Bleeding due to injury: applying a tourniquet. How to properly apply a tourniquet

When it comes to emergency medical care, unfortunately, it can happen to anyone. That is why everyone must know the rules for applying a tourniquet; the life of the victim completely depends on it. There are few nuances in saving a life, but they affect the favorable outcome of the situation.

Bleeding care options

A short-term stop of external bleeding helps to gain time before doctors intervene and provide professional medical care. Temporary stopping techniques include: applying a tourniquet, pressing the artery with a finger, applying pressure bandages. A tourniquet is the most reliable way to stop bleeding of the extremities. The rules for applying an arterial tourniquet imply a serious attitude towards the procedure.

In case of arterial bleeding, a tourniquet is needed only in case of damage to a large artery; in all other cases, this emergency measure is not necessary (you can get by with bandaging or bandaging the wound).

Stages of applying a tourniquet

When providing first aid for major arterial bleeding on the extremities, it is necessary to strictly follow the rules for applying a tourniquet. In the absence of a specialized device (a self-tightening strip with holes for fixation), you can use improvised means (a belt, a bandage folded in several layers, a rubber tube or rope).

The rules for applying a tourniquet are an algorithm of sequential actions:

Apply a bandage to the exposed limb (from 5 to 7 cm above the upper edge of the wound) or wrap it in a terry towel, eliminating any bumps or bumps.
Above the bleeding area, wrap the limb with a tourniquet several times and secure it (if the tourniquet is applied tightly enough, the bleeding stops).
The time for applying a tourniquet is determined by the season: in winter it should not exceed 90 minutes, in summer - two hours.

In cold weather, the injured limb should be isolated from low temperatures if possible. After providing assistance, the tourniquet should be loosened for 5-10 minutes, and the wound should be pressed firmly with your hand through the bandage. The tourniquet should be loosened an hour after its application, and then every hour.

Errors when applying a tourniquet

When applying a tourniquet, you need to avoid common mistakes:

The tourniquet is not tightened tightly enough, while the victim continues to lose blood; a symptom of a weak tourniquet is a cyanotic coloration of the skin.
The tourniquet is applied too tightly, which can lead to paralysis of the limbs and damage to the nerve trunks.
Applying a tourniquet to bare skin leads to injury to the latter without stopping the bleeding.
Exceeding the permissible application time.

Prohibited areas when applying a tourniquet:

lower third of the thigh;
middle third of the shoulder;
upper third of the leg.

Features of applying a tourniquet, control

The rules for applying a tourniquet during bleeding imply constant monitoring of the pulse and attaching a mandatory note under it with the data of the person who provided assistance and information about the time and date of application of the tourniquet. Such information is needed in order to know the time when it is necessary to loosen the tourniquet in order to provide nutrition to the tissues located below. In the absence of oxygen access, tissues gradually begin to die, which is why it is so important not to miss the time, after which weakening is simply necessary. The tourniquet must not be bandaged or covered with clothing; it must be conspicuous.
A tourniquet should be used only in extreme cases, when large main vessels are damaged.

Important points when applying a tourniquet:

if there is bleeding from the arm, it is advisable to apply a tourniquet in the upper third of the shoulder;
if a leg is injured, a tourniquet is applied in the middle of the limb.

Application of a tourniquet is also provided for amputation of limbs. In this case, to drain the blood, the limb is raised for a while, and a tourniquet is applied over the operation site.

Rules for applying a hemostatic tourniquet for venous bleeding

For this procedure you will need three tourniquets.

First, you need to sit the victim down for 10-15 minutes, which will reduce blood flow to the heart; most of the blood remains in the lower extremities.
Apply tourniquets (if possible simultaneously) to three limbs: on the thigh, on the arm (on the middle third) and 15 cm below the inguinal fold. It is necessary to place napkins under the tourniquets.
Inject the medicinal solution into your free hand (intravenously).
Measure the arterial pulse below the tourniquet.
Pay special attention to the color of the skin below the places where the tourniquets are applied (the skin should not be pale).
After completing the procedure, remove the tourniquets one by one in the absence of the necessary medications to reduce the volume of circulating blood.

It is very important to establish trusting contact with the victim before the procedure. His panicked state may have consequences. The victim must understand that he will receive the right help; any opposition from him can seriously interfere.

Signs of arterial bleeding: scarlet blood is released from the wound in a stream in time with the heartbeat.

The tourniquet usually used is a standard rubber Esmarch tape tourniquet or a fabric tourniquet in the form of a braid with a twist. Do not use wire or rope.

Rules for applying a hemostatic tourniquet

The tourniquet is used only for damage to the arteries of the extremities. If the carotid artery is damaged on the opposite side of the neck, an improvised splint or Kramer splint is applied with emphasis on the head and shoulder joint (Mikulich method). If there are no splints, you can use the hand on the healthy side, which is placed on the head and bandaged. The splint (arm) should prevent compression of the carotid artery on the opposite side. A cushion is placed on the damaged carotid artery below the damage and a tourniquet is pulled through the splint (arm).
Do not apply a tourniquet to a bare wound. There should be no folds on the lining. The tourniquet is applied over clothing or some kind of soft padding (bandage, gauze, scarf, etc., folded in several layers and wrapped around the limb).
The damaged limb is given an elevated position and the artery is pressed with fingers above the wound (subclavian artery - to the first rib, femoral artery to the pubic bone).
The tourniquet is applied 5 - 7 cm above the upper edge of the wound. The optimal localization of the tourniquet on the upper limb is the upper third of the shoulder (the tourniquet cannot be applied in the middle of the shoulder to avoid damage to the radial nerve). On the lower limb - the upper third of the thigh.
The first round should be tight, the subsequent rounds should be fixing.
The tourniquet is applied in a tiled manner without pinching the skin.
The tourniquet should not be crushing. The approximate force of application of the tourniquet is until the pulse disappears in the artery below the tourniquet.
With a properly applied tourniquet, the bleeding should stop, and the pulse in the artery below the tourniquet should not be detected, the skin becomes pale.
A note indicating the date and time of its application is attached under the last round of the tourniquet.
Be sure to carry out transport immobilization of the injured limb and anesthesia.
The tourniquet should always be visible.
In cold weather, the limb must be insulated to avoid frostbite.
The duration of application of the tourniquet in the summer is no more than 1 hour, in the winter - no more than half an hour. (For children, a shorter time is preferably 40-20 minutes).
If the time has expired, but the tourniquet cannot be removed:

The damaged artery is pressed with fingers above the tourniquet;

Carefully loosen the tourniquet for 20-30 minutes to restore blood circulation in the injured limb;

The tourniquet is reapplied, but above or below the previous location and a new time is indicated;

If necessary, repeat the procedure after half an hour or an hour.

Errors

The tourniquet was not applied according to indications.
Poor tourniquet application.
Excessive stretching of the tourniquet, which leads to injury to the nerve trunks and muscles.
There is no note indicating the time and date.
Disguise the tourniquet under clothing or bandages.
Apply a tourniquet to the bare body and away from the wound.
Overlay in the middle third of the shoulder.
Delivery of the victim to a medical facility with a tourniquet without immobilization of the limb and insulation.

A hemostatic tourniquet is a device for stopping blood. It is a rubber tape 125 cm long. Its width is 2.5 cm, thickness - 3 - 4 cm. One end of the tape is equipped with a hook, the other with a metal chain. It is no coincidence that this simple device is found in the first aid kit of every car. Sometimes its absence can be fatal. As a result, a big person can die without waiting

How to apply a tourniquet correctly?

When applying a tourniquet, first put rubber gloves on your hands. Then the limb affected by the injury is raised and examined. The tourniquet is not applied to the naked body, but over a fabric pad. This could be a person’s clothing, a towel, a bandage, or cotton wool. A medical tourniquet applied in this way will not cross and will not pinch the skin.

Its end must be taken in one hand, and the middle in the other. Then stretch it harder, and only then circle it around your arms or legs. With each subsequent turn of the winding, the harness stretches less. The loose ends are tied with a knot or secured with a hook and chain. A note must be placed under any one turn of the tape indicating the time it was applied.

The hemostatic tourniquet should not be left in place for more than two hours, otherwise paralysis or necrosis of the arm or leg may occur. Every hour in the warm season and half an hour in winter, the tourniquet is relaxed for a few minutes (at this time the vessel is pressed with your fingers), the application of the tourniquet during bleeding is done in the same way as the first time, only a little higher.

If the tourniquet is applied incorrectly. Their veins could have been accidentally pulled. This will cause the pressure in the blood vessels to increase and bleeding to increase. If the tourniquet is too tight, muscles, nerves, and tissues can be damaged, which leads to paralysis of the limbs. The victim with a tourniquet applied is transported to a medical facility first.

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

A tourniquet is applied to the damaged vessels of the neck using a wooden strip or splint in the form of a ladder. These devices are placed on the side opposite the wound. Due to the splint, the trachea will not be compressed and if there is no splint at hand, you need to put your hand on the back of your head, it will act as a splint. The hemostatic tourniquet can be replaced with a twist, using available material for this: handkerchiefs, scarves, belts, ties.

Application

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

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

In the area of the upper third of the shoulder (the radial nerve can be injured) and the lower third of the thigh (tissue is injured when the femoral artery is pinched).
There are no muscles in the lower third of the forearm and lower leg, and if a tourniquet is applied to these areas, skin necrosis may begin to develop. These areas of the body are shaped like cones, so the tourniquet may slip off when the victim is moved. It’s easier, more convenient and more reliable to apply the tape to your shoulder or thigh.

Arterial bleeding. First aid before the doctor arrives

Loss of blood through an artery often causes death in the victim, so it must be stopped quickly. In the adult body, the blood volume is 4-5 liters. If the victim loses one third of this volume, he may die.

The first thing to do when helping with arterial bleeding is to compress the artery so that blood does not flow into the wounded area and does not flow out. To determine the place where it is located, you need to feel the pulse. Where he is, there is an artery. Confidently press this place with your fingers, but 2-3 centimeters above the wound.

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

When the victim is first, you need to remember that when a tourniquet is applied, the blood supply to all sections that are located below it is stopped. You need to know that blood moves through the arteries from the heart to all peripheral parts.

Internal bleeding

Blood loss as a result of damage to human internal organs is very life-threatening, since its detection is often delayed for some time.

Bleeding occurs when a strong blow is inflicted, as a result of which the spleen and liver are ruptured. In this case, the victim experiences severe abdominal pain, shock and may lose consciousness.
Esophageal bleeding occurs as a result of rupture of veins, as some liver diseases lead to their expansion.
Stomach bleeding occurs due to an ulcer, tumor, or injury to the stomach. The defining sign is vomit of dark red or clotted blood. In this case, the victim must be ensured rest and a semi-sitting position with legs bent at the knees. A compress should be applied to the peritoneal area and food and drink should not be allowed. The victim urgently needs to be hospitalized, where he will undergo surgery.
Bleeding in the chest cavity occurs due to a strong blow or trauma to the chest. The accumulating blood begins to put pressure on the lungs, as a result of which their normal functioning is disrupted. Breathing becomes difficult and suffocation may occur. The victim urgently needs to be transported to the hospital, and before the doctor arrives, put an ice compress on his chest and ensure that he is in a semi-sitting position with his legs bent.

Venous bleeding. First aid

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

But first, the skin around the injury site is treated with iodine, the wound is closed with a sterile bandage, and a sealing roller is applied on top, along the location of the bones. Now the injury site needs to be tightly bandaged, and the injured limb must be elevated. The pressure bandage is applied correctly when the bleeding stops and there are no blood stains on the bandage.

In cases where such assistance is not enough to stop the bleeding, venous tourniquets are applied, only below, and not above, the site of the vessel lesion. You just need to know that venous blood flows in the opposite direction, that is, towards the heart.

Bleeding

When the integrity of the walls of blood vessels is compromised, blood leaks out of them. This is called bleeding. Its danger lies in the fact that the amount of blood that circulates in the vessels decreases. This leads to deterioration of cardiac activity and insufficient supply of human organs with oxygen.

With prolonged blood loss, anemia begins to develop. This is especially dangerous for children and the elderly. Their body does not cope well with the rapidly decreasing blood volume. So, there are three types of bleeding. It depends on the vessel in which they were localized.

Arterial. It can be easily identified: scarlet blood flows like a fountain from the artery.
Venous. Dark blood flows from the injured vessel.
Capillary. This is a mild type of bleeding in which small blood vessels are damaged.
Parenchytamous. It occurs when non-hollow internal human organs, such as the spleen, liver, and kidneys, are damaged. This type of bleeding is mixed. It is associated with the rupture of some organ. Without surgery, it is impossible to completely stop parenchymal bleeding. But when providing first aid to the victim, you should put ice on the site of the alleged damage.

Bleeding occurs:

External.
Internal. In this case, blood from the affected vessel flows into the tissue of an organ.

Signs that indicate bleeding

The most important sign is blood flowing from the vessel. But with internal bleeding, you may not notice it. Therefore, there are other signs:

The skin and mucous membranes become pale.
Dizziness and thirst appear.
Blood pressure drops.
The pulse is weakly palpable and tachycardia appears.
The man loses consciousness. This occurs when there is rapid and severe blood loss.

Arterial and venous bleeding in wounds. First aid

A wound is an injury in which the integrity of the skin, tissues, membranes is damaged, and which is accompanied by pain and blood loss. When injured, pain is caused by damaged receptors and nerve trunks, and bleeding is directly related to the nature and number of damaged vessels. That is why, first of all, the depth of the wound is established and it is determined from which vessel the blood is flowing: veins or arteries. You need to act especially quickly if the wounds are very deep and punctured, and large blood vessels are damaged when wounded.

The assistance is usually provided by people nearby before the ambulance arrives. To stop bleeding, a tourniquet is applied to the injury site.

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

First aid for injuries to the head, chest, neck, abdomen and other areas of the body is carried out by applying a pressure bandage. Sterile gauze is placed on the wound and bandaged.

Please note: there is no need to apply cold when bleeding from a vein or artery, as there is no point in doing so. These large vessels do not narrow when exposed to low temperatures.

Natural openings on the human body. Bleeding from them

Blood loss occurs as it drains from the nose. This can be due to a strong blow or as a result of a traumatic brain injury. To stop the bleeding, the victim should be placed on his back and his head raised slightly. Ice should be placed on the bridge of the nose, neck, and heart area. During this time, you should not clear your nose or blow your nose.

If a person has an ear canal injury or a skull fracture, bleeding from the ear may occur. In this case, a sterile gauze bandage is applied to it, and the victim is placed on the opposite side and his head is raised. It is strictly forbidden to rinse the ear.

How to stop bleeding with bent limbs?

If a wound has formed in the area of the hand or forearm and blood is flowing out of it, you need to place a roll of gauze, bandage or soft fabric in the elbow bend and bend your arm. To fix it in this position, you should tie your forearm to your shoulder. The bleeding will stop.
To stop it from the artery of the forearm, a roller is placed under the armpit, the arm is bent at the elbow, placed on the chest and bandaged.
In case of axillary bleeding, the arms are bent, pulled back and the elbows are tied. This position allows the subclavian artery to press the collarbone to the rib. This technique cannot be used if a person has a fracture of the bone tissue of the extremities.

Car first aid kit. Its equipment

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

Currently, car first aid kits are equipped according to new standards. It includes: a device with which you can perform artificial ventilation of the lungs, bandages, hemostatic gloves and scissors. Disinfectants and all medications are excluded from the first aid kit. It does not contain analgin, aspirin, activated carbon, validol, nitroglycerin, and even iodine with brilliant green.

The contents of a car first aid kit have become much poorer. What caused her to change? First of all, the European practice of providing first aid before the arrival of doctors. They believe that most drivers in Russia do not know how to use the necessary medications. Therefore, for them, calling a doctor and stopping the loss of blood to the victims will be the main task.

Depending on the type of damaged vessel:
View	What does it look like?	Characteristic
Arterial bleeding		The color is bright scarlet. The blood flows out in a pulsating stream, quickly, under pressure. High rate of blood loss.
Venous bleeding		Cherry color of blood. Constant, uniform flow of blood without pulsation. The bleeding rate is less than with arterial bleeding.
Capillary bleeding		Occurs as a result of damage to capillaries, small veins and arteries. The wound surface is bleeding. Bleeding is not as severe as with arterial or venous bleeding.
Parenchymal bleeding		Occurs due to damage to internal organs, such as the liver, spleen, lungs, kidneys. Similar to capillary bleeding, but poses a greater health threat.
Depending on the reason that led to the release of blood from the vascular bed:
1.Haemorrhagia per rhexin		Bleeding as a result of mechanical damage to the vessel wall. The most common.
2. Haemorrhagia per diabrosin		Bleeding due to ulceration or destruction of the vascular wall during pathological processes (inflammatory processes, tumor decay, peritonitis, etc.).
3. Haemorrhagiaperdiapedesin		Bleeding as a result of impaired permeability of the vascular wall. Increased wall permeability is more common in the following conditions: decreased vitamin C in the body, hemorrhagic vasculitis, scarlet fever, uremia, sepsis, etc.
In relation to the external environment
External bleeding		Blood flows from the wound into the external environment.
Internal bleeding		Blood pours into the internal cavities of the body, into the lumen of hollow organs and tissues. Such bleeding is divided into obvious and hidden. Explicit: blood, even in a changed form, appears outside after a certain time Example: gastric bleeding - vomiting or feces with blood (melena); Hidden: blood pours into various cavities and is not visible to the eye (into the chest cavity, into the joint cavity, etc.
By time of occurrence
Primary bleeding		Bleeding occurs immediately at the time of injury when a vessel is damaged.
Secondary bleeding		There are: early and late bleeding. Early ones that occur from several hours to 4-5 days after damage. Causes: slipping of the thread from the vessel applied during the initial operation, washing out of the blood clot from the vessel when pressure increases, blood flow accelerates or the tone of the vessel decreases. Late ones appear 4-5 days or more after damage. This is usually associated with destruction of the vascular wall as a result of the development of infection in the wound.
Downstream
Acute bleeding		The bleeding occurs in a short period of time.
Chronic bleeding		The bleeding occurs gradually, in small portions.
By severity
Lightweight		The volume of blood loss is 500-700 ml;
Average		Loss 1000-1400 ml;
Heavy		Loss 1.5-2 liters;
Massive blood loss		Loss of more than 2000 ml; A sudden blood loss of about 3-4 liters is regarded as incompatible with life.

Common symptoms of bleeding

Classic signs:

The skin is pale, moist;
Rapid heartbeat (tachycardia);
Reduced blood pressure.

Patient complaints:

general weakness and malaise, anxiety,
dizziness, especially when raising the head,
“floaters” before the eyes, “darkening” in the eyes,
nausea,
feeling of lack of air.

Local symptoms of bleeding
For external bleeding:

direct leakage of blood from the damaged vessel.

For internal bleeding:

Gastrointestinal bleeding: vomiting of blood, unchanged or altered (“coffee grounds); change in color of stool, black stool (melena).
Pulmonary hemorrhage: coughing up blood or foaming blood from the mouth and nose.
Bleeding from the kidneys: scarlet color of urine.
Accumulation of blood in cavities (thoracic, abdominal, joint cavity, etc.). When bleeding into the abdominal cavity, the abdomen is swollen, the motor activity of the digestive tract is reduced, and pain is possible. When blood accumulates in the chest cavity, breathing weakens and motor activity of the chest is reduced. When there is bleeding into the joint cavity, there is an increase in its volume, severe pain, and dysfunction.

Providing first aid for bleeding

Methodstemporary stop of bleeding

Pressing the artery
Fixing a limb in a certain position
Elevated limb position
Pressure bandage
Wound tamponade
Vessel clamp

Tourniquet for bleeding

Rules for applying a tourniquet
Applying a tourniquet is a very reliable way to stop bleeding, however, if used inappropriately, it can lead to very serious complications.
Standard tourniquet (Esmarch tourniquet) is a rubber band 1500 cm long, with special fastenings at the ends. Available means (belt, rope, etc.) can be used as a tourniquet. Modern tourniquets have the ability to self-tighten.

Types of harnesses:

Name of the tourniquet	What does it look like?
Rubber band tourniquet (Langenbeck tourniquet)
Esmarch's tourniquet
Tourniquet with dosed compression
Tourniquet NIISI RKKA
Atraumatic tourniquet "Alpha"

When to use?

Arterial bleeding
Any massive bleeding on the limbs.

Placing a tourniquet in the axillary and groin area, as well as on the neck, is not excluded

Rules for applying a tourniquet:

Before applying a tourniquet, it is necessary to elevate the limb;
You cannot apply a tourniquet to a bare limb; you must substitute a cloth (towel, clothing).
If possible, a tourniquet should be applied as close to the wound as possible, on the blood flow side;
When placing a tourniquet, perform 2-3 rounds, evenly stretching the tourniquet so that the tourniquets do not overlap one another, the tourniquet should press the vessel to the bony protrusion;
In case of bleeding from the wrist area, a tourniquet is applied to the shoulder;
After installing the tourniquet, be sure to indicate the exact time of its installation (hour and minutes);
The part of the body where the tourniquet is placed must be accessible for inspection. This is necessary to monitor changes that may occur in the absence of blood supply;
The victim who has a tourniquet applied must be transported to a medical facility and treated there first;
The tourniquet should be removed gradually, loosening it little by little, after performing anesthesia;
The tourniquet should be kept for no more than 2 hours on the lower extremities and no more than 1.5 hours on the upper extremities, with the condition that the tourniquet will be loosened for 20-30 seconds every 30-40 minutes. In the cold season, the tourniquet holding time is reduced to 40-60 minutes on the lower extremities and 30-40 minutes on the upper extremities. Low temperatures impair circulation in tissues, especially in the extremities, this is due to a reflex narrowing of blood vessels under the influence of cold. During long-term transportation of the victim, a tourniquet is applied every 30-40 minutes, regardless of external temperature, should be removed for 20-30 seconds until the skin below the tourniquet turns pink. You can do this for several hours; do not change the time originally written in the note. This technique allows you to avoid irreversible processes in the tissues of the limb. Temporary delivery of blood to tissues will help maintain their viability.
If, after applying a tourniquet, the limb suddenly begins to swell and turn blue, the tourniquet should be immediately removed and reapplied. At the same time, controlling the disappearance of the pulse below the application of the tourniquet.

Method of applying a tourniquet to a limb

The upper third of the shoulder is where the tourniquet is applied. In case of bleeding from the vessels of the upper limb, the tourniquet is applied. In case of bleeding from the vessels of the lower limb, a tourniquet is applied in the middle third of the thigh.
A towel or the victim’s clothing should be placed under the tourniquet so as not to pinch the skin and the pressure on the vessels is uniform.
The limb is raised, a tourniquet is placed under it, stretching it as much as possible. Then wrap it around the limb several times. The tours should lie next to each other without pinching the skin. The first round is the tightest, the second is applied with less tension, the subsequent ones with minimal tension. The ends of the tourniquet are secured over all tours. The tissues should be compressed until the bleeding stops, no more, no less. It is important to make sure that there is no pulse in the artery below the applied tourniquet. If the disappearance of the pulse is incomplete, after 10-15 minutes the limb will swell and turn blue.
Apply a sterile bandage to the wound.
Attach a piece of paper with the exact time of application of the tourniquet (hours and minutes).
Secure the limb using a transport splint, bandage, scarf or other available means.

Method of applying a tourniquet to the neck
In emergency situations, applying a tourniquet to the vessels of the neck is vital and can save lives. However, placing a tourniquet on the vessels of the neck has some peculiarities.
The tourniquet is applied in such a way as to compress the vessels only on one side of the neck and not on the other. To do this, use a Kramer wire splint or other available means on the opposite side of the bleeding, or use the victim’s hand behind the head. This helps maintain blood flow to and from the brain.

Staging technique: A cloth cushion is applied to the bleeding wound (preferably a sterile bandage; if not, you can use improvised means). The roller is pressed with a tourniquet and then wrapped around the arm or splint. Control of pulse arrest is not required. You can keep the tourniquet on your neck for as long as necessary.

Criteria for a correctly applied tourniquet:

Bleeding from the damaged vessel has stopped;
The pulse on the limb below the tourniquet cannot be felt;
The limb is pale and cold.

Errors when applying a tourniquet:

A tourniquet should not be applied to the upper third of the thigh and the middle third of the shoulder; this can cause serious damage to the nerve trunks and be ineffective in stopping bleeding.
The wrong type of bleeding has been determined, and applying a tourniquet only intensifies it (for example: venous bleeding);
The tourniquet is not tightened enough or large vessels are not pressed against the bony protrusions;
Excessive tightening of the tourniquet can cause severe damage to soft tissues (muscles, blood vessels, nerves), which can lead to paralysis of the limb.
Exceeding the time limit for applying a tourniquet can subsequently lead to the loss of a limb;
Applying a tourniquet to a bare leg. Sufficient pressure on the vessels does not occur, and the skin under the tourniquet is injured.
Apply a tourniquet far from the wound. However, if the source of bleeding is not identified in an emergency situation, applying a tourniquet as high as possible from the wound is a vital action. So bleeding from the femoral artery within 2-3 minutes leads to death, therefore there is no time for long discussions and applying a tourniquet at the base of the leg, just below the inguinal ligament would be the best option.

Finger pressure on the artery

A simple method that does not require any auxiliary equipment. The advantage is that it can be completed as quickly as possible. Disadvantage - it is used for a short time, for 10-15 minutes. The method is especially important in emergency situations, when it gives time to prepare for another method of stopping bleeding (application of a tourniquet). The arteries are pressed at certain points. At these points, the arteries lie most superficially and can be easily pressed against bone structures.

Indications:

Arterial bleeding

The main pressure points of the arteries

Pressing the temporal artery, 2 cm upward and anterior to the auditory canal.
Pressing the maxillary artery, 2 cm anterior to the angle of the lower jaw.
Pressing the carotid artery, the middle of the edge of the sternocleidomastoid muscle (upper edge of the thyroid cartilage).
Pressing the brachial artery, the inner edge of the biceps.
Pressure of the axillary artery, the anterior border of hair growth in the armpit.
Pressure of the femoral artery, middle of the inguinal ligament.
Pressing the popliteal artery, the top of the popliteal fossa.
Pressing the abdominal aorta, the navel area (pressing is done with a fist).

Fixing a limb in a certain position

This method of stopping bleeding is used when transporting the victim to the hospital. The technique is more effective if you place a gauze or cotton roll in the flexion area. The indications are generally the same as when applying a tourniquet. The method is less reliable, but also less traumatic.

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

Elevated limb position

The method is simple, but quite effective in case of venous or capillary bleeding. When the limb is raised, the flow to the vessels decreases, the pressure in them decreases, which creates favorable conditions for the formation of a blood clot and stopping bleeding. The method is especially effective for bleeding from the lower extremities.

Pressure bandage

Required materials: bandage and dressing material.
Indications:

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

Technique:
Several sterile napkins are applied to the wound, sometimes a special roller is applied on top, then bandaged tightly. Before applying the bandage, place the limb in an elevated position. The bandage is applied from the periphery to the center.

Wound tamponade

Indications:

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

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

Circular dragging of a limb

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

Clamping a vessel

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

How to stop arterial and venous bleeding?

Step by step guide for bleeding

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

For this you need the following. Place the victim in a horizontal position. In case of massive blood loss or fainting, place the victim in such a way that the head is lower than the body. They raise the upper and lower limbs, thereby increasing the flow to vital organs (brain, lungs, kidneys, etc.). If consciousness is preserved and there is no damage to the abdominal organs, you can give the victim tea, mineral or ordinary water, which will help replenish fluid loss from the body.

Capillary bleeding

Regular bandage on the wound easily stops bleeding. It is enough just to raise the injured limb above the body and the bleeding decreases. At the same time, blood flow to the wound decreases, pressure in the vessels decreases, which contributes to the rapid formation of a blood clot, closure of the vessel and cessation of bleeding.

Venous bleeding

To stop bleeding you need to: pressure bandage. Place several layers of gauze over the wound, a thick wad of cotton wool and bandage tightly. This leads to the fact that under the bandage in the vessels the blood turns into blood clots, which reliably stop the bleeding. Of particular danger are bleeding from large veins of the neck and chest, which normally have negative pressure. And if they are damaged, air can enter them, which can subsequently cause blockage of vital vessels in the lungs, heart, brain and lead to death. Therefore, in case of bleeding from large venous vessels, a tight, airtight bandage should be applied. And if the bandage is completely saturated with blood, you should not remove it; you should put another clean one on top of it.

Arterial bleeding

If the bleeding is small, it is possible to stop it with a pressure bandage. When bleeding from a large artery, finger pressure on the vessel in the wound is used to immediately stop the bleeding while the tourniquet is being prepared. Stop bleeding by applying a clamp to the bleeding vessel and tightly tamponade the wound with a sterile napkin. The clamp should only be used by a surgeon or an experienced paramedic. Also, to urgently stop bleeding, pressing the artery along its length is used. The arteries are pressed against the underlying bone formations. Stopping bleeding with finger pressure is performed only as a short-term measure.

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

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

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

How to stop bleeding from the femoral artery?

Simple actions that will save lives when bleeding from the femoral artery:

Signs of bleeding from the femoral artery: bleeding from a wound on the leg, in which the pool of blood increases to 1 m in a matter of seconds.
Immediately press the arteries below the inguinal ligament with your fist, then press with a hard object (for example: a rolled bandage), through which apply a tourniquet to the thigh. Include a note with the time the bandage was applied. The tourniquet must not be removed until medical workers arrive, even if their arrival is delayed.
Bleeding from the femoral artery for more than 2-3 minutes leads to death.

In case of arterial bleeding, you cannot waste a minute, as it can be fatal. You need to apply a tourniquet as soon as possible. You will learn how to do this correctly in this article.

Knowing how to apply a tourniquet can save lives.

How to apply a tourniquet for arterial bleeding

First of all, you need to make sure that the bleeding is arterial. The blood from the artery is bright, scarlet, flowing from the wound profusely, in spurts.

How to apply a tourniquet correctly? It should be higher than the wound and press the artery against the bony protrusions.

An ordinary tourniquet looks like a long elastic rubber band. At its ends you can see a hook and a chain. With their help, the tourniquet is fixed.

To avoid damaging soft tissues, place gauze, a bandage or any piece of clean cloth under the tourniquet.

They make several turns around the limb, the first one is as tight as possible, blocking the flow of blood, the others are weaker. The tension of the tourniquet should be released gradually.

How to determine that the tourniquet has been applied correctly? The bleeding should stop. A correctly tightened limb should not have a pulse; the skin will turn very pale. But if it acquires a bluish tint and swelling appears, it means that the tourniquet is applied incorrectly. It is untied and reapplied, otherwise it may result in the loss of a limb.

It is important to know how long a tourniquet can be applied. It is quite short, in summer – two hours, in winter – one hour. After this time, the tissue begins to die. Necrotic changes are irreversible, and there is a risk of amputation. To prevent this, the exact time of application of the bandage is recorded. When providing emergency assistance to victims of any accident, you need to write it down on paper and put it under a tourniquet so that it is easier for arriving doctors to navigate.

How to apply a tourniquet to the neck

What to do if the artery passing through the neck is injured? A cloth folded several times is pressed to the wound, and a tourniquet is placed on it. On the opposite side, the tourniquet goes through the arm placed behind the head. Since the other side of the neck is not pinched, blood continues to circulate freely and flow to the brain. The tourniquet can also be passed through the armpit.