Types of bleeding. Types of bleeding and first aid First aid for various types of bleeding

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All people experience bleeding throughout their lives. Hemorrhage is a condition in which blood leaks from a damaged vessel. Most often, capillary bleeding occurs, which the body usually copes with on its own. Venous and arterial bleeding is life-threatening and requires medical intervention. But the most insidious are internal bleeding, which is difficult to detect.

It is important to be able to distinguish between types of bleeding and know their main characteristics in order to provide first aid in a timely manner and save a person’s life. After all, incorrect diagnosis or violation of the rules for stopping bleeding can cost the victim his life.

What types of bleeding are there, what are the main signs of external and internal hemorrhages, what actions exist when providing first aid (FAM) - you will learn about this and much more later in the article.

Classification of bleeding

Hemorrhages are divided into different types; this is necessary to save time and make it easier to determine a treatment plan. After all, thanks to prompt diagnosis, you will not only save lives, but also minimize blood loss.

General classification of types of bleeding:

• Depending on the location of the bleeding:
  • External - a type of bleeding that comes into contact with the external environment;
  • Internal - blood pours into one of the body cavities;
• Depending on the damaged vessel:
  • – capillaries are damaged;
  • – the integrity of the veins is compromised;
  • – blood flows out of the arteries;
  • Mixed – different vessels are damaged;

• Depending on the body cavity into which the blood flows:
  • Bleeding into the free abdominal cavity;
  • Blood flows into the internal organs;
  • Hemorrhage into the cavity of the stomach or intestines;
• Depending on the volume of blood loss:
  • I degree – the victim has lost about 5% of blood;
  • II degree – loss of up to 15% fluid;
  • III degree – the volume of blood loss is up to 30%;
  • VI degree – wounds have lost 30% of blood or more.

The most life-threatening are III and VI degrees of blood loss. Next, we will consider in detail the characteristics of the various and at the same time the most common and dangerous types of bleeding.

Capillary

The most common is capillary hemorrhage. This is external bleeding, which is considered not life-threatening, unless the area of ​​the wound is too large or the patient has reduced blood clotting. In other cases, blood stops flowing out of the vessels on its own, since a blood clot forms in its lumen, which clogs it.

Capillary bleeding occurs due to any traumatic injury during which the integrity of the skin is compromised.

As a result of the injury, bright scarlet blood flows evenly from the damaged capillaries (the smallest blood vessels). The liquid flows out slowly and evenly, there is no pulsation, since the pressure in the vessels is minimal. The amount of blood loss is also insignificant.

First aid for capillary bleeding consists of disinfecting the wound and applying a tight bandage.

You can also apply a cold compress to the damaged area. Typically, capillary bleeding does not require hospitalization.

Venous

Venous hemorrhage is characterized by a violation of the integrity of the veins that are located under the skin or between the muscles. As a result of a superficial or deep injury, blood leaks from the vessels.

Symptoms of venous hemorrhage:

• Blood of a dark burgundy hue flows from the vessels; a subtle pulsation may be present;
• The hemorrhage is quite strong and is manifested by a constant flow of blood from the damaged vessel;
• When you press on the area under the wound, the bleeding decreases.

Venous bleeding is life-threatening, because in the absence of timely medical care, the victim may die from excessive blood loss. In rare cases, the body can cope with such hemorrhage, and therefore it is not recommended to delay stopping it.

If the superficial veins are damaged, the hemorrhage is less intense, and if the integrity of the deep vessels is damaged, profuse blood loss (profuse bleeding) is observed.

With venous bleeding, the victim can die not only from massive blood loss, but also from air embolism. After damage to a large vein, air bubbles clog its lumen at the moment of inhalation. When air reaches the heart, it cuts off blood access to important organs, and as a result, the person may die.

Arterial

Arteries are large vessels that lie deep in soft tissues. They transport blood to all important organs. If the integrity of the vessel is violated, blood begins to leak out of its lumen.

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Arterial bleeding is rare. Most often, the injury occurs as a result of a knife, gunshot, or mine explosion wound. This dangerous injury threatens human life, because the blood loss is quite large.

If you do not provide assistance to the victim for arterial bleeding within 3 minutes after the injury, he will die from exsanguination.

The easiest way to identify arterial hemorrhage is to pay attention to the following signs:

• The blood is bright red;
• The blood does not flow out, but pulsates from the wound;
• The bleeding is very heavy;
• The bleeding does not stop even after pressing under or above the wound;
• The wound is localized at the site of the intended passage of the artery.

Intense arterial hemorrhage quickly provokes massive blood loss and shock. If the vessel ruptures completely, the victim can die from bleeding of the body in just 1 minute. That is why arterial bleeding requires prompt first aid. A tourniquet is most often used to stop bleeding.

You now know what the main signs of external bleeding are, then we will consider what to do if the hemorrhage occurs inside the body.

Internal

This type of hemorrhage is the most insidious, since, unlike external bleeding, it has no obvious symptoms. They appear when a person has already lost a lot of blood.

Internal hemorrhage is a condition characterized by bleeding into one of the body cavities due to damage to blood vessels.

Bleeding can be detected at an early stage by the following signs:

• The victim feels weak and wants to sleep;
• There is discomfort or pain in the abdominal area;
• Blood pressure drops for no reason;
• The pulse quickens;
• The skin turns pale;
• Pain appears when the victim tries to stand up, which disappears when he assumes a semi-sitting position.

Types of internal bleeding occur as a result of penetrating wounds of the abdomen, lower back, rib fractures, stab or gunshot injuries. As a result, internal organs are injured, which disrupts the integrity of their vessels and begins bleeding. As a result, blood accumulates in the abdominal cavity, chest, and permeates wounded organs or subcutaneous fat (hematoma).

The intensity of internal bleeding varies, that is, it can develop quickly or increase over several days after the injury. The severity of such hemorrhages depends on the size of the injury to a particular organ.

In most cases, the spleen is damaged, a little less often – the liver. A one-stage rupture of an organ provokes instant and rapid bleeding, and a two-stage rupture provokes a hematoma inside the organ, which ruptures over time, and the victim’s condition sharply worsens.

Gastrointestinal

This type of hemorrhage is most often a complication of diseases of the digestive tract (for example, gastric and duodenal ulcers). Blood accumulates in the cavity of the stomach or intestines and does not come into contact with air.

It is important to detect the symptoms of gastrointestinal hemorrhage in time in order to transport the victim to a medical facility.

Symptoms of gastrointestinal hemorrhage:

• The patient feels weak and dizzy;
• The pulse quickens and the blood pressure decreases;
• The skin turns pale;
• There are attacks of vomiting mixed with blood;
• Thin, bloody stools or thick black stools.

The main causes of such a complication are ulcers, cancer, various necrotic processes on the inner lining of the gastrointestinal tract, etc. Patients who know their diagnosis must be prepared for such situations in order to go to the hospital on time.

First aid for different types of hemorrhages

It is important to be able to carry out differentiated diagnostics in order to timely determine the type of bleeding and provide competent pre-medical care.

General rules that should be followed for any bleeding:

• If symptoms of bleeding occur, the wounded person is placed on his back;
• The person providing assistance must ensure that the victim is conscious and periodically check his pulse and blood pressure;

• Treat the wound with an antiseptic solution (hydrogen peroxide) and stop the bleeding using a pressure bandage;
• Apply a cold compress to the damaged area;
• The victim is then transported to a medical facility.

The above actions will not harm a person for any type of bleeding.

Detailed tactics for dealing with different types of bleeding are presented in the table:

Type of hemorrhage	Procedure for temporarily stopping hemorrhage (first aid)	Procedure for the final stop of bleeding (medical assistance)
Capillary	Treat the wound surface with an antiseptic; Cover the wound with a tight bandage (dry or moistened with peroxide).	Stitch up the wound if necessary.
Venous	Perform all actions as for capillary hemorrhage; Apply a pressure bandage to the wound, and you need to grab the area above and below the wound (10 cm each).	If the superficial vessels are damaged, they are bandaged and the wound is sutured; If deep veins are damaged, then the defect in the vessel and the wound are sutured.
Arterial	Carry out the activities that are described in the first two cases; Press the bleeding vessel over the wound with your fingers or fist; Insert a tampon soaked in hydrogen peroxide into the wound; Apply a tourniquet to the place of finger pressure.	The damaged vessel is sutured or prosthetized, and the wound is sutured.
Internal (including gastrointestinal)	General first aid measures are carried out.	Doctors administer hemostatic drugs; Infusion treatment to replenish blood volume; Medical supervision; Surgery if bleeding continues.

The measures described above will help stop the hemorrhage and save the victim.

Rules for applying a tourniquet

This method of stopping blood is used for severe venous or arterial hemorrhages.

To properly apply a tourniquet, follow these steps:

It is important to be able to distinguish between different types of bleeding in order to competently provide first aid to the victim.

It is important to strictly follow the rules of first aid so as not to worsen the condition of the wounded person. By remembering even the basic rules, you can save a person’s life.

Conventionally, bleeding is divided into three categories, depending on how deeply the tissue is damaged:

capillary;

venous;

arterial

First aid for capillary bleeding

First aid for capillary bleeding is quite simple: you need to disinfect the wound, bandage the cut and tighten it, but not too tightly, so that the skin area does not turn blue.

To stop the bleeding faster, cold is applied to the wound, however, since ice can lead to infection, it is better to use household metal objects that have been treated with 96% alcohol. Before treating an item with alcohol, it is better to cool it in the freezer.

It is quite easy to distinguish capillary bleeding from others:

superficial wound;

the amount of blood is small;

blood flow is slow;

the color is dark red (since both venous and arterial blood mix in the capillaries).

First aid for venous bleeding

Venous bleeding is more difficult to stop because in this case the blood loss is significantly accelerated and the damage is of medium depth. If the bleeding is of the venous type, then first apply a pressure bandage to the wound. However, the bandage should not be too tight and at the same time weakened, since in the latter case its presence is meaningless.

After applying the bandage, you need to carefully look at the wound for 10 minutes to see if the blood has begun to flow more intensely, because this can happen if the bandage is weak. In this case, the tight bandage needs to be tightened more. If a limb is injured, it can be raised up to the level of the heart so that the blood flows less intensely. Then a cold compress is applied to the wound for 40 minutes, which is replaced as it warms up.

The difference between venous bleeding and others:

The blood is dark in color.

Intense current.

There may be clots.

First aid for arterial bleeding

First aid for arterial bleeding should occur as quickly as possible, however, it is not always possible to provide full assistance for this type of bleeding at home. The area where the injury occurred is lifted and then a tight bandage is applied using an elastic bandage. The bandage is applied a few centimeters above the wound.

Difference between arterial bleeding:

The blood is a rich scarlet color.

It is characterized by “pulsating” leaks in rhythm with heartbeats.

First aid for bleeding differs not only in the depth of the damage, but also in whether the bleeding is internal or external.

First aid for external bleeding

External bleeding always requires disinfection and dressing. The application of a cold compress is only relevant for capillary and venous types: arterial bleeding cannot be reduced with cold.

You can also speed up the stop of external bleeding by changing the position: if possible, the damaged part should be located above or at the level of the heart.

Help with internal bleeding

Help with stomach bleeding is to ensure the correct position for the victim: he should be in a semi-sitting position. Applying a cold compress to the abdomen using ice can reduce blood loss.

Help with pulmonary hemorrhage also lies in the correct positioning of the victim: he must lie on a flat, hard surface. This will reduce the load on the lungs and will save time until the ambulance arrives, since with such bleeding there is a possibility that the person will not be able to breathe when the lungs fill with blood. First aid for bleeding

If a person loses more than 1 liter of blood, he may die. When a large artery is injured, this amount of blood can leak out in a few minutes. Therefore, stopping severe bleeding is as urgent as artificial respiration and cardiac massage . To stop bleeding (in general), you need to: 1. Raise the wounded part of the body as high as possible and press the wound with a scarf or piece of cloth. (If the arm is wounded below the elbow or the leg below the knee, bend your elbow or knee. This way, you can reduce the flow of blood to the bleeding wound.) 2. In case of severe arterial bleeding (if the blood is bright red and pulsating), it is necessary to compress the artery with a tourniquet. There are only 4 places on the human body where a tourniquet can be successfully applied - at the top of the leg and at the top of the arm. Even if bleeding is in the hand or foot area, a tourniquet is applied to the upper part of the limb. A tourniquet can be made from a belt, rope, or twisted piece of fabric. You need to put a towel or piece of cloth under the tourniquet). The tourniquet must be removed after at least 1 hour so that it does not lead to nerve atrophy. If bleeding resumes when the tourniquet is removed, it is necessary to apply another pressure bandage over the wound. 3. Apply a pressure bandage (Place a gauze pad or folded handkerchief on the wound. Place something hard on the cloth, such as a roll of bandage or a mobile phone. Bandage should be done in the direction from the wound to the heart - so that as little blood as possible remains in the limb - this will help reduce pain. If not have a bandage at hand - use a piece of cloth or toilet paper. You can secure the bandage with a pin or bandage). Under no circumstances should you remove objects from the wound - this can significantly increase bleeding and damage tissue. If there is a wounding object or bone sticking out of the wound, make a donut-shaped tampon out of gauze and cotton wool that will surround it and secure it with a bandage.

Features of medical supervision of children.

Features of medical supervision of children, adolescents, boys and girls

Physical education and sports in childhood, adolescence and youth stimulate the growth and development of the body, metabolism, health promotion, promote better plastic processes, increase the functionality of all systems, and also have great educational value.

However, these classes ensure a more harmonious development of the student’s body only if they are carried out taking into account the characteristics of age-related development and under the supervision of a sports doctor.

Based on the dynamics of age-related development of the body, the following age groups are distinguished: 1) pre-school (from 1 year to 3 years); 2) preschool (from 4 to 6 years); 3) junior school (from 7 to 11 years); 4) middle school (from 12 to 15 years old) and 5) high school (from 16 to 18 years old). Ages up to 7 years are considered children, from 8 to 14 – teenage, from 15 to 20 – youth.

When conducting physical exercises with children and during medical supervision over them, it must be taken into account that the development of the child’s body occurs in waves and each age group has its own characteristics. Body growth in length changes unevenly: periods of slow growth (7-10 years) are replaced by accelerated growth at 10-12 years in girls and 13-14 years in boys. The greatest increases in body weight occur during periods of relatively slow body growth in length, that is, from 7 to 10 and from 17 to 20 years.

Periods of increased growth are characterized by a significant increase in energy and plastic processes in the body. During these periods, the body is least resistant to unfavorable environmental factors: infections, nutritional deficiencies, very heavy physical exertion. On the contrary, during periods of greatest weight gain and relatively slow growth, the body is more resilient.

The pace and level of physical development of adolescents largely depend on the degree of puberty. In adolescents with signs of earlier puberty, indicators of physical development and physical fitness are higher than in children in whom the appearance of secondary sexual characteristics is delayed.

It is known that the physical education system and all regulatory requirements are based on passport age. However, there can be significant discrepancies between biological and passport ages, especially at the ages of 11-15 years for girls and 13-16 years for boys. At the same passport age, there are significant differences in the degree of puberty and the level of physical development. For example, one 12-year-old teenager may have the same performance as a 14-year-old, and another 14-year-old can match an 11-year-old. Consequently, a decisive role in assessing the development of children and adolescents is played by the biological level of maturity, determined on the basis of studying the severity of secondary sexual characteristics and indicators of physical development. When drawing up educational and training programs, the biological age of adolescents, that is, their individual deviations from their passport age, should be taken as a basis.

Children are characterized by high excitability of the nervous system, including the centers that regulate the activity of the motor system and internal organs. Children and adolescents are characterized by greater mobility of cortical processes and significant lability of the neuromuscular system. By the age of 13-15, intensive and diversified development of motor function occurs; adolescents easily develop a wide variety of motor skills. At the same time, the functional capabilities of the cardiovascular and respiratory systems in adolescents and even young men and women are still significantly lower than in adults.

In particular, their heart is smaller in weight and size than in adults, and therefore the stroke and cardiac output in young athletes does not reach the values ​​observed in adults.

These and other features of the body of children and adolescents require careful medical supervision during physical exercise and sports.

Only absolutely healthy children should be allowed to participate in sports training. A number of health conditions that do not interfere with performance during normal school activities limit or exclude sports activities associated with intense training. Particular care must be taken to identify foci of chronic infection in children and adolescents. It has been noted that during the period of the most intense stress, young athletes with foci of chronic infection are more susceptible to colds, pustular skin lesions, etc. The reason for this may be fatigue caused by intense muscle activity, and the resulting decrease in the immunobiological, protective forces of the body. Therefore, before children and adolescents begin intensive sports activities, such foci of infection must be eliminated.

Adolescents and young men are characterized by high lability of the nervous devices of the heart. They often exhibit heart rhythm disturbances, which always requires special medical examination, since in some cases these disturbances may be associated with heart damage.

During puberty, adolescents sometimes develop so-called juvenile hypertension. This is due to a violation of vascular tone that occurs during the restructuring of the activity of the endocrine glands (genital, thyroid and adrenal glands). Proper physical exercise and sports help reduce blood pressure. To do this, you should reduce physical activity and especially limit the number of competitions (even eliminating them) in order to reduce emotional arousal. It is also necessary to exclude exercises with weights (especially with a barbell), as they can further increase blood pressure.

In adolescents and young men, sometimes there is a slight lag in the size of the heart from growth and increase in body weight, the so-called small heart. Adaptation of the circulatory system to physical activity with a “small” heart is carried out with greater effort and less economically. In this regard, the performance of such adolescents is reduced. Physical exercise and sports have a beneficial effect on a teenager with a “small” heart, but this requires a particularly careful increase in loads and careful medical supervision.

Various tests are used to assess the functional state of young athletes. For 7-10 year olds, a test with 20 squats or 60 jumps performed in 30 seconds is used. For older and systematically trained young athletes, tests are used with a 15-second run in place at a maximum pace and a 1-2-minute run in place at a pace of 180 steps per minute, as well as the Letunov test, climbing a step of a certain height, and bicycle ergometric loads etc.

The principles for assessing samples are the same as for adults, but taking into account the above age characteristics.

The physical performance of children and adolescents can be quantified using the Harvard Step Test. The height of the step, duration and pace of ascent depending on age and gender are presented in Table. 1.

Table 1 Step height, duration and rate of ascent for children, adolescents and boys (girls) in the Harvard step test

Groups	Step height, cm	Climbing duration, min	Number of ascents per minute
Boys and girls under 8 years old
Boys and girls 8-12 years old
Girls 12-18 years old
Boys 12-18 years old

It is believed that if In<50, работоспособность очень плохая, 51-60 – плохая, 61-70 – достаточная, 71-80 – хорошая, 81-90 – очень хорошая, 90 – отличная. Однако для юных спортсменов, как правило, должны получаться цифры больше 90. Большое значение имеет определение этого индекса в динамике.

When studying children and adolescents, assessment of physical development is relatively more important than in adults. At the age of 4 to 11-12 years, the trunk muscles do not yet fix the spine well enough when holding static poses. In this regard, as well as due to the great plasticity of the bone skeleton in children, the teacher (coach) must constantly monitor their correct posture.

It is also important to pay attention to the symmetrical development of the muscles of the right and left half of the body, limbs and foot muscles. The latter is necessary to prevent flat feet, which can occur in children due to the high plasticity of the muscles and ligaments of the foot and lower leg. Excessive stress on the foot muscles causes flat feet, which cannot always be eliminated.

When playing sports for children and adolescents, the following conditions must be met:

1. Systematic medical control taking into account age characteristics. Children, teenagers, boys and girls involved in sports must undergo a medical examination at least 2 times a year.

2. Strict compliance by the teacher (trainer) with medical recommendations.

3. Only absolutely healthy children, including those without foci of chronic infection, are allowed to play sports.

4. Dividing students into groups homogeneous in biological age and level of preparedness; mandatory individualization of loads.

5. Strict adherence to the regime (household, nutrition), sufficient rest between exercises (young athletes should sleep at least 9-10 hours a day), during the exam period a sharp decrease in physical activity.

6. Mandatory adherence to regularity and gradual increase in loads. The specialization of young athletes should be built on the basis of broad general physical training.

7. It is unacceptable to transfer the features of the regime and methods of training adult athletes into the practice of working with adolescents, boys and girls (highly specialized training without sufficient use of general developmental exercises), frequent use of maximum (maximum) loads, and training with high intensity and large volumes of loads are prohibited.

There are age standards for starting classes in children's sports schools, depending on the type of sport and starting performances in sports competitions of various scale and content, as well as for transition to the category of adult athletes (Table 2).

Table 2 Age of initial training in various sports

Age, years	What kind of sport can you do (initial training)
	Swimming, sports gymnastics
	Figure skating
	Table tennis, tennis
	Diving, skiing (ski jumping and mountain sports), trampolining
	Ski racing
	Rhythmic gymnastics, badminton
	Speed ​​skating, skiing (both combined), football, athletics, sailing, chess and checkers
	Acrobatics, basketball, volleyball, handball, water polo, ice hockey, archery
	Classical wrestling, freestyle, sambo, equestrianism, rowing, shooting, fencing
	Cycling, kayaking and canoeing
	Weightlifting

In classes with children and adolescents, means of physical education and sports are selected depending on the stage of sports training, designed for a number of years: Stage I - initial training, Stage II - special training, Stage III - sports improvement.

At the stage of initial training of children and adolescents, the main content of classes consists of teaching the technique of the chosen sport and various means of general physical training. The duration of the stage is 1-2 years. The first entry into the competition must be at the end of this stage.

The stage of special training is characterized by the fact that an increasing share of it is occupied by improving technique and training in the chosen sport. The stage of sports improvement begins 2-3 years after the start of systematic training. Along with training in the chosen sport, at this stage the means of general physical training do not lose their knowledge, the volume of which is only slightly reduced.

Graduality in competitive loads is established by dosing their number throughout the year: from 13-14 years old - no more than 5-10 competitions, at 17-18 years old - up to 20. The scale of the competition is also taken into account: at primary school age it is allowed to participate only in competitions within schools, on average - in city, and in senior - in republican and all-Union competitions.

Embolism(ancient Greek ἐμβολή - invasion) - a typical pathological process caused by the presence and circulation in the blood or lymph of particles that are not found there under normal conditions (embolus), often causing occlusion (blockage) of the vessel with subsequent disruption of the local blood supply.

Blockage of the bloodstream can occur as a result of injuries, fractures, amputation, and can also be a consequence of intravenous injection, in which case the vessel is blocked by an air plug (also used as a method of killing euthanasia).

Embolism is divided according to the nature of the object causing it as follows:

tissue and fat embolism occur mainly in cases of extensive and severe injuries, fractures of long tubular bones, etc.;

embolism with fluids (amniotic fluid, fat, other);

gas embolism (more specifically, air embolism) occurs during open-heart surgery, injuries to large veins of the neck and chest, and decompression illnesses;

bacterial embolism is associated with blockage of blood vessels by accumulations of microbes;

embolism with foreign bodies, mainly small fragments from gunshot wounds; often has a retrograde character;

embolism caused by a detached blood clot or part of it - thromboembolic disease - is of greatest practical importance. Blood clots or their parts (thromboemboli) from peripheral veins settle, as a rule, in the pulmonary artery basin (see Pulmonary embolism). In the arteries of the great circle, embolism is usually caused by the separation of thrombotic deposits on the valves or walls of the left half of the heart (with endocarditis, heart defects, aneurysmal ventricle);

drug embolism can occur when injecting oil solutions subcutaneously or intramuscularly if the needle accidentally enters a vessel. Oil trapped in the artery clogs it, which leads to malnutrition of surrounding tissues and necrosis.

Local circulatory disorders (hyperemia, ischemia, heart attack).

Local circulatory disorders include arterial and venous hyperemia, stasis, thrombosis and embolism. Their occurrence may be associated both with a violation of neurohumoral regulation and with the pathology of the corresponding organs and systems. These disorders, being the leading link in the pathogenesis of most diseases, require detailed consideration.

Ischemia (anemia)

Develops as a result of insufficient or complete cessation of arterial blood flow.

Based on the causes of occurrence and mechanisms of development, the following forms are distinguished:

1. Angiospastic (reflex) -

It occurs as a result of arterial spasm, caused either by an increase in the tone of vasoconstrictors, or by the effect of vasoconstrictor substances on the vessel wall. In some cases, vasospasm is associated with a change in the functional state of the smooth muscles of the vascular walls, as a result of which their sensitivity to pressor agents increases;

2. Compression

When arteries are compressed by a scar, a tumor, a tourniquet, etc.

3. Obstructive

Occurs when the artery lumen is partially or completely closed by a thrombus, embolus, atherosclerotic plaque,

4. Redistribution (with centralization of blood circulation, although this is essentially a compensatory-adaptive process). Signs of ischemia:

Pallor of tissues and organs due to decreased blood supply.

A decrease in the temperature of the ischemic area due to a decrease in the influx of warm arterial blood and a decrease in the intensity of metabolic processes.

Decrease in volume and turgor of ischemic tissues and organs due to insufficient blood and lymph supply,

A decrease in the magnitude of arterial pulsations as a result of a decrease in their systolic filling,

The occurrence of pain, paresthesia due to irritation of receptors by under-oxidized metabolic products.

A classic example of tissue ischemia is INFARCTION, which was discussed in detail in the lecture.

It should be noted that the outcome of ischemia is ambiguous and depends on the degree of development of collaterals. The opening of collaterals during ischemia is caused by two factors.

Firstly, a pressure difference arises above and below the site of obstruction and blood tends to flow to an area of ​​lower pressure, thereby opening the collaterals. In this case, a decrease in pressure distal to the site of compression or obstruction plays a role, and not an increase above this area, since elastic arteries can stretch, which will practically not lead to an increase in the level of pressure above the obstruction.

Secondly, in the ischemic area, under-oxidized metabolic products accumulate, which irritate tissue chemoreceptors, resulting in a reflex opening of collaterals

Myocardial infarction- one of the clinical forms of coronary heart disease, occurring with the development of ischemic necrosis of the myocardium, caused by an absolute or relative insufficiency of its blood supply.

On December 17, 2012, the American College of Cardiology and the American Heart Association published the most current clinical guidelines for the management of persistent ST-segment elevation myocardial infarction on the ECG and its early complications. A little earlier, in October 2012, the European Society of Cardiology updated its recommendations on this form of the disease. The societies published their latest updates to their recommendations for the management of acute coronary syndrome without persistent ST segment elevations on the ECG in May and December 2011, respectively.

Hyperemia(from ancient Greek ὑπερ- - over- + αἷμα - blood) - overflow of blood vessels of the circulatory system of any organ or area of ​​the body.

There are:

active hyperemia or arterial, depending on increased arterial blood flow;

venous (passive) hyperemia caused by difficulty in the outflow of venous blood.

Dystrophy.

Dystrophy (Old Greek dystrophe, from dys... - a prefix meaning difficulty, disturbance, and trophe - nutrition) - difficult pathological a process based on a violation of cellular metabolism leading to structural changes. Dystrophy is characterized by damage to cells and intercellular substance, as a result of which the function of the organ changes. Dystrophy is based on a violation of trophism, that is, a complex of mechanisms that ensure metabolism and preservation of the structure of cells and tissues. Trophic mechanisms are divided into cellular and extracellular. performs its inherent function. Extracellular mechanisms include a system for transporting metabolic products (blood and lymphatic microvasculature), a system of intercellular structures of mesenchymal origin and a system of neuroendocrine regulation of metabolism. If there is a violation in any link of the trophic mechanisms, one or another type of dystrophy may occur.

Hypertrophy.

Hypertrophy(from ancient Greek ὑπερ- - “through, too” and τροφή - “food, food”) - an increase in the volume and mass of an organ, cells under the influence of various factors. Hypertrophy can be true or false. With false hypertrophy, the enlargement of the organ is due to the increased development of adipose tissue. The basis of true hypertrophy is the reproduction (hyperplasia) of specific functioning elements of the organ.

True hypertrophy often develops as a result of increased functional load on a particular organ (so-called working hypertrophy). An example of such hypertrophy is the powerful development of muscles in people engaged in physical labor and athletes. Depending on the nature of training, different types of hypertrophy can occur in muscles: sarcoplasmic and myofibrillar.

Sometimes the term is used figuratively, as a metaphor.

Atrophy is the partial destruction of the protoplasm of a muscle cell in a living organism. With atrophy, a decrease in the thickness of muscle fibers is observed, the content of contractile proteins and energy substances in them decreases, areas of necrosis appear in the heart muscle, and ulcers appear in the stomach. Atrophy often develops in people who have been ill for a long time and are on bed rest, in people with injured nerves, cut tendons or with plaster casts. A direct consequence of atrophy is a decrease in muscle mass and a decrease in their performance. With timely restoration of motor activity, the consequences of atrophy gradually disappear.

Thrombosis(Novolat. thrombōsis - coagulation from ancient Greek θρόμβος - clot) - intravital formation of blood clots inside blood vessels, preventing the free flow of blood through the circulatory system. When a blood vessel is damaged, the body uses platelets and fibrin to form a blood clot (thrombus), preventing blood loss. Under certain conditions, blood clots can form in the bloodstream even without damaging blood vessels. A clot that circulates freely throughout the bloodstream is called an embolus.

When a thrombus covers more than 75% of the cross-sectional area of ​​the artery lumen, the flow of blood (and, accordingly, oxygen) to the tissue is reduced so much that symptoms of hypoxia and accumulation of metabolic products, including lactic acid, appear. When obstruction reaches more than 90%, hypoxia, complete oxygen deprivation and cell death may follow. Thromboembolism is a combination of thrombosis and its main complication, embolism.

Stasis, hemostasis, lymphostasis.

Stasis(Greek στάσις - standing, immobility) - a stop in the lumen of a particular tubular organ of its physiological contents.

Stasis can occur in various cases:

Stopping the flow of blood (hemostasis) or lymph (lymphostasis) in the vessels of the microvasculature

The cessation of the outflow of bile into the duodenum as a result of a violation of its formation or excretion due to pathological processes ( cholestatic syndrome, depending on the location of the obstacle, is divided into intrahepatic and extrahepatic).

Stopping the movement of feces (coprostasis).

Hemostasis system is a biological system in the body, the function of which is to maintain the liquid state of the blood, stop bleeding in case of damage to the walls of blood vessels and dissolve blood clots that have fulfilled their function. There are three main mechanisms for stopping bleeding in case of vascular damage, which, depending on the conditions, can function simultaneously, with one of the mechanisms predominant:

Vascular-platelet hemostasis, caused by spasm of blood vessels and their mechanical blockage by platelet aggregates. On collagen molecules exposed as a result of damage to the vessel wall, platelet adhesion (sticking), activation and aggregation (sticking together) occurs. In this case, a so-called “white thrombus” is formed, that is, a thrombus with a predominance of platelets.

Coagulation hemostasis (blood clotting) , is triggered by tissue factor from the tissues surrounding the damaged vessel, and is regulated by numerous blood clotting factors. It ensures a tight blockage of the damaged area of ​​the vessel with a fibrin clot - this is the so-called “red thrombus”, since the resulting fibrin network includes blood cells and red blood cells. Earlier vascular-platelet hemostasis called primary coagulation secondary, since it was believed that these mechanisms successively change, but it has now been proven that they can occur independently of each other.

Fibrinolysis- dissolution of the blood clot after reparation (repair) of the damaged vessel wall.

The final result of the blood coagulation system is the conversion of fibrinogen into fibrin fibers under the action of thrombin. It has been established that any clot that forms in blood vessels, including arteries, is platelet-fibrin. Platelets play an important role in the restoration of vessel walls: a large number of active substances are released from the platelets involved in the formation of a clot. Among others, it stands out platelet growth factor(English) Platelet- derived growth factor, PDGF) is a strong stimulator of tissue repair. The final stage of the hemostatic system is fibrinolysis. The fibrinolysis system breaks down the fibrin clot as the damaged vessel is repaired and the clot is no longer needed.

Lymphedema (lymphostasis) - congenital or acquired disease lymphatic system associated with impaired outflow lymph from lymphatic capillaries and peripheral lymphatic vessels limbs and other organs to the main lymphatic collectors and the thoracic duct. This is tissue swelling caused by impaired outflow of lymphatic fluid. The latter is a component that is produced in the tissues (part of the fluid from the tissues is evacuated through the veins and through the lymphatic system), which leads to an increase in the size of the affected organ.

Necrosis(from Greek νεκρός - dead), or necrosis is a pathological process expressed in the local death of tissue in a living organism as a result of any exo- or endogenous damage. Necrosis manifests itself in swelling, denaturation And coagulation cytoplasmic proteins, destruction of cellular organelles and finally the entire cell. The most common causes of necrotic tissue damage are: interruption of blood supply (which can lead to heart attack, gangrene) and exposure to pathogenic products of bacteria or viruses ( toxins, proteins that cause hypersensitivity reactions, etc.).

Desynchronosis.

DESYNCHRONOSIS (simultaneous), a change in various physiological and mental functions of the body as a result of disruption of the circadian rhythms of its functional systems.

Inflammation.

Inflammation (lat. inflammatio) is complex, local and general pathological process, which occurs in response to damage (alteratio) to the cellular structures of the body or the action of a pathogenic irritant and manifests itself in reactions (exudatio, etc.) aimed at eliminating the products of damage, and, if possible, also agents (irritants), and also leading to maximum given conditions for restoration (proliferatio, etc.) in the damage zone.

Regeneration.

Regeneration(restoration) - the ability of living organisms to restore damaged tissues, and sometimes entire lost organs, over time. Regeneration is also called the restoration of a whole organism from its artificially separated fragment (for example, the restoration of a hydra from a small fragment of the body or dissociated cells). In protists, regeneration can manifest itself in the restoration of lost organelles or cell parts.

Regeneration is the restoration by the body of lost parts at one or another stage of the life cycle. Regeneration that occurs in the event of damage or loss of any organ or part of the body is called reparative. Regeneration during the normal functioning of the body, usually not associated with damage or loss, is called physiological.

Tumor(syn.: neoplasm, neoplasia, neoplasm) - a pathological process represented by newly formed tissue, in which changes in the genetic apparatus of cells lead to disruption of the regulation of their growth and differentiation.

All tumors are divided depending on their potential for progression and clinical and morphological features into two main groups:

benign tumors,

malignant tumors.

There are 5 classic features of tumor tissue: atypia (tissue, cellular), organoid structure, progression, relative autonomy and unlimited growth.

Allergy.

Allergy(ancient Greek ἄλλος - other, different, alien + ἔργον - impact) - hypersensitivity of the body's immune system upon repeated exposure to an allergen on an organism previously sensitized by this allergen.

Symptoms: pain in the eyes, swelling, runny nose, hives, sneezing, coughing, etc.

Periods of illness.

hidden or latent(for infectious diseases - incubation), - the period between the onset of exposure to a pathogenic agent and the appearance of the first symptoms of the disease. It can last from a few seconds (for example, in case of poisoning with strong poisons) to tens of years (for example, in case of leprosy).

prodromal period- the period of appearance of the first signs of the disease, which may be of an uncertain, nonspecific nature (fever, fatigue, general malaise) or in some cases be typical for a given disease (for example, Filatov-Koplik spots in measles).

period of full development of the disease, the duration of which ranges from several days to tens of years (tuberculosis, syphilis, leprosy).

period of completion of illnesses(recovery, convalescence) can occur quickly, critically or gradually, lytically. Depending on the duration of the course and the speed of increase and disappearance of the manifestations of diseases, acute and chronic are distinguished. The addition to the main manifestations of the disease of additional changes that are not related to the direct cause of the disease, but develop as a result of its course, is called a complication. It can occur at the height of the disease and after its main manifestations have passed. Complications aggravate the disease and sometimes cause an unfavorable outcome. The outcome of diseases can be: complete recovery, recovery with residual effects, persistent changes in organs, sometimes the emergence of new forms of the disease in the form of long-term consequences and death. Death as the end of the disease can occur suddenly, after a short agony, or gradually, through a more or less prolonged agonal state

Pathology.

Pathology(from the Greek παθος - suffering, pain, illness and λογος - study) - a painful deviation from the normal state or development process. Pathologies include processes of deviation from the norm, processes that disrupt homeostasis, diseases, dysfunctions (Pathogenesis).

In biology, refers to the study of structural and functional changes in cells, tissues and organs during disease. Also used in English terminology.

In medicine the word pathology- often synonymous with disease.

Mud therapy. Indications, t, duration of exposure, contraindications.

Healing mud(peloids) - sediments of various bodies of water, peat sediments swamps (peat bogs), eruptions mud volcanoes and other (modern or geologically young) natural formations consisting of water, mineral and, as a rule, organic matter, having a uniform, finely dispersed structure and, in most cases, an ointment-like consistency (plastic masses), due to which they can be used in a heated state for medicinal purposes in the form of baths and local applications - for mud therapy . Healing mud is the result of complex long-term processes - under the influence of factors of geological, climatic, hydrogeological (geochemical), biological (chemical-biological) and other nature. The material for the formation of medicinal mud are mineral particles, organic matter(remains of plant and animal organisms), colloidal particles of organic and inorganic composition, water. The formation of mud occurs under the influence of microorganisms, the number of which can reach 1 billion or more in 1 g of dry mud. As a result of the biochemical processes occurring with their participation, medicinal muds are enriched with so-called biogenic components (compounds of carbon, nitrogen, sulfur, iron, etc.), many of which (for example. hydrogen sulfide) exhibit high therapeutic activity. The physical properties of mud are similar to those of peloid-like substances (paraffin, ozokerite), used using thermotherapy methods similar to mud therapy.

Indications: Diseases of the musculoskeletal system; rheumatism (not earlier than 6-7 months after an acute attack); chronic rheumatoid polyarthritis; infectious and nonspecific polyarthritis; dystrophic (non-infectious) polyarthritis; residual effects after joint injuries; osteomyelitis; diseases of the genitourinary system in men; diseases of the female genital organs, including chronic inflammatory processes and infertility; spastic constipation; chronic hepatocholecystitis; adhesive processes. Many diseases and consequences of injuries of the peripheral nervous system, especially: radiculitis, plexitis, polyneuritis, neuritis - infectious, rheumatic, due to poisoning; consequences of polio in children.

Mud therapy is used with great success for many surgical, otorhinolaryngological, eye and skin diseases.

11

Health 05/05/2016

Dear readers, today we will talk about an important topic. How to provide first aid for bleeding. Surely many of you have encountered this in this life. And it is on competent and timely assistance that a person’s life can depend. We have already discussed how to help ourselves and loved ones, but bleeding can also be more dangerous, for example, with deep and numerous wounds.

Injuries occur even in everyday life due to negligence, not to mention car accidents, in which sometimes the lives of the injured person are counted by literally minutes. And in such cases, it is very important not to get confused, but to do everything possible to save the person. Today we will look at the types of bleeding and what you can do on your own before the ambulance arrives. We will not delve into medical terms, but will only talk about what we all need to know at our everyday level of life.

A person can lose up to 0.5 liters of blood without harm to health. A blood loss of more than 1 liter already poses a danger to the body, and a blood loss of more than 2 liters requires its immediate replenishment - otherwise death is possible. This is why it is so important for us to know how to stop bleeding.

Types of bleeding and first aid for them

In order to correctly provide first aid to an injured person, you need to know that there are different types of bleeding, this is very important, since with different bleeding, first aid measures can differ significantly. It is also important to have in your home first aid kit, and even more so in your car, everything you need to provide first aid for wounds and bleeding. Now let's look at the types of bleeding and how to recognize them correctly.

Bleeding can be external and internal, arterial, venous and capillary. Bleeding also differs in the time of its manifestation. In this case, we talk about primary bleeding, which begins immediately after the injury, or secondary bleeding, which does not develop immediately, but over the course of even several days due to the fact that blood clots can form thrombi in the damaged vessel, and then be pushed out by the blood flow , causing bleeding.

External bleeding

If bleeding occurs when the skin, nearby soft tissues or mucous membranes are damaged and are visible to any person, then we are talking about external bleeding. Such bleeding usually occurs from wounds, cuts and other injuries, and their intensity varies depending on which vessel is damaged.

Internal bleeding

Internal bleeding is not immediately visible, and only by certain indirect signs can trouble be suspected. Internal bleeding occurs when there is injury to internal organs, such as the liver, spleen, kidneys, lungs, bladder, or blood vessels located inside the body. In this case, blood loss can be so profuse that medical attention is needed immediately.

If the affected person turns pale, feels dizzy, has general weakness, tinnitus, lethargy, rapid heartbeat, blood pressure drops, a weak pulse can be heard, cold sweat appears, bleeding in the internal organs can be suspected. In such cases, symptoms increase very quickly until loss of consciousness and help is needed immediately.

Internal bleeding can occur not only as a result of injury, but also due to certain diseases. For example, stomach ulcers, malignant tumors of the stomach, gastric diverticula, the presence of polyps, diaphragmatic hernia and many others. In the case of gastric bleeding, vomiting of blood may occur, but only a specialist can determine the severity and cause of the bleeding, which means that if there is the slightest suspicion of internal bleeding, the person must be taken to a medical facility as soon as possible.

Arterial bleeding

It is equally important to distinguish which vessels are damaged during injury and cause bleeding. Arterial bleeding is most dangerous when the arteries, the largest blood vessels in our body, are damaged. Arterial blood has a bright scarlet color; from a damaged artery it not only flows out, but literally gushes out in a pulsating stream, creating a threat to life.

Signs of arterial bleeding: a large amount of blood near the victim. And the amount of blood can increase quickly. That’s why you can’t hesitate at all!

Venous bleeding

Venous bleeding differs from arterial bleeding in a much smaller volume of blood emitted, and the blood is darker in color and flows in a continuous stream. If the veins are damaged, it is easier to stop the bleeding, but if large veins are damaged, this is also life-threatening and requires immediate, correct assistance.

Capillary bleeding

Capillary bleeding is considered the least dangerous, since the blood flows from small blood vessels, and, as a rule, when many capillaries located close to the surface of the skin are damaged. In this case, the entire wound bleeds bright scarlet blood.

First aid for external bleeding

We have looked at the types of possible bleeding, now let's talk about first aid for various types of bleeding. Knowledge of first aid for external bleeding is necessary to help yourself in case of injury, as well as other people who may need this help.

Of course, first of all we will talk about life-threatening arterial or venous bleeding, when it is necessary to apply a sterile bandage and a tourniquet that blocks the blood flow in a matter of minutes. A person’s life literally depends on this.

First aid for arterial bleeding

During arterial bleeding, a person loses blood very quickly and can die from blood loss, so it is necessary in the very first minutes to stop the blood flowing from the artery by pressing the damaged artery with your fingers or fist, and then try to quickly apply a tourniquet constricting the artery. If you don’t have a medical tourniquet on hand, you can use a scarf, belt, rope or something else that can temporarily compress the damaged artery.

How to provide first aid for arterial bleeding? Rules for applying a tourniquet for bleeding .

Sterile dressing . After clamping the artery, a sterile dressing must be applied to the wound to avoid bacterial contamination of the wound. It is better if another person does this while the second one pinches the artery with his fingers.

Application of a tourniquet. If the artery is damaged in the arms or legs of a person, then the medical rubber tourniquet needs to be stretched a little and tightly wrapped around the limb in 2 or 3 turns, 2 to 3 centimeters above the wound, securing its ends. You can quickly stop blood loss before applying a tourniquet by bending your arm or leg as much as possible in the joint located above the wound, thus temporarily squeezing the artery. But if there are visible fractures, then the injured limb must be kept motionless.

A note indicating the time of application of the tourniquet. Heart rate monitoring . There must be a note placed under the tourniquet indicating the time of application of the tourniquet. The pulse in the limb bandaged with a tourniquet should not be audible. The tourniquet cannot be kept tight for more than an hour, and if during this time it was not possible to deliver the victim to the hospital, the tourniquet is loosened, the blood is allowed to drain and the tourniquet is tightened again. If the hand swells and turns blue, you need to immediately remove the tourniquet and after a while you need to reapply it.

If the wound is on the leg, then the artery should be compressed with a fist closer to the groin. Then apply a tourniquet.

If the wound is on the lower leg, a tourniquet is applied under the knee through a hard object. Anything will do: a piece of soap, a pebble, whatever you have on hand.

For a wound on the thigh, a tourniquet is also applied through a hard object. Place it closer to your groin.

Particular attention should be paid to wounds on the neck. The video, which you can watch below, clearly shows what should be done with such wounds.

Pressure bandage. After applying the tourniquet, a pressure bandage is applied to the wound itself.

We do not allow the skin to turn blue . You should not cover the place where the tourniquet is applied with clothing in order to see the condition of the wound and, if the skin turns blue, immediately loosen the tourniquet to prevent tissue necrosis, which often leads to amputation of the limb.

If the carotid artery is damaged, the tourniquet is applied only through a soft bandage and always through the shoulder or armpit, so as not to aggravate the situation and not lead to suffocation.

Urgently call an ambulance . After providing first aid, you must call an ambulance or take the injured person to the hospital yourself.

Since it is quite difficult to describe in words how to correctly apply a tourniquet for arterial bleeding when various arteries are damaged, I suggest watching a short video on this topic, which clearly shows how to apply a tourniquet in different parts of the body and what to do if the vessels of the neck are damaged.

Providing first aid for bleeding. Video

First aid for venous bleeding

Venous bleeding differs from arterial bleeding in that the color of the blood is darker and the blood, as I already said, flows out in a continuous stream. It must be remembered that venous blood flows from peripheral vessels to the heart, so it is necessary to clamp the vein both above and below the wound to avoid severe blood loss.

That is, the main difference between venous bleeding and arterial bleeding is that the blood flows slowly and is dark in color.

In case of venous bleeding, there is no need to apply a tourniquet. It will be enough to apply only a pressure bandage, placing a sterile bandage or napkin and a piece of cotton wool under it.

When bleeding from deep veins, the threat to life is very high, and if you see that the bleeding does not stop and the bandage is quickly soaked in blood, then the deep vein is damaged and the wounded person must be urgently taken to a hospital or emergency room. If possible, apply cold over a compressive bandage.

Look at the video on how to provide assistance for arterial and venous bleeding using improvised means and how this assistance differs.

First aid for internal bleeding

If, based on a number of signs, you suspect internal bleeding, you should urgently call an ambulance. Before the doctors arrive, the person needs to be provided with fresh air and a stationary state. Make sure that the person does not move, does not talk, and do not give him anything to drink. Only a doctor can determine which internal organ is damaged, so the main thing with increasing signs of internal bleeding is emergency medical care.

Little Prince Gregory Lemarchal

Providing first aid for bleeding is actions aimed at stopping it. Every person should know about them and be able to do them: a situation may arise that will require the necessary measures to help the victim live to receive qualified help. And sometimes you have to act quickly and accurately.

Characteristics of bleeding: first aid

They are distinguished by the type of damaged vessel. You must be able to identify all types of bleeding. Providing first aid depends on what exactly is damaged in the body. There are three:

1. Capillary. The integrity of a small vessel (or several) is compromised.
2. Arterial. The artery leading from the heart is broken. The bleeding is very severe and threatens the victim with death from blood loss if certain actions are not taken urgently.
3. Venous. The flow of blood is not as intense as with arterial bleeding, but it is also significant.

In addition to obvious, external bleeding, there are also internal ones. You need to be able to recognize them: timely provision of first aid in case of bleeding into internal cavities significantly increases the chances of survival of the victim (or patient).

Capillary bleeding

Let's start with the simplest, one might say, everyday situations. Damage to capillaries is common, especially in children with an immature vestibular system. Broken knees and scraped elbows are such common injuries that parents take them calmly. Providing first aid for bleeding caused by a violation of the integrity of the capillaries is quite routine: disinfecting the wound and applying a bandage to prevent infection. In case of deeper damage, when quite a lot of blood flows out, it is necessary to apply a pressure bandage. In this case, you should consult a doctor only when the victim has

Bleeding from the nose

Another fairly common household variant of blood loss. It can be caused by an unsuccessful fall when a person does not have time to put his hands out, a blow to the face, or a rupture of a vessel (for example, with high blood pressure in a hypertensive patient). Forcing the victim to lift their face up is the first reaction of most people to nosebleeds. Providing it, however, consists in exactly the opposite actions. The person must be seated with a slight tilt forward so that blood does not enter the throat and nasopharynx - this can cause vomiting and coughing. If the nose is not broken, a tight tampon soaked in peroxide is inserted into the nostril and pressed with a finger. Cold is applied to the bridge of the nose - it will not only speed up the stopping of bleeding, but also prevent the appearance of swelling if a person has received a blow. In about twenty minutes the bleeding will stop. To check, you need to ask the victim to spit - if the saliva does not contain blood, the person can continue to live peacefully. A visit to the doctor is required only in case of a broken nose or unstoppable bleeding.

Arterial bleeding

The most dangerous of external (and internal) types. If the provision of first emergency medical aid for bleeding from the arteries is illiterate or delayed, the person will die very quickly. Signs of damage to the artery:

• very bright, scarlet color of blood;
• gushing from a wound;
• splashes of blood in rhythm with the pulse.

If a small artery is damaged, the limb is pulled above the wound, and the victim is quickly taken to a medical facility (by ambulance or by own transport). If a large vessel is damaged, the limb is raised, the artery above the wound is pressed with a finger (with a fist, if the artery is femoral) - this is necessary to stop the “fountain”. Then a tourniquet is applied. Usually there is no medical equipment at hand, so its functions are performed by string, a strip of fabric, a towel, a belt, a dog leash - whatever is closest. Delivery to the hospital is required, and as quickly as possible.

Venous bleeding

It is characterized by intense, but not gushing, smooth flow of blood of a dark, purple color. First, first aid for bleeding from a vein involves applying a fairly wide pressure bandage. If it is ineffective, a tourniquet is used, but it should be applied below the wound. The arm or leg, as in the case of the arteries, needs to be slightly elevated so that the blood flow to the limb is weakened.

How to apply a tourniquet

In case of serious bleeding, you cannot do without it. However, in addition to the place where it should be fixed, you need to know how to do it correctly.

1. The area of ​​the limb is wrapped with clean cloth above the wound (in case of venous bleeding - below).
2. The leg (arm) is raised and placed on any support.
3. The tourniquet stretches a little, if, of course, you have a medical rubber one. After wrapping it around the limb two or three times, it is secured in the desired position with a chain and hook. If the tourniquet is made from scrap materials, the ends are simply tied.
4. A note is placed under the bandage indicating the time (up to a minute) for applying the tourniquet. There is no paper - the data is written directly on the skin, away from the wound (even on the forehead). Keeping it longer than an hour and a half in summer and an hour in winter is fraught with the onset of necrotic phenomena. If it was not possible to get to the hospital during this time, the tourniquet is removed for ten minutes, the artery or vein is manually clamped for this time, and after “rest” it is applied again.
5. The wound is bandaged sterilely.
6. The victim is urgently taken to the hospital.

If swelling is observed and the skin becomes blue, it means that the tourniquet is not applied correctly. It is immediately removed and applied more successfully.

Prohibited actions

Providing first aid for bleeding also includes observing the main medical commandment: “do no harm.” We list things that you cannot do if you do not have a medical education.

1. Do not touch the wound with your hands: infection is possible, and in some cases, painful shock.
2. It is strictly forbidden to clean the wound. This should only be done by a surgeon and in an operating room. If a foreign object sticks out of the wound, it is carefully fixed so that it does not expand the damage during transportation. In this case, the bandage is applied around it.
3. Bandages should not be changed, even if they are soaked in blood.

And most importantly, go to the hospital as soon as possible. If there is no ambulance, take the victim yourself.

Internal bleeding

No less dangerous than arterial. A particular threat is posed by the fact that a non-professional may not immediately identify him. Considering that often the patient does not feel pain, we have to rely on secondary signs:

• weakness accompanied by pallor;
• chills with;
• dizziness, possible fainting;
• breathing disorders: irregular, shallow, weak;
• the stomach hardens and swells, the person tries to curl up into a ball.

Actions must be quick and decisive: calling an ambulance, an ice heating pad on the stomach, transport while sitting. Under no circumstances should food, drink or pain medication be given.

Traumatic amputation

In case of road accidents or possible separation of a limb from the body. Providing first aid for bleeding caused by amputation should also be supplemented by preserving the limb if the arm is torn off below the elbow and the leg below the knee. The limb is placed in two bags, covered with ice if possible and sent along with the victim. If transportation does not take more than six hours, there is a possibility of sewing the limb back to its rightful place. In Moscow, for example, this is possible in hospitals No. 1, 6, 7, 71, in the Scientific Center of Surgery of the Russian Academy of Sciences and the City Clinical Hospital. When calling an ambulance, be sure to clarify that the victim has a traumatic amputation.

Stopping bleeding - this is the first thing instructors talk about when teaching how to provide first aid for injuries and accidents. What types of bleeding are there and first aid for them is what will be discussed below.

Types of bleeding

First, let's look at why it is dangerous. In medicine, there are several classifications. At the same time, the familiar bleeding from an injured arm or leg is just a special case.

Types of bleeding. First aid for bleeding depends on what kind of vessel was damaged, in what location and how intense the bleeding is.

Separation according to the place of blood flow:

• external;
• internal.

Separation by type of damaged vessels:

• venous;
• arterial;
• capillary;
• parenchymal;
• mixed.

According to the nature of the process that led to bleeding:

• traumatic;
• pathological.

By severity:

• light - up to 500 ml;
• average - up to 1 l;
• heavy - up to 1.5 l;
• massive - up to 2.5 l;
• fatal - up to 3 liters (which is 50-60% of the total blood volume);
• absolutely lethal: from 3 to 3.5 liters (more than 60% of the total volume).

For small children, blood loss of about 250 ml is considered dangerous.

Common signs of bleeding

In this case, general symptoms appear:

• weak pulse;
• rapid heartbeat;
• dizziness;
• decreased blood pressure;
• fainting state.

In severe cases, hypovolemic shock develops, caused by a decrease in the amount of blood in the vascular bed and insufficient blood supply to vital organs with oxygen.

Ways to help with external bleeding

When providing first aid, so-called temporary stopping methods are used. Depending on the type of bleeding, first aid for bleeding may include the following techniques.

If serious types of bleeding are observed, treatment should be provided as quickly as possible. Sometimes the minutes count. How do you know how dangerous a situation is? To do this, it is necessary to distinguish one type of bleeding from another.

Arterial

Damage to the arteries causes dangerous types of bleeding. First aid for bleeding from a great vessel consists of pressing the artery with a finger, flexing a limb, or applying a tourniquet. If the assistance measures are carried out correctly, the bleeding stops immediately; when a tourniquet is applied, the limb below the area turns pale and becomes cold.

If the artery is damaged, death from blood loss can occur within 10 to 15 minutes. In case of damage to the carotid and femoral arteries, this time is reduced. How to distinguish arterial bleeding? The blood is bright scarlet and flows out in a strong pulsating stream.

Venous

Venous bleeding: first aid, types and signs, ways to stop differ from arterial bleeding in the following points.

Capillary

Capillary bleeding, first aid for bleeding, types of first aid are similar to those for venous bleeding.

Such vascular damage is dangerous only when there is internal bleeding or poor blood clotting.

Nosebleed

This pathology occurs with various systemic diseases, injuries, fever, sunstroke, overexertion, circulatory disorders, diseases and defects of the nasal cavity. Possibly due to anxiety and stress. Often occurs in young children and adolescents during the period of hormonal changes in the body.

If someone has first aid for bleeding, the types and methods to stop it are as follows.

When applying a cold compress or tampons, keep your head slightly tilted back. In other cases, tilt it slightly so that the blood flows out of the nose rather than going down the throat.

If the bleeding does not stop within 15 minutes, you must call an ambulance.

Internal bleeding

Types of bleeding, first aid for bleeding into the internal cavities of the body, their signs.

• Blood enters the lungs - causing pulmonary edema. When bleeding into the pleural cavity - difficulty breathing due to compression of the lung. The victim is placed in a semi-sitting position, the legs are bent, and a cushion is placed under the knees.
• When blood enters, general signs of bleeding and abdominal pain are observed. The position of the victim is lying on his back, legs bent.
• In both cases, put ice on the site of suspected bleeding and provide sufficient fresh air. Keep the victim motionless.
• When blood leaks into the muscles, bloating and hematoma are formed.

All cases of internal bleeding require immediate hospitalization.

Uterine bleeding

Various types of bleeding and first aid for disorders in the reproductive system of the female body require qualified medical care. The uterus is abundantly supplied with blood vessels, and stopping bleeding is not so easy. This requires the administration of medications and often surgical interventions.

Uterine bleeding is possible due to inflammatory and degenerative processes in the uterus, hormonal disorders, and pregnancy.

First aid measures:

• Take a lying position, raise your legs, placing a pillow under them.
• Place an ice pack or a bottle of cold water on your lower abdomen through a cloth. Keep the ice for 10-15 minutes, then take a break for 5 minutes. Keep it cold for about 1-2 hours in total.
• Drinking plenty of fluids is recommended to replenish blood loss.

In camping conditions, first aid for bleeding is very important. Emergency medicine involves providing competent assistance in conditions where it is impossible to quickly see a doctor. When planning hiking trips, various sports, hunting, fishing, you should have at your disposal a minimum set of medical supplies - a first aid kit. To stop bleeding, a tourniquet, bandage, and disinfectant are needed. A three percent solution of hydrogen peroxide will not only disinfect the wound, but will also help stop bleeding. To compress the vessels of the extremities, you can use available means: clean cotton cloth, handkerchiefs, scarf, belt, clothing. Instead of a tourniquet, you can apply a twist using a strip of fabric and a stick.

In any case, if bleeding occurs, you should determine its type and degree of danger, if necessary, squeeze the vessel with your finger and prepare means to stop the bleeding. In case of serious injuries, take the victim to the first aid station and then to the hospital. Counting on qualified medical care, you must have a sufficient level of knowledge to help yourself and your loved ones if necessary. Indeed, in some cases, the ambulance may arrive only after a few hours, and sometimes you have to deliver the victim to the nearest town yourself.