Providing first aid for mixed bleeding. Providing first aid for bleeding. What to do in case of venous hemorrhage

External bleeding, depending on the type of damaged vessels, can be divided into three categories: capillary, venous and arterial.

With capillary bleeding, blood is released from damaged small blood vessels (capillaries) with low intensity. It usually does not lead to large blood losses. This type of bleeding can be stopped fairly quickly. To do this, the edges of the wound are treated with an alcohol-containing antiseptic. Clean gauze and a layer of cotton wool are applied to the wound and wrapped with a bandage. In this case, the bandage should not be tight.

With venous or arterial bleeding caused by damage to the veins or arteries, blood loss can be significant. You can distinguish venous bleeding by the color of the blood: in contrast to the scarlet color of the blood during arterial bleeding, the blood during venous bleeding is dark in color. In addition, arterial bleeding is characterized by pulsating flow in time with heart contractions, while venous bleeding occurs evenly. With venous bleeding, blood clots may appear that cannot be removed, as this will provoke an increase in blood loss.

First aid should be provided as quickly as possible. If bleeding is severe, death can occur within minutes.

First aid for external bleeding

Ask others to call an ambulance

1. Make sure that neither you nor the victim is in danger. Use medical gloves to protect the victim from body fluids. Carry (take) the victim out of the affected area.

2. Check the victim's consciousness.

3. If the victim is conscious, quickly (within a few seconds) conduct a physical examination to determine if there is severe external bleeding.

4. Stop bleeding if there is any.

Methods for temporarily stopping external bleeding

1. Apply direct pressure to the wound.

2. Apply a pressure bandage. Cover the wound with several folded napkins or several tightly folded layers of gauze. Bandage the top tightly. If the bandage gets wet, place a few more tightly folded tissues on top of it and press firmly with your palm over the bandage.

3. If a pressure bandage and direct pressure on the wound are ineffective or arterial bleeding from a large artery (femoral, brachial) was immediately detected, apply digital pressure to the artery. It should be pressed firmly with your fingers or fist against nearby bone formations until the bleeding stops.

Before applying a tourniquet, do not release the pinched artery so that bleeding does not resume. If you start to get tired, ask someone present to press your fingers on top.

Apply a hemostatic tourniquet.

It is applied to a soft pad (an element of the victim’s clothing) above the wound and as close to it as possible.

6. Place the tourniquet under the limb and stretch.

Tighten the first turn of the tourniquet and make sure that the bleeding from the wound has stopped.

A tourniquet is an extreme measure to temporarily stop arterial bleeding!

7. Apply subsequent turns of the tourniquet with less force in an ascending spiral, capturing the previous turn approximately halfway.

8. Place a note under the tourniquet indicating the date and exact time of application. Do not cover the tourniquet with a bandage or splint! In summer, the tourniquet can be held for 1 hour, in winter - 30 minutes.

If the maximum tourniquet application time has expired and medical assistance is not available, do the following:

1. Use your fingers to press the artery above the tourniquet.

2. Remove the tourniquet for 15 minutes.

3. If possible, massage the limb.

4. Apply a tourniquet slightly above the previous application site (if possible).

5. The maximum reapplication time is 15 minutes.

9. If there is severe bleeding in the joint area (for example, the groin), use the method of maximum flexion of the limb. Place some bandages or rolled up clothing in the joint area and bend the limb. Secure the limb in a bent position with your hands, a few turns of a bandage, or using improvised means.

10. If there is significant blood loss, place the victim with his legs elevated.

If you do not have a service tourniquet, use a twist tourniquet:

1. Place a twist tourniquet made from available material (fabric, scarf) around the limb above the wound on top of clothing or placing fabric on the skin.

Tie the ends with a knot so that a loop is formed.

Insert a stick (or other similar object) into the loop so that it is under the knot.

2. Rotate the stick and tighten the tourniquet until the bleeding stops.

3. Secure the stick to prevent it from unwinding.

The twist tourniquet is applied according to the same rules as the service tourniquet.

After the bleeding has stopped, the victim should be carefully examined again for any injuries. Taking into account the detected emergency conditions, continue providing first aid.

Then give the victim the optimal body position, taking into account his condition and the nature of the injuries received. Until paramedics arrive, it is necessary to constantly monitor the victim’s condition, keep him warm and provide psychological support.

Article publication date: 05/19/2017

Article updated date: 12/21/2018

From this article you will learn: that correctly provided first aid for bleeding helps save the life of the victim; what assistance should be provided in case of heavy or slight bleeding; about types of bleeding; how to properly provide assistance in certain cases.

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Types of bleeding

If large arteries and veins are injured, life-threatening blood loss can occur. Therefore, it is necessary to stop the bleeding as soon as possible and immediately call emergency help. With minor damage to blood vessels, it is also very important to stop the bleeding in a timely manner. Even with mild but ongoing blood loss, a person can lose consciousness.

Incorrectly provided first aid can cause harm to the victim, namely: large blood loss, infection and inflammation of the wound.

If the bleeding is not very severe, after providing assistance, you should also urgently contact a surgeon, since the loss of blood can be completely stopped only after the wound has been treated and sutured or surgery has been performed. Depending on the source of bleeding, consultation with specialized specialists such as a gastroenterologist, oncologist, pulmonologist, or gynecologist may also be required.

Briefly about first aid:

1. If the bleeding is severe, the victim should be laid down and his legs elevated.
2. You can temporarily stop the bleeding by squeezing the damaged vessel or by strongly bending the limb or applying a tourniquet.
3. Call emergency services immediately.
4. The wound must not be touched, washed, or foreign bodies removed from it.
5. If the wound surface is dirty, then its edges must be cleaned in the direction away from the wound; Apply an antiseptic such as iodine, chlorhexidine, hydrogen peroxide around the damage; Iodine should not get inside the wound.

Four main types of bleeding

Depending on the source, the following main types of bleeding are distinguished:

1. First aid for arterial bleeding

The damaged artery must be immediately pressed against the adjacent bone to temporarily stop the bleeding.

Methods of pressing arteries:

1. Carotid artery – press your palm to the back of the victim’s neck and press the fingers of the other hand on the artery.
2. The brachial artery is easily accessible and must be pressed against the humerus.
3. It is quite difficult to stop bleeding from the subclavian artery. To do this, you need to take the victim’s hand back and press the artery located behind the collarbone to the first rib.
4. You have to press hard on the axillary artery with your fingers to squeeze it, because it is located quite deep.
5. The femoral artery is very large and must be pressed against the femur with a fist. If this is not done, the victim may die within 2-3 minutes.
6. The popliteal artery must be pressed into the knee fossa, which does not require much effort.

First aid for bleeding from the arteries of the extremities is performed by compressing them, strongly bending the limb and applying a tourniquet. If you cannot squeeze the vessel of the limb with your fingers, you need to bend the limb as much as possible, after first placing a thick gauze roller on the inside of the joint.

If the blood continues to flow, a tourniquet must be applied. It must be provided quickly, since the blood flows out very intensely.

The tourniquet can be held for up to half an hour in winter and up to an hour in summer. If the doctor does not arrive within the specified period of time, you must slowly remove the tourniquet and wait until blood circulation is restored. After that, apply it again. In this case, the pulse on the injured limb should not be palpable. Then the bleeding will stop.

We must remember that a tourniquet, if used incorrectly, poses a greater danger than the bleeding itself.

If there is no special tourniquet, it can be replaced with materials such as a towel, belt, bandage. They are twisted with a stick and secured to prevent unwinding. Shoelaces, thin rope and similar materials must not be used.

2. Assisting with bleeding from a vein

Such blood loss occurs with deep injuries. First aid for venous bleeding is carried out immediately. Injured veins can suck in air because the pressure in them is lower than atmospheric pressure. In this case, air bubbles can clog blood vessels in various organs, which can lead to the death of the victim.

When providing assistance, the wound should not be washed or cleaned of dirt and blood clots. You need to do the following:

In order to apply a bandage correctly, you need to:

1. When bandaging your hand, you need to bend it.
2. If a leg is bandaged, it must also be bent at the knee.
3. When applying a bandage, cover half of its previous turn.
4. The position of the bandaged limb must be left the same as it was before bandaging.

3. First aid for capillary bleeding

It often stops on its own. Characteristic is the slow leakage of blood from the entire wound surface. However, there are also serious injuries accompanied by significant blood loss. The greatest danger is caused by internal capillary bleeding.

The main causes of bleeding from capillaries:

• Blood diseases accompanied by impaired blood clotting.
• Various traumatic injuries.
• Vascular diseases (tumors, purulent inflammation of the skin affecting capillaries).
• Common diseases affecting the walls of blood vessels such as neoplasms, atherosclerosis, rheumatoid arthritis.
• Hormonal disorders.

More often, capillary bleeding does not cause large blood loss; its danger lies in infection with pathogenic microbes.

When providing medical care for bleeding from the capillaries of the extremities, the following actions must be taken:

1. Elevate the injured limb above the heart area, which helps reduce blood loss.
2. For minor injuries, it is necessary to treat the skin around the wound with antiseptics. Cover the top with a bactericidal plaster.
3. If there is a lot of bleeding, you need to apply a pressure bandage.
4. If there is very strong bleeding, it is necessary to bend the limb as much as possible over the wound. If this does not help, apply a tourniquet.
5. Apply cold to the wound, which will help stop blood loss and reduce pain.

When bleeding from numerous capillaries of the nose, which is quite common, you also need to be able to provide assistance. The reason for this may be the weakening of the vascular wall due to colds. It can also be contributed by a hypertensive crisis, traumatic injuries to the nose and other negative factors. First you need to calm the patient down, because when a person is worried, his heart beats faster, which contributes to increased bleeding.

Steps to help with nosebleeds:

1. It is necessary to press the wings of the nose with your fingers, this helps to compress the bleeding vessels and stop the bleeding. The patient's head should be tilted slightly forward and not thrown back, since this will make it impossible to control the intensity of blood loss.
2. Apply ice or a cold object to the bridge of the nose so that the blood vessels narrow under the influence of cold. This will help reduce bleeding.
3. If the bleeding continues, folded pieces of bandage, previously soaked in 3% hydrogen peroxide, should be inserted into the nasal passages. Leave the ends of these tampons outside and secure with a bandage.
4. Six hours after the bleeding has stopped, remove the tampons very carefully, after moistening their tips, being careful not to tear off the formed blood clot.
5. To stop the bleeding faster, the patient must be given a medicine that strengthens the walls of blood vessels - calcium preparations, Ascorutin, Rutin.
6. If blood loss continues, the patient must be given a hemostatic medicine (Ditsinon, Vikasol), and urgently contact an otolaryngologist or call emergency help.

4. First aid for internal bleeding

Such bleeding can be caused by diseases or injuries to internal organs. It is very insidious because blood loss cannot be controlled. There is also no pain syndrome that signals danger, so internal bleeding can go unnoticed for a long time. And only when the patient’s condition deteriorates sharply is attention paid to it.

The most dangerous of bleedings is the outflow of blood from parenchymal organs, which usually do not have a cavity, and in which the arterial-venous network is well developed. These include organs such as the lungs, pancreas, and liver.

Damage to these organs can cause severe bleeding. It practically cannot stop on its own, since the vessels of these organs are fixed in the tissues and can collapse. Therefore, first aid for bleeding from parenchymal organs is carried out immediately. The causes of this type of blood loss are injuries, infectious diseases such as tuberculosis; decay or rupture of tumors.

Bleeding from internal organs may be accompanied by the gradual appearance of general subjective symptoms and objective signs, namely:

• weakness;
• bad feeling;
• dizziness;
• fainting;
• lack of interest in everything;
• drowsiness;
• pressure drop;
• paleness;
• frequent pulse.

The main task of first aid for bleeding from internal organs is urgent hospitalization of the patient. Before the ambulance arrives you need to:

• Lay the patient down and provide him with peace.
• Apply cold to the abdomen or chest, depending on the location of the source of the suspected bleeding.
• Hemostatic drugs (Aminocaproic acid, Vicasol) can be administered.

In the case of parenchymal bleeding with a sharp decrease in pressure, it is necessary to raise the patient’s legs above the heart area by about thirty to forty centimeters. Monitor your breathing and heartbeat at all times. If necessary, perform resuscitation. The patient should not be given painkillers or any other medications. Do not give food or water; rinsing the mouth with water is acceptable.

With quick and correct first aid for various types of bleeding, the prognosis is favorable; quick first aid will also contribute to a faster recovery of the victim.

First aid for external bleeding:

Applying a pressure bandage, finger pressing of the artery to the bone, maximum flexion of the limb at the joint, application of a hemostatic tourniquet.

Applying a pressure bandage. Venous bleeding and bleeding from small arteries can be controlled with a pressure bandage. Sterile gauze pads are applied to the wound in several layers, with a tight wad of cotton wool on top of them (not a rolled out roll of bandage or a clean handkerchief folded into a tight roller). Without a gauze pad, cotton wool cannot be applied directly to the wound. All this is tightly fixed with circular rounds of bandage. If possible, it is necessary to give the limb an elevated position. To do this, you can place a cushion, tightly rolled clothes, or a pillow under it. This leads to decreased blood flow to the extremities and decreased pressure in the veins, which allows blood clots to form quickly in the wound.

Finger pressing the artery to the bone: done above the wound from which blood flows. To do this, you need to know the points at which the arteries can be pressed against the bone. Pressing the artery with a finger or fist ensures almost immediate bleeding stop. However, after 10-15 minutes, the hands begin to get tired and the pressure weakens. In this regard, immediately after pressing the artery, an attempt should be made to stop the bleeding.

Maximum flexion of the limb at the joint:

This method is effective when the wound is located below the joints - elbow, hip or in the articular fossa. A tight cotton-gauze roll should be placed in the joint area. So, for example, if there is bleeding from the forearm and hand, you need to put a cotton-gauze roll into the ulnar fossa, bend the arm as much as possible at the elbow joint and fix the forearm to the shoulder in the position of maximum flexion. If the femoral artery is damaged, the limb is bent as much as possible at the hip and knee joints, the thigh and lower leg are bandaged to the body. When bleeding from the lower leg and foot, a thick pad must be placed in the popliteal fossa, the leg is fixed in the position of maximum flexion in the knee joint.

Application of a hemostatic tourniquet:

Indications for applying a tourniquet are arterial bleeding, as well as bleeding that cannot be stopped by other means. The tourniquet should be located above the damaged area (for a wounded foot or lower leg - at the level of the thigh, above the knee; for a wounded hand or forearm - on the shoulder, except for its middle third, as this can lead to damage to the radial nerve).

At the level of application, straighten the folds of clothing or wrap the limb in this place with a soft cloth.

The tourniquet is brought under the limb, then grabbed at the end and in the middle part, stretched and, already stretched, wrapped around the limb until bleeding from the wound stops.

The first round of the tourniquet is hemostatic, the subsequent rounds are fixing. Gradually reducing the stretch of the rubber, secure the entire tourniquet to the limb. Its rounds are laid close enough to each other to avoid pinching the fabric between them.

To monitor the effectiveness of arterial compression after applying a tourniquet, you can feel the pulse below it - the disappearance of the pulse indicates compression of the artery.

A note should be placed under the tourniquet indicating the exact time it was applied (hours and minutes). The tourniquet can remain on the limb for no more than two hours after its application, and in winter or in a cold room for 1-1.5 hours.

If the victim is not delivered to a medical facility within the specified time, the tourniquet must be released briefly. To do this, press the artery with a finger above the wound and slowly release the tourniquet for 3-5 minutes, after which it is applied again, but above the previous place.

You can use an improvised tourniquet - a rubber tube, a tie, a belt, a belt, a scarf, a bandage, etc., but you should not use wire. You can use a twist.

If the tourniquet is applied correctly, the pulse in the arteries below the tourniquet cannot be felt, the limb turns pale and the bleeding stops.

During transportation of the injured limb with a tourniquet applied, it is necessary to give it an elevated position.

Nose bleed

Nosebleeds - can occur with a blow to the nose, strong blowing of the nose or severe injuries to the skull, as well as with certain diseases: hemorrhagic diathesis, bleeding ulcers, tumors, hypertension..

First aid - The victim must be seated so that the head is in an upright position and slightly tilted back. If the bleeding is intense, the victim should be laid on his back, his head raised slightly, and his collar and belt unfastened. Cold compresses or ice should be placed on the bridge of the nose and neck. The victim squeezes the wings of his nose with his fingers for several minutes. If the bleeding does not stop, then a gauze swab moistened with hydrogen peroxide should be inserted into the nose and pressed through the wing of the nose to the septum. If you have a nosebleed, you should not blow your nose, rinse your nose with water, or breathe through your nose. Blood flowing into the nasopharynx must be spat out

Bleeding from the ear

When the external auditory canal is injured and the base of the skull is fractured, bleeding from the ear is observed.

First aid - The victim should be laid horizontally and an aseptic bandage should be applied to the ear. You cannot rinse your ear. It is urgent to call an ambulance. If bleeding occurs from the auricle, an aseptic bandage is applied to the wound and the victim can independently contact the nearest medical facility for further assistance.

The body of humans and mammals is penetrated by thousands of small, medium and large vessels, which contain a valuable liquid that performs a huge number of functions - blood. Throughout life, a person experiences the influence of a considerable number of harmful factors, among them the most common are traumatic effects such as mechanical damage to tissue. As a result, bleeding occurs.

What it is? The medical science of “pathological physiology” gives the following definition to this condition: “this is the release of blood from a damaged vessel.” At the same time, it pours out or into the body cavity (abdominal, thoracic or pelvic) or organ. If it remains in the tissue, saturating it, it is called hemorrhage; if it freely accumulates in it, it is called a hematoma. A condition in which blood vessels are damaged, most often occurring suddenly, and if there is a strong rapid leakage of vital fluid, a person can die. That is why first aid for bleeding often saves his life, and it would be nice for everyone to know the basics. After all, such situations do not always occur when there are medical workers nearby or even just specially trained people.

What types of bleeding are there and why do they occur?

There are many classifications of this pathological condition and specialists teach them all. However, we are interested in dividing bleeding into types, first of all, from a practical point of view. The following classification is important for successful first aid. It shows the types of bleeding depending on the nature of the damaged vessel.

Arterial bleeding

It comes from the arteries containing oxygenated blood flowing from the lungs to all organs and tissues. This is a serious problem, since these vessels are usually located deep in the tissues, close to the bones, and situations where they are injured are the result of very strong impacts. Sometimes this type of bleeding stops on its own, since the arteries have a pronounced muscular layer. When such a vessel is injured, the latter goes into spasm.

Venous bleeding

Its source is venous vessels. Through them, blood containing metabolic products and carbon dioxide flows from cells and tissues to the heart and further to the lungs. Veins are located more superficially than arteries, so they are damaged more often. These vessels do not contract during injury, but they can stick together because their walls are thinner and their diameter is larger than that of arteries.

Capillary bleeding

Blood bleeds from small vessels, most often the skin and mucous membranes; usually such bleeding is insignificant. Although it can be frighteningly abundant with a wide wound, since the number of capillaries in the tissues of the body is very large.

Parenchymal bleeding

Separately, so-called parenchymal bleeding is also distinguished. The organs of the body are hollow, essentially “bags” with multi-layered walls, and parenchymal, which consist of tissue. The latter include the liver, spleen, kidneys, lungs, and pancreas. Typically, this type of bleeding can only be seen by a surgeon during an operation, since all parenchymal organs are “hidden” deep in the body. It is impossible to determine such bleeding based on the type of damaged vessel, because the organ tissue contains all their varieties and all of them are injured at once. This is mixed bleeding. The latter is also observed with extensive wounds of the extremities, since the veins and arteries lie nearby.

Depending on whether the blood remains in the cavity of the body or organ or pours out of the body, bleeding is distinguished:

• Internal. Blood does not come out, staying inside: in the abdominal, thoracic, pelvic cavities, joints, and ventricles of the brain. A dangerous type of blood loss that is difficult to diagnose and treat because there are no outward signs of bleeding. There are only general manifestations of its loss and symptoms of significant dysfunction of the organ(s).
• External bleeding. Blood is poured into the external environment, most often the causes of this condition are injuries and various ailments that affect individual organs and systems. These bleedings can be from the skin and mucous membranes, gastric and intestinal, or from the urinary system. In this case, visible outpourings of blood are called obvious, and those that occur in a hollow organ communicating with the external environment are called hidden. The latter may not be detected immediately after bleeding begins, because it takes time for blood to come out, for example, from a long digestive tube.

Typically, bleeding with clots is external, hidden or internal, when the blood is retained inside the organ and partially coagulates.

1. Spicy. In this case, a large amount of blood is lost in a short period of time, usually occurring suddenly as a result of injury. As a result, a person develops an acute state (anemia).
2. Chronic. Long-term loss of small volumes of this biological fluid is usually caused by chronic diseases of organs with ulceration of the vessels of their walls. Causes a state of chronic anemia.

Video: bleeding in the “School of Doctor Komarovsky”

Main causes of bleeding

What can cause bleeding? It is appropriate to note here that two fundamentally different types are also distinguished, based on the factor of whether the normal vessel is damaged or the pathological condition arose against the background of destruction of the altered vascular wall. In the first case, bleeding is called mechanical, in the second - pathological.

The following main causes of bleeding can be identified:

• Traumatic injuries. They can be thermal (from exposure to critical temperatures), mechanical (from a bone fracture, wound, bruise). The latter occur in various extreme situations: road accidents, train and plane crashes, falls from a height, fights involving piercing objects, gunshot wounds. There are also industrial and domestic injuries.
• Vascular diseases, including tumors (purulent tissue lesions involving blood vessels, atherosclerosis, hemangiosarcoma).
• Diseases of the blood coagulation system and liver (fibrinogen deficiency, hypovitaminosis K, hepatitis, cirrhosis).
• General diseases. For example, diabetes mellitus, infections (viral, sepsis), lack of vitamins, and poisoning cause damage to the vascular walls throughout the body, as a result of which plasma and blood cells leak through them and bleeding occurs.
• Diseases affecting various organs. Bleeding from the lungs can cause tuberculosis, cancer; from the rectum - tumors, hemorrhoids, fissures; from the digestive tract - stomach and intestinal ulcers, polyps, diverticula, tumors; from the uterus - endometriosis, polyps, inflammation, neoplasms.

What is the risk of bleeding for a person?

One of the most important, but by no means the only function of blood is the transport of oxygen and nutrients. It delivers them to the tissues, and takes metabolic products and carbon dioxide from them. With significant bleeding, there is a significant loss of this substance necessary for the body. The nervous system and heart muscle are very sensitive to oxygen deficiency. Brain death, when the flow of blood into it completely stops, occurs in humans and animals in just 5-6 minutes.

However, in addition to the immediate loss of precious oxygen-containing fluid, there is another problem. The fact is that it keeps the blood vessels in good shape and with a significant loss of blood vessels, they collapse. In this case, the oxygen-containing blood remaining in the human body becomes ineffective and can help little. This condition is very dangerous, it is called vascular shock or collapse. It occurs in acute severe cases.

Its consequences described above are life-threatening to the patient and develop very quickly after bleeding.

Blood performs a huge number of functions, among which very important are maintaining the balance of the internal environment of the body, as well as ensuring the communication of organs and tissues with each other by transporting various biologically active substances. In this way, billions of cells in the body exchange information and, as a result, can work harmoniously. Bleeding, to one degree or another, disrupts the constancy of the internal environment of the body and the functions of all its organs.

Often, blood loss does not directly threaten the patient’s life; this is observed in many diseases. In such cases, blood loss is chronic and mild. Replacement of the outflowing blood occurs through the synthesis of plasma proteins by the liver and cellular elements by the bone marrow. Bleeding becomes an important diagnostic sign for recognizing the disease.

Signs of bleeding

Are common

Patient complaints:

1. Weakness, unmotivated drowsiness;
2. Dizziness;
3. Thirst;
4. Feeling of palpitations and shortness of breath.

External symptoms of blood loss that are observed with any type of bleeding are as follows:

• Paleness of the skin and mucous membranes;
• Cold sweat;
• Increased heart rate;
• Dyspnea;
• Urinary disorders up to complete absence of urine;
• Drop in blood pressure;
• Frequent weak pulse;
• Impaired consciousness up to and including loss of consciousness.

Local

External effusion of blood

The main local symptom is the presence of a wound on the surface of the skin or mucous membrane and visible bleeding from it. However, the nature of bleeding varies and is directly dependent on the type of vessel.

1. Capillary is manifested by that the blood collects in large drops and oozes from the entire surface of the wound. Its loss per unit of time is usually small. Its color is red.
2. Signs of venous bleeding: blood can flow quite quickly when a large vein or several at once is wounded; it flows out of the wound in strips. Its color is dark red, sometimes burgundy. If the large veins of the upper body are injured, there may be intermittent bleeding from the wound (however the rhythm is synchronized not with the pulse, but with breathing).
3. Signs of arterial bleeding: blood pours out from the site of injury in pulsating tremors - “fountains” (their frequency and rhythm coincide with heartbeats and pulse), its color is bright scarlet, red. Blood loss per unit time is usually rapid and significant.

Manifestations of hidden bleeding

• From the lungs - blood is released with a cough (a symptom of hemoptysis), it is foamy, the color is bright red.
• From the stomach - the color is brown (the hydrochloric acid of the gastric juice reacts with the blood, the latter changes color). There may be clots.
• From the intestines - feces acquire a dark brown or black color and a viscous, viscous consistency (tarry stool).
• From the kidneys and urinary tract - urine becomes red (from a brick shade to brown with “rags” - clots and pieces of tissue).
• From the uterus and genitals - blood is red, often there are pieces of mucous membrane in the discharge.
• From the rectum - scarlet blood can be found in drops on the feces.

Signs of internal bleeding

1. There is no bleeding into the environment. There are general symptoms of blood loss.
2. Local manifestations will depend on the location of the vessel damage and in which body cavity the blood accumulates.
3. - loss of consciousness or confusion, local impairment of motor functions and/or sensitivity, coma.
4. In the pleural cavity - chest pain, shortness of breath.
5. In the abdominal cavity - abdominal pain, vomiting and nausea, tension in the muscles of the abdominal wall.
6. In the joint cavity there is swelling, pain on palpation and active movements.

Can the body cope with bleeding?

Nature has provided for the possibility that fragile and delicate living tissues of the body will be injured over a long life. This means that a mechanism is needed to resist the flow of blood from damaged vessels. And people have it. Blood plasma, that is, the liquid part that does not contain cells, contains biologically active substances - special proteins. Together they make up the blood coagulation system. It is assisted by special blood cells - platelets. The result of complex multi-stage blood clotting processes is the formation of a thrombus - a small clot that clogs the affected vessel.

In laboratory practice, there are special indicators that show the state of the blood coagulation system:

• Duration of bleeding. An indicator of the duration of blood effusion from a small standard injury caused by a special stylet on a finger or earlobe.
• Blood clotting time - shows how long it takes the blood to clot and form a blood clot. Conducted in test tubes.

The normal duration of bleeding is three minutes, time - 2-5 minutes (according to Sukharev), 8-12 minutes (according to Lee-White).

Often, trauma or damage to a vessel by a pathological process is too extensive and natural mechanisms to stop bleeding cannot cope, or a person simply does not have time to wait due to the threat to life. Without being a specialist, it is difficult to assess the condition of the victim, and treatment tactics will vary depending on the cause.

Therefore, a patient who has severe bleeding from a vein or artery must be urgently transported to a medical facility. Before this, he must be provided with emergency assistance. To do this, you need to stop the bleeding. Usually this is a temporary cessation of blood flow from the vessel.

First aid

What methods are known to temporarily stop bleeding? Here they are:

1. Pressure (pressing a vessel in the wound, applying a pressure bandage).
2. Applying a hemostatic sponge, ice, irrigation with hydrogen peroxide (for capillary bleeding).
3. Very strong flexion of the limb.
4. Dense tamponade with bandage, gauze, cotton wool (for the nasal cavity, deep external wounds).
5. Application of a hemostatic tourniquet.

Methods to finally stop bleeding, which can only be performed by a doctor and in a hospital setting, are:

• Mechanical: ligation of a vessel in a wound, making a vascular suture, suturing the tissue together with the vessel.
• Chemical: anti-clotting and vasoconstrictor drugs (calcium chloride, epinephrine, aminocaproic acid)
• Thermal: electrocoagulation.
• Biological (to stop capillary and parenchymal bleeding during operations): fibrin films, hemostatic sponges, suturing of the body’s own tissues (omentum, muscle, fatty tissue).
• Embolization of a vessel (introduction of small air bubbles into it).
• Removal of the affected organ or part thereof.

It is very important to determine the type of damaged vessel, because this will determine how to stop the flow of blood from it.

First aid for arterial bleeding

Applying a tourniquet is very effective if a limb vessel is damaged. The method of pressure and tight wound tamponade is also used.

Rules for applying a tourniquet

While he is preparing, you need to press the artery with your fist or fingers to the bones above the wound, remember that when a large vessel is injured, minutes count. The brachial artery is pressed against the shoulder bone along its inner surface, the ulnar artery in the elbow bend, the femoral artery in the groin fold, the tibia in the popliteal fossa, the axillary artery in the cavity of the same name.

The injured leg or arm needs to be raised. Apply a tourniquet, tightening it tightly and placing a towel or rag between it and the skin. If there is no special rubber band, you can use a regular bandage, scarf, thin rubber hose, trouser belt, scarf or even rope. Then it is tied loosely around the limb, a stick is inserted into the loop and twisted until the desired compression is achieved. The criterion for correct application of a tourniquet is the cessation of bleeding. Time spent on the limb: no more than two hours in summer and half an hour in winter. To record the moment of vascular compression, the time is written on a piece of paper and secured to the affected limb.

Danger

The problem is that it is impossible to apply a tourniquet for more than the above-mentioned time interval due to poor circulation in the injured leg or arm; the tissues die. The function of the limb will then not be fully restored, and sometimes amputation becomes necessary. In addition, there is a danger of development in the area of ​​damage (bacteria that live in the soil and multiply in living tissues in the absence of oxygen enter the wound). If the person has not yet been delivered to the hospital within the specified time, in any case the tourniquet should be loosened for a few minutes. The wound is then clamped using a clean cloth..

If the carotid artery is injured and there is bleeding from it, it is necessary to compress it with a finger and tamponade the wound with a sterile dressing. A tourniquet can be applied to the neck; a special technique is used for this to prevent suffocation of the victim. Raise the arm on the side opposite to the injury and tighten the neck with a tourniquet below places of injury along with the limb.

Video: emergency care for severe bleeding

Venous bleeding

For venous bleeding, tight bandaging or a tourniquet works well. The peculiarity of the latter’s technique is that its location is not above the site of injury, as with arterial injury, but, on the contrary, below.

With any method of stopping bleeding, the wound itself is covered with a sterile napkin or clean cloth. If pain medication is available, you can give the person an injection or a pill if they are conscious. A person lying on the ground should be covered to prevent hypothermia. The victim must not be moved or turned over.

If internal bleeding caused by injury is suspected, it is necessary to ensure the patient is completely rested and send him to the hospital as soon as possible.

Video: first aid for venous bleeding

Capillary bleeding

For capillary bleeding, a pressure method is used, including using the palm or fingers, applying a bandage, hemostatic sponges, and cold objects. With adequate functioning of the coagulation system, temporary cessation of bleeding becomes final.

Therapy after stopping bleeding in the hospital

The use of blood coagulation improving drugs, blood replacement drugs, whole blood/plasma/platelet suspension is mandatory. Intravenous fluid therapy is also necessary to restore ion balance. Since bleeding is usually not the only problem after serious traumatic incidents, in parallel with the work to stop it, doctors carry out emergency diagnosis and treatment of concomitant disorders.

The main thing is not to lose your head if something bad happens to someone around you and the person is bleeding. In order to cope with it, you can use materials from your car first aid kit, items from your own bag, items of clothing or household items.

The task and duty of every normal person is providing first aid to the victim, which consists of temporarily stopping the loss of blood. And then you should immediately take the patient to a medical facility under your own power or urgently call an ambulance.

Bleeding is usually observed when the integrity of the walls of blood vessels is violated in the form of bleeding of varying intensity.

Bleeding can be: external, when blood flows onto the surface of the body, and internal, in which blood flows into internal organs, cavities and tissues. Depending on the type of damaged blood vessels, there are several types of bleeding. External arterial flow is fast and pulsating, the color of the blood is bright red. Moreover, it “gushes” from the wound, accompanied by general weakness and severe pain in the damaged part of the body. First aid for this type of bleeding consists of:

• 1) in finger pressure of a superficially located arterial vessel slightly above the bleeding wound;
• 2) applying a tourniquet 3-5 cm above the wound;
• 3) applying a pressure bandage to the bleeding site;
• 4) for wounds on the limbs - maximum flexion of the limbs;
• 5) raising the injured limb slightly above the chest.

They try to stop arterial bleeding from the vessels of the upper and lower extremities in two steps - first, they press the artery above the site of injury to the bone to weaken the flow of blood to the site of injury, and then apply standard or made from various auxiliary means: belts, rope, cord, tie and etc. Superficial venous bleeding has the following symptoms:

• 1) blood flows calmly from the wound, and does not flow like a “fountain”,
• 2) blood is dark red or burgundy.

First aid for this type of bleeding must be provided urgently. It consists of temporarily and effectively stopping bleeding using a special tourniquet or one made from improvised means. This type of bleeding is very dangerous for the victim, because the loss of even a small amount of blood disrupts the functioning of the heart and breathing.

After first aid is provided, the victim is urgently taken to the nearest medical facility in a horizontal position on a board or stretcher. In all cases of superficial wounds of the upper or lower extremities, one of the possible ways to stop venous bleeding is to elevate the extremity. If your arm is injured, it should be raised up, slightly above your head. If the leg is injured, place a small roll rolled up from some fabric under it. For this purpose, you can also use a bag, pillow, blanket, small backpack, a bunch of branches or an armful of hay or straw. In this case, the leg should be slightly higher than the chest, and the victim in this situation should be placed on his back on some kind of shield or homemade stretcher made from improvised means.

When the smallest blood vessels are damaged, capillary bleeding occurs. This type of bleeding is characterized by the fact that blood oozes from the entire surface of the wound, the color being intermediate between venous and arterial. Typically, such bleeding stops spontaneously within a few minutes due to blood clotting. In cases where the bleeding does not stop for a long time, a pressure bandage is used (with first aid), and a sterile napkin is applied to the damaged bleeding area, which is then pressed to the injured surface with a bandage. If the limbs are damaged and capillary bleeding opens after applying a bandage, they must be given an elevated position.

The most dangerous to human health are internal bleeding, in which blood does not leave the skin from damaged blood vessels - an artery, vein or capillary. This type of bleeding usually occurs in the abdominal cavity or chest cavity. Internal bleeding into the cavity of the cranium is very dangerous, in which extensive hematomas are formed, disrupting the activity of the brain and internal organs. Only minor internal capillary bleeding, which causes bruising under the skin, is not dangerous. Deep arterial or venous bleeding leads to large blood loss and serious consequences that threaten human life.

With internal bleeding, the following phenomena are observed: blue skin (bruising in the area of ​​​​the injury), drop in blood pressure, cough with bloody discharge, vomiting and nausea, rapid breathing, rapid weak pulse, pale or gray skin, cool or damp to the touch, feeling of insatiable thirst. First aid for internal bleeding consists of providing the victim with absolute rest, directly pressing the area of ​​bleeding in order to stop or reduce it if possible, and applying cold to the area of ​​bleeding (this relieves pain and relieves swelling).

If you use ice, it must be wrapped in gauze or a clean towel or cloth, and the best option would be to place the ice in a cellophane (or plastic) bag, apply the ice for 15 minutes, then after it melts, remove the water and apply ice again to the damaged surface. If there is severe pain and a very serious injury, in order to avoid serious complications, you must urgently call an ambulance.