Bleeding, first aid. First aid for bleeding Help for bleeding and various types of injuries

Types of bleeding can be different, both external and internal. For example, uterine, intestinal, in the cavity of the heart, pleura or articular. Wounds and bleeding are best left to be treated by doctors, as damage can be very dangerous, blood vessels, skin tissue and internal organs are disturbed. You need to know how to provide first aid before the ambulance arrives. If done correctly, it can save the life of the victim. It must be remembered that all types of bleeding are dangerous for humans, so it is impossible to neglect first aid while waiting for doctors.

Classification

There are three main types:

What is bleeding in the direction of travel

In the direction of movement, bleeding is divided into overt and latent. The first is of two types:

internal - occurs in the cavity between the internal organs (gastric, pulmonary, etc.);
external - blood flows from the skin. In this case, she finds herself in the external environment.

With a latent form, hemorrhage occurs in the body cavity, but it does not communicate with the external environment. For example, pericardial, pleural, abdominal, articular, etc. Hidden view is considered one of the most dangerous.

Types of bleeding and their characteristics by vessels

It all depends on the vessels that are damaged. Types of bleeding:

By origin, bleeding is divided into two types: traumatic and pathological. In the first case, it occurs when the vessels are damaged, in the second - if there is a pathological process or wall permeability. Types of bleeding and their characteristics:

Traumatic usually occurs when internal organs are damaged. In this case, due to external factors at the site of the wound, the entire vascular network is disrupted.
Pathological is a consequence of pathophysical processes that are already taking place in the body. The cause may be a malfunction of any component of the cardiovascular system or the presence of poor blood clotting. In this case, there may be no injury at all.

By severity

Types of bleeding according to severity:

What to do if bleeding starts?

It depends on its type. If it is external, the blood should be stopped until a clot appears, which serves as a kind of barrier to flow. If it is very strong - wear rubber gloves, if they are not available, then plastic bags (or any waterproof material) will do. Then press the wound for 15 minutes. If the blood does not stop under pressure, you can try to clamp the artery higher, then apply a tourniquet.

What to do with bleeding that occurs inside the body: you need to lay the patient down and raise his legs up. If the injury is in the chest, the victim must be held in a sitting position. When the head is damaged, raise it. Be sure to cover the patient warmly.

Doctors with external bleeding pour saline into a vein and then make a transfusion. The victim is taken out of the state of shock, the wound is treated and bandaged. To prevent infection, a tetanus shot is given and antibiotics are prescribed. With internal bleeding, an operation is performed, a transfusion is prescribed, and saline is injected into a vein. If it occurs in the stomach, anti-ulcer drugs are prescribed.

How is first aid provided for arterial bleeding?

At the first stage, in order to stop the bleeding, it is necessary not to compress, but to compress the artery just above the damaged vessel. You can do this with your finger or fist. Options for clamping the artery:

with bleeding in the temporal part - a finger is applied in the area of the earlobe, towards the cheekbones;
in the area of the mouth, face and head - the carotid artery is clamped;
in the upper limbs - the fist rests on the armpit, the injured arm should be bent at the joint;
if the femoral artery is damaged, it is pinched with a fist in the groin;
bleeding in the lower extremities - the fist is sent to the popliteal region, and the leg itself is bent at the joint.

At the second stage, after the artery has been clamped, a tourniquet is applied. To do this, you need to wrap the area on which it will be applied with gauze. Next, raise the injured limb, stretch a little and wrap the tourniquet 3 times around it. The latter must be applied tightly, the ends should be fastened or tied. This can be done only if large arteries are damaged. The tourniquet lasts no more than an hour in summer and half an hour in winter. Under it you need to put a note (for doctors), which indicates the time of application.

This is all that you can do on your own, then doctors should deal with patients. It must be remembered that first aid for arterial bleeding is vital. If it is not provided and just wait for the doctors, then the patient may die.

Bleeding from the nose

It rarely occurs in young children, more often in schoolchildren. Quite often - during puberty. It arises from the nasal septum, which is called the Kisselbach zone. It is here that the vascular network is most developed.

There are a number of main reasons why nosebleeds begin:

any blood diseases (leukemia, etc.);
diseases of the heart, blood vessels, kidneys and liver;
nasal injuries (they can occur not only from a blow, but also from picking your nose or with a very strong nose blowing);
from excitement;
with tumors;
from overheating in the sun.

In order to stop nosebleeds, first of all, you need to calm the patient. Then seat him in a chair. Tilt your head back is not recommended, it contributes to a poor outflow of blood. The stop flow effect will be erroneous. Blood simply enters the throat, and then into the respiratory tract, resulting in vomiting.

Additionally, you need to open the window, providing fresh air, relax the collar. Make the patient exhale through the nose and inhale through the mouth, so the blood coagulates better. Apply ice or a wet cold cloth to the bridge of the nose, and a heating pad to the legs. Drops during bleeding can not be instilled. If the above does not help, then a gauze or cotton ball is inserted into the nose, which is dipped in 3% hydrogen peroxide. You need to keep it for 15 minutes.

What remedies are used for nosebleeds?

If it does not go away for a long time, they cauterize the nasal mucosa with lactic, chromic or trichloroacetic acid, a solution of silver nitrate, alum, zinc salt. In modern medicine, ultrasound, laser treatment and liquid nitrogen, oxygen are used.

Blood provides organs and tissues with the necessary nutrients, protects them from foreign agents, and removes metabolic end products. The stability of its transport activity contributes to the coordinated work of all body systems. If the integrity of the vascular bed is violated and bleeding occurs, malfunctions in the functioning of organs appear. Massive blood loss (more than 50% of blood volume) poses a serious danger to human life and health, so you need to know the basics of first aid in this situation.

Blood loss occurs as a result of damaging effects on the vascular system of various factors: injuries, diseases of internal organs, disorders of coagulation processes. As a result, bleeding of varying severity occurs. The choice of method of assistance directly depends on the type of blood loss.

Depending on the area of bleeding, it can be:

outdoor- blood flows from the vascular bed into the external environment. Its outpouring occurs on the surface of the skin from wounds, which are of various types, based on the damaging factor: cut, torn, stabbed, bruised, chopped, gunshot, bitten, crushed;
internal- when blood flows into the body. The causes of its appearance are strokes, diseases of internal organs (parenchymal bleeding), stab and gunshot wounds, fractures, falls. It can be overt and covert.

The first variant is characterized by bloody discharge from natural openings: ears, nose, vagina, anus, oral cavity, urethra. With a latent form, blood accumulates in a certain cavity (abdominal, pelvic, pleural).

Depending on the type of damaged vessel, bleeding is classified:

capillary- appears as a result of a superficial wound, deep tissues are not affected, the blood is bright red in color. Blood loss in this case is small, there is a danger of infection entering the affected area;
venous- occurs with deeper damage. Blood loss can be quite abundant, especially when a large vein is traumatized. This condition can be fatal. The outpouring of blood occurs at a measured pace, continuously, without spouting;
arterial- the most dangerous type of bleeding, especially when large arteries are injured. Blood loss develops at a rapid pace, often massive, which is a mortal danger. The ejection of blood of a scarlet color occurs in pulsating shocks (gushing), since it is under great pressure in the vessel, moving in the direction from the heart;
mixed- characteristic of a deep wound, appears when blood loss of various types is combined.

Symptoms

To determine the necessary measures to help the victim, sometimes you need to know the clinical manifestations of blood loss. At outdoor the form of bleeding diagnosis of difficulties does not cause. There are pallor, dizziness, fainting, a feeling of thirst and dryness in the oral cavity, blood pressure drops, the pulse quickens, but its filling is weak, there may be difficulty in breathing, a state of shock.

At internal blood loss evaluation of symptoms is important to confirm the fact of bleeding. In this case, the same symptoms are present as in the external form. However, hemoptysis, respiratory failure (with pulmonary hemorrhage), painful, hard abdomen, coffee-colored vomiting, melena (with blood loss in the abdominal cavity) can be added in addition. The patient's condition deteriorates sharply up to shock and cardiac arrest.

First aid for bleeding

In the event of a situation that threatens a person’s life, in particular with blood loss, you need to know the basics and some of the nuances of first aid. This will save precious minutes before the arrival of doctors, help preserve the health and life of a person.

The table shows general methods for stopping and reducing blood loss in various types of bleeding.

Type of bleeding	First aid
capillary	clamp the wound with the palm of your hand or cloth; elevate a limb wash, disinfect the wound area (excluding the wound itself); the use of a sterile bandage, possibly pressing (with oozing blood)
Venous	pressing the wound with fingers or palms; lifting up the affected limb; application of a pressure bandage
Arterial	finger pressure on the artery above the damaged area; the use of a tourniquet above the lesion; limb flexion
internal	to give a comfortable posture, based on the localization of blood loss; apply cold; cover the victim; not allowed to move, eat, drink

To put into practice these methods of stopping and reducing blood loss, you need to know their detailed technique, take into account some of the nuances and possible consequences.

With capillary bleeding

With minor damage, a regular sterile dressing made from a bandage or napkin is often sufficient. The wound must be washed, treated with an antiseptic agent (iodine, brilliant green, alcohol). A pressure bandage may be applied if blood continues to ooze. At the same time, a sterile napkin with an antiseptic is placed on the wound, tightly bandaged, a cotton roll is applied on top and again tightly fixed with a bandage.

For venous bleeding

With this type of blood loss, the use of a pressure bandage is most justified. Its purpose is to accelerate thrombosis of the vessel, often such a technique is enough to stop blood loss. If it is saturated with blood, it is not necessary to change it, it is necessary to bandage an additional one on top.

ATTENTION! In the absence of means for making a bandage, it is possible to press the wound with your fingers or palm.

Elevation of the limb helps to reduce or stop blood loss.

The mortal danger of such bleeding may lie in the possible occurrence of an air embolism, due to the suction of air bubbles through damage in the venous bed and their entry into the heart.

ATTENTION! It is forbidden to remove blood clots from the wound, this can provoke massive blood loss!

For arterial bleeding

With this type of blood loss, every minute is valuable, so clamping an artery, usually the brachial or femoral, is a priority technique. This is done above the injury site with significant use of force. Pressing is carried out with a finger or palm, fist (in case of damage to large vessels). This method is designed for a short period of time, since it requires a lot of effort, but it makes it possible to prepare a tourniquet and seek medical help during this period.

ATTENTION! If blood loss does not stop when pressing the artery for ten minutes, you should take a break for a few seconds to avoid the formation of a blood clot in the vascular bed!

Flexion of the limbs can help stop bleeding. If the popliteal artery is damaged, it is necessary to bend the leg at the knee joint to the stop, if the femoral artery is damaged, bring the thigh to the stomach as much as possible. The subclavian artery is clamped with the help of arms bent at the elbows, wound behind the back and securely fixed. When the brachial artery is injured, the arm is bent all the way at the elbow joint.

The use of a tourniquet is advisable in extreme situations, with the failure of other methods, since its prolonged use leads to nerve atrophy and tissue necrosis. The tourniquet is stretched and the leg or arm is wrapped several times above the site of the lesion like a bandage, the first wrap (tour) is the tightest that needs to be fixed, the subsequent rounds (3-4) are weaker. It is superimposed exclusively on clothing or any material at hand in order to avoid infringement of tissues. You can make a tourniquet yourself from a rope, belt, twisted fabric (twist). In this case, the arm or leg is tightly bandaged, a stick or other similar objects (pen, spoon) are inserted into the knot, fixed with an additional knot and wrapped several times until the blood loss stops. The correct use of the tourniquet is determined by the pronounced pallor of the limb and the absence of a pulse. Be sure to specify the time of application of the tourniquet.

IMPORTANT! The time of its exposure should not exceed two hours in summer and half an hour in winter (for children - no more than fifty minutes). With a delay, the tourniquet is loosened for a quarter of an hour, using the method of pressing the vessel, then again applied slightly above or below the original location.

For internal bleeding

The main thing in this state is to completely immobilize the patient, giving him a certain pose:

with blood loss in the chest, in the stomach, with a miscarriage, the patient takes a semi-sitting position;
with damage to the abdominal cavity, pelvic organs give the legs an elevated position;
in case of traumatic brain injury, a pose with a slightly raised head is used.

It is forbidden to feed, drink, anesthetize the patient, cold is applied to the affected area, the victim must be covered.

IMPORTANT! It is necessary to monitor the condition of the person and be ready to carry out resuscitation measures! Transportation is carried out in a sitting position!

First aid in special cases

In some cases of bleeding, a special approach to first aid is required, subject to certain rules.

It is forbidden to remove anything from the wound on your own, whether it be glass, sand, or a protruding object. This is done exclusively by a doctor. With a protruding object (or part of a bone), it is recommended to apply a bandage near it. Self-removal can provoke increased blood loss.
When bleeding from the nose, cold is applied to this area, the head is slightly forward. If after a quarter of an hour the blood loss has not stopped, this is a reason to seek medical help.
With ear bleeding, an examination should be carried out for superficial wounds that can be treated with an antiseptic. If there are no injuries, it is necessary to urgently seek medical help, this may be a symptom of a fracture of the base of the skull.
In case of damage to the peritoneum (penetrating), assistance is provided in the same way as with internal blood loss. If there are internal organs that have fallen out, they are placed in a bag and bandaged or glued with a plaster. In this case, the intestines must be constantly moistened.
In case of traumatic amputation, together with measures to stop blood loss, the amputated limb should be placed in a bag, then in another one with cold water or ice. At the same time, you need to keep it on weight.

In the event of serious bleeding, you should immediately seek medical help. The danger of blood loss lies in the fact that the deterioration of the condition increases sharply and without the provision of high-quality first aid, the prognosis in most cases is disappointing. Proper and quick application of methods to stop bleeding can save the health and life of the injured person.

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All people experience bleeding throughout their lives. Hemorrhage is a condition in which blood leaks from a damaged vessel. The most common is capillary bleeding, which the body usually copes with on its own. Venous and arterial bleeding is life-threatening and requires medical attention. But the most insidious are considered 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, what are the main signs of external and internal hemorrhages, what are the steps in providing first aid (PMP) - 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 the treatment plan. After all, thanks to prompt diagnostics, you will not only save a life, but also minimize blood loss.

General classification of types of bleeding:

Depending on the site of bleeding:
- External - a type of bleeding that is in contact with the external environment;
- Internal - blood is poured into one of the body cavities;
Depending on the damaged vessel:
- - damaged capillaries;
- - the integrity of the veins is broken;
- - 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 in the cavity of the stomach or intestines;
Depending on the amount of blood loss:
- I degree - the victim lost about 5% of the blood;
- II degree - loss of up to 15% of the fluid;
- III degree - the volume of blood loss is up to 30%;
- VI degree - wounds lost from 30% of blood or more.

The most dangerous for life are III and VI degree of blood loss. Next, we consider in detail the characteristics of 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 that is not considered life-threatening, unless the area of injury is too large or the patient has reduced blood clotting. In other cases, the blood ceases to flow 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 violated.

As a result of an injury, blood of a bright scarlet color evenly flows out of 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 is to disinfect the wound and apply a tight bandage.

In addition, a cold compress can be applied to the damaged area. Usually, with capillary bleeding, hospitalization is not needed.

Venous

Venous hemorrhage is characterized by a violation of the integrity of the veins that are under the skin or between the muscles. As a result of a superficial or deep wound, blood flows out of the vessels.

Symptoms of venous hemorrhage:

Blood of a maroon hue flows from the vessels, a barely perceptible 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, bleeding decreases.

Venous bleeding is life threatening, because in the absence of timely medical care, the victim may die from heavy blood loss. The body in rare cases can cope with such a hemorrhage, and therefore it is not recommended to hesitate to stop it.

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

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

internal

This type of hemorrhage is the most insidious, since, unlike external bleeding, it does not have 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 cavities of the body due to damage to blood vessels.

You can detect bleeding at an early stage by the following signs:

The victim feels weak, he is drawn to sleep;
There is discomfort or pain in the abdomen;
Blood pressure drops for no reason;
The pulse quickens;
The skin turns pale;
There is pain when the victim tries to get 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, broken ribs, stab-knife or gunshot injuries. As a result, the internal organs are injured, because of which the integrity of their vessels is violated and bleeding begins. As a result, blood accumulates in the abdominal cavity, chest, impregnates wounded organs or subcutaneous fatty tissue (hematoma).

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

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

Gastrointestinal

This type of hemorrhage is most often a complication of diseases of the digestive tract (for example, stomach 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 symptoms of gastrointestinal hemorrhage in time in order to transport the victim to a medical facility.

Symptoms of gastrointestinal hemorrhage:

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

The main reasons for this complication are ulcers, oncological diseases, various necrotic processes on the inner lining of the gastrointestinal tract, etc. Patients who know their diagnosis should 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 conduct a differentiated diagnosis in order to determine the type of bleeding in time and provide competent first aid.

General rules that should be followed for any bleeding:

If symptoms of bleeding occur, the wounded person is laid on his back;
The person providing assistance should observe that the victim is conscious, periodically check his pulse and pressure;

Treat the wound with an antiseptic solution (hydrogen peroxide) and stop the bleeding with a pressure bandage;
A cold compress should be applied to the damaged area;
Then the victim is transported to a medical facility.

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

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

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

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

Harness rules

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. By remembering even the basic rules, you can save a person's life.

Questions regarding bleeding will never lose their relevance. After all, no matter how medicine learns to deal with them, there will still be unresolved issues in some cases. This is especially important in relation to massive blood loss, in which it is extremely important to instantly recognize specific types of bleeding, which will provide the right assistance. And although, at first glance, there is nothing complicated about this, even experienced doctors in some critical situations can make mistakes, getting lost at the sight of a large amount of blood. Therefore, each person must know what a particular type of bleeding looks like, and what amount of measures should be taken in this case.

General classification

The division of bleeding into different types is of great expediency due to the ease of determining treatment tactics at different stages of medical care. Wherever she finds herself, all doctors know her clear algorithm. This approach minimizes the time spent and minimizes the amount of blood loss. People who are not related to medicine should also know the main features and possible types of bleeding in order to help themselves or their loved ones if necessary.

The classification is given in the form of a table.

External bleeding (outflow of blood with direct contact with the external environment)	Internal bleeding (the spilled blood does not have direct contact with the environment)
capillary; arterial; Venous; Mixed.	In the free abdominal cavity; Hemorrhages in the internal organs (intraorganic hematomas); Gastrointestinal bleeding.
The amount of blood loss in any bleeding
Easy blood loss; Blood loss of moderate severity; severe blood loss; Extremely severe bleeding.

Capillary bleeding

The most common type of external bleeding is capillary. They occur with any traumatic injuries with a violation of the integrity of the skin. They are manifested by a non-intensive uniform outflow of blood from the wound due to damage to the capillaries (the smallest vessels of the body). Rarely lead to severe blood loss, as in most cases they stop on their own. They are not difficult to diagnose or treat. The exception is extensive superficial wounds, in which prolonged neglect of medical care can cause large blood loss.

Venous bleeding

Venous bleeding occurs with superficial and deep wounds of any size, in which the integrity of the saphenous or intermuscular veins is violated. In this case, there is quite intense bleeding. Clinically, venous bleeding can be recognized by the following symptoms:

Dark blood;
The bleeding is very violent, like a constant flow of blood from the wound;
Decreases when pressing the area below the wound.

Venous bleeding is extremely dangerous if medical care is not provided in a timely manner. In this case, massive blood loss occurs in a short time, up to a state of shock. They rarely stop on their own, so you should not neglect their stop. Superficial veins bleed less intensively, damage to deep veins causes profuse bleeding.

Differences between arterial (a) and venous (b) bleeding

arterial bleeding

Given the deep occurrence of arteries in the tissues, their damage is the least common. The most common causes are knife, gunshot and mine-explosive wounds. In everyday life, these can be stab wounds with thin and narrow objects. Clinically, arterial bleeding can be suspected by the following signs:

Bright red blood;
Expires in the form of a pulsating jet;
Very intense;
Does not decrease with normal pressure on the wound or tissues above and below it;
Localization of the wound corresponds to the projection of the course of large arteries.

Usually, arterial bleeding is very intense and quickly leads to massive blood loss and shock. If there is a complete rupture of the artery, then in just one minute you can lose almost the entire volume of circulating blood. Therefore, such bleeding requires immediate attention.

Internal bleeding

Unlike external bleeding, in which their symptoms cannot be overlooked, internal bleeding is more insidious. After all, it is not so easy to recognize them. Usually they manifest themselves with a sufficiently large blood loss. Therefore, it is extremely important to know all the possible signs of this dangerous condition. These include:

General weakness and drowsiness;
discomfort or pain in the abdomen;
Unmotivated decrease in blood pressure;
Frequent pulse;
pale skin;
The appearance of pain in one of the halves of the neck, which occurs in a horizontal position and decreases in a vertical position (a symptom of Vanka-vstanka).

The occurrence of internal bleeding is preceded by closed or penetrating wounds of the abdomen, lower back, rib fractures, stab or gunshot injuries. In this case, damage to the internal organs occurs, which causes a violation of the integrity of blood vessels and bleeding. As a result - the accumulation of blood in the abdominal cavity, chest, soaking it with a damaged organ or visceral fatty tissue (hematoma).

Such bleeding can progress at lightning speed, but may also increase for several days after the injury. It all depends on their intensity and the amount of damage to the injured organ. The spleen is usually affected, less often the liver. With their simultaneous rupture, bleeding occurs immediately, with a two-stage rupture, an intraorgan hematoma first occurs, which ruptures after a few days, causing an instant aggravation of the patient's condition.

Gastrointestinal bleeding

If you understand to the end, then this type of bleeding cannot be classified unambiguously. After all, blood flows into the lumen of the gastrointestinal tract, but at the same time it comes into contact with air. But this is not as important as the detection of symptoms of such a condition. After all, the life of the patient sometimes depends on timeliness. Signs of gastrointestinal bleeding include:

General weakness and dizziness;
Frequent pulse and low blood pressure;
pale skin;
Vomiting blood or brown mass;
Liquid bloody or thick black stools.

Gastrointestinal bleeding occurs with peptic ulcer, tumor diseases, various necrotic processes in the mucous membrane of the digestive tract, and some other diseases. Therefore, people with a similar pathology must be aware of the possibility of bleeding and, if they occur, be sure to seek medical help.

Educational video on the topic of first aid for bleeding:

What to do about bleeding

Therapeutic tactics should be differentiated and depend on the specific type of bleeding. There is a general scope of activities that must be carried out in any of its forms. All specific manipulations are purposeful, since their incorrect provision can harm the patient. Common bleeding relief measures include:

Lay the victim in a horizontal position;
Monitor consciousness, pulse and blood pressure;
Wash the bleeding wound with hydrogen peroxide and apply a pressure clean bandage;
If possible, apply cold to the source of bleeding;
Transport the patient to the nearest facility.

The listed measures will never hurt, regardless of the source and characteristics of bleeding.

Differentiated tactics are given in the form of a table.

Type of bleeding	Scope of necessary measures
Type of bleeding	First aid (temporary stop of bleeding)	Specialized medical care (final control of bleeding)
capillary	Wash the wound with an antiseptic; Cover with a sterile dry or peroxide-moistened dressing.	Sewing the wound if necessary.
Venous	Perform activities, as in capillary bleeding; Apply a pressure bandage, capturing the wound with the above- and underlying areas (about 10-15 cm).	If the superficial veins are damaged, they are ligated and the wound is sutured; If the deep veins are damaged, the defect in the vein and the skin wound are sutured.
Arterial	Carry out general activities; Finger compression of a bleeding vessel in the wound; Tight packing of the wound with a bandage moistened with peroxide; Applying a tourniquet above the wound.	Suturing or prosthesis of the damaged artery with further suturing of the wound.
Internal and gastrointestinal bleeding	General measures for bleeding, characteristic of the prehospital stage.	The introduction of hemostatic drugs; Infusion therapy to replenish blood loss; Observation; Operative treatment in the presence of signs of ongoing bleeding.

Harness rules

The tourniquet should be applied only for arterial bleeding. Its erroneous use in venous bleeding will lead to their intensification. Characteristics of the correct application of the tourniquet:

It is applied to the affected segment not lower than 20 cm from the wound. Can be higher. A lower location is permissible only if it is impossible to complete the classic manual;
A tissue bandage is placed on the skin under the tourniquet;
As a tourniquet, a special hemostatic tourniquet or improvised materials can be used to replace it;
The first circular tours of the tourniquet around the limb are less tight. After them, tighter tours should be applied;
After a properly applied tourniquet, bleeding decreases. If this did not happen, this indicates either an incorrect imposition of it, or the absence of indications for this;
The permissible duration of holding the tourniquet on the limb should not exceed 2 hours in summer and 1-1.5 hours in winter;
If it is impossible to apply a tourniquet (neck wounds, high wounds of the shoulder and thigh), it is replaced by other methods of stopping bleeding: external finger pressing of a pulsating vessel above the wound or directly in it.

Proper application of a tourniquet as one of the ways to stop arterial bleeding

Only strict adherence to algorithms for determining the type of bleeding and step-by-step implementation of therapeutic measures can really effectively help in the fight against this problem. Remember the general rules and then you can protect yourself and your loved ones from the dangerous complications of any bleeding.

Bleeding is the most dangerous post-traumatic complications that threaten the life of the injured person. The degree of possible risk depends on the specific characteristics and location of the damaged vessels.

There is the following classification of types of bleeding:

capillary bleeding. This type of bleeding occurs when the smallest vessels located in the mucous membranes, muscle tissues, and skin are injured. Signs of bleeding from the capillaries are: dark red blood, bleeding in a small trickle (with superficial cuts) or uniform bleeding over the entire surface of the wound (with abrasions). Capillary bleeding rarely threatens the life and health of the affected person (if there is no hemophilia and problems with blood clotting) and, as a rule, stops on its own.
Venous bleeding. The main sign of bleeding from the veins is a slow but continuous outflow of blood from the wound. The blood is dark red. In case of significant venous bleeding, in order to prevent the loss of a large amount of blood, it is urgent to clamp the damaged vessel with any available means (you can even use your finger).
Parenchymal bleeding. Refers to internal bleeding. It is typical for wounds and injuries of the lungs, liver, spleen and other internal organs. With this type, bleeding of various colors is possible (depending on which internal organ is damaged) - dark red and bright scarlet. When blood comes out, it acts evenly over the entire wound surface. The greatest danger is the option when parenchymal bleeding is hidden. The patient runs the risk of losing a lot of blood without waiting for first aid, because. diagnosis of internal bleeding is extremely difficult.
arterial bleeding. A characteristic sign of bleeding from the arteries is a pulsating jet outflow of blood from the wound, the color of the blood has a bright scarlet hue. This species poses a particular danger to the life of the victim, because. rapidly leads to the onset of complete bleeding of the body. The development of acute anemia in arterial bleeding is accompanied by the following most obvious signs: a drop in heart rate and blood pressure, progressive pallor of the skin and mucous membranes, nausea, vomiting, darkening of the eyes, dizziness, loss of consciousness.
Mixed (combined) bleeding - occurs with extensive injuries and combines various types of bleeding described in the previous paragraphs.

Treatment of bleeding

First aid measures for bleeding should be started as soon as possible after injury. They consist primarily in stopping bleeding and preventing significant blood loss. If we are talking about arterial bleeding, the necessary measures to stop the bleeding must be taken immediately, because with this type of bleeding, a significant amount of blood flows out of the wound in a short period of time. Rapid and sudden loss of blood (more than two liters) can lead to death of the victim, especially if the bleeding is combined with combined traumatic injuries.

For obvious reasons, first aid for bleeding, as a rule, is performed outside the walls of a medical institution. Therefore, this procedure is temporary, and consists in stopping the bleeding for the speedy transportation of an injured person to a medical hospital.

Ways to temporarily stop bleeding:

Pressure bandage. Used to press the immediate site of bleeding. A sterile gauze bandage is applied to the wound surface (in the absence of a piece of any clean natural tissue) and bandaged tightly (in the absence of material for bandaging, simply press the bandage to the wound with your hand). Applied with capillary, venous and mixed bleeding of moderate intensity.
With minor bleeding in case of wound injuries of the feet, lower leg, fingers, etc. use the method of giving the injured limb an elevated position. It is good to combine this method with the application of a pressure bandage.
In the case of arterial bleeding and the need to immediately stop the bleeding (when there is no time to look for suitable means), the method of pressing the bleeding artery with a finger is used. The arteries are pressed at certain anatomical points where they can be pressed tightly against the bones and thereby temporarily stop the bleeding.

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