusion, a tourniquet is applied. You can use a standard rubber tourniquet, in its absence, you can use a bandage, a cuff from a tonometer, a scarf, a towel. A tourniquet (standard or impromptu) is stretched, brought under the injured limb and tightly tightened around the arm or leg. With a properly applied tourniquet, bleeding from the wound stops, the pulse on the wrist (when the tourniquet is applied to the arm) or foot (when the tourniquet is applied to the leg) disappears, skin blanching is noted. In order not to injure the skin under the tourniquet, it is recommended to place a double-folded towel (or napkin) between it and the skin of the limb. Since prolonged compression of the limb with a tourniquet (more than 1.5 hours in summer and 30-60 minutes in winter) can lead to irreversible circulatory disorders in the affected limb, it is very important to remove the tourniquet in time. After its imposition, the patient must be urgently delivered to a surgical hospital, where the final stop of bleeding (suturing of the vessel) will be performed. If 1.5 hours after applying the tourniquet, the patient is not taken to the hospital, it is necessary to loosen the tourniquet for 15 minutes every 30 minutes to restore blood circulation in the constricted limb, after first pressing the injured artery above the tourniquet with a finger. After that, the tourniquet is applied again, but each time it is slightly higher than the previous level.

First aid for bleeding from the arteries of the head, neck and trunk

If the arteries on these parts of the body are damaged, the bleeding is temporarily stopped as follows: a large number of sterile napkins are placed on the wound, an unfolded sterile bandage is placed on top, and the whole structure is tightly bandaged to the head, neck or torso. A tourniquet is not applied if the victim cannot be quickly taken to the hospital and the bleeding can be completely stopped. As the tampons get wet, they are not removed from the wound, additional gauze pads and a folded sterile bandage are applied on top, and everything is tightly bandaged again. With heavy bleeding and the absence of dressing material at hand, it is possible to use finger pressure of a large vessel supplying the affected area.
When bleeding from wounds of the face and upper neck, the carotid artery is pressed. Finger pressure on the carotid artery instantly stops bleeding from it for 10-15 minutes (more than 15 minutes, this method cannot be used, since the arm gets tired and the pressure exerted is insufficient to stop the bleeding). Pressing the vessel is made with the thumb or 3 fingers (index, middle and ring), folded together. It is carried out towards the spine. After finger pressing the artery, it is necessary to quickly apply a pressure bandage, then urgently hospitalize the victim.

With stab wounds, the outflow of blood from the wound may be small. At the same time, a deep wound channel is able to penetrate into body cavities, causing damage to internal organs and large vessels. Therefore, only by the volume of blood loss it is impossible to judge the severity of the condition of the wounded.

With heavy bleeding due to injury to the axillary, subclavian areas of the body, shoulder joint, with a high detachment of the arm, a temporary stop of bleeding is performed by digital pressing of the subclavian artery. Pressing this vessel is carried out with the thumb or 3 fingers folded together. The artery is pressed over the clavicle, the direction of pressure is from top to bottom. To further stop the bleeding, the following method is used: the arm from the side of the lesion is brought as far as possible behind the back, bent at the elbow joint and, in this form, is wrapped with a bandage to the body.

First aid for bleeding from small veins

With these types of bleeding, a tourniquet is not required. Several sterile gauze pads are applied to the wound, after which everything is tightly fixed with a sterile bandage. Sometimes it is required to give the wounded limb a somewhat elevated position.

First aid for bleeding from large (main) veins

The main veins include the neck, subclavian and femoral veins. When they are injured, either a hemostatic tourniquet is applied (according to the same rules as for arterial bleeding), or the wound is plugged. For this purpose, a large number of sterile wipes are placed in it, a folded sterile bandage is placed on top and all this is tightly wrapped with another sterile bandage.

First aid for capillary bleeding

All types of capillary bleeding are stopped by applying a tight pressure bandage to the wound using a sterile bandage.

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 gushing;
• 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 stomach, 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 absorption 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, secured 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.