Types of bleeding and first aid. Features of first aid for bleeding What types of bleeding

The human body contains many vessels filled with blood. In the life of any person there has always been a situation when the skin was injured and blood flow occurred. It is important at this moment to provide assistance correctly and on time, because sometimes human life depends on it. And for this you need to know what kind of bleeding there is and its types, because it depends on what your independent actions will consist of in providing first aid before the ambulance arrives, as well as what first aid for bleeding consists of.

Kinds

What is bleeding in medical terms? Bleeding refers to the release of blood from the walls of injured hematopoietic vessels. This may be due to injury or have another cause. What types of bleeding are there? Bleeding types of bleeding first aid are very interrelated with each other. Separation into different types of bleeding is necessary, since when providing first aid for bleeding, it will be easy to determine the algorithm of actions that any physician clearly knows. This allows you to quickly provide assistance with bleeding and minimize blood loss. But a person who is far from medicine must also have an understanding of the types of bleeding, so that in difficult times he knows the rules of first aid and is able to apply them in practice, thereby possibly saving the lives of his friends, relatives and himself.

What types of bleeding exist:

1. To correctly provide first aid for bleeding, a table will help, which presents the definitions of injured vessels in connection with what type of vessel is damaged.

Type of injured vessel	Characteristic
capillary	blood flows from small vessels on the skin surface; if the mucous membranes are injured, they also bleed; characterized by low intensity; -if the injury is wide, it differs in abundance due to the large capillary damage.
arterial	flows from the lungs through the arteries; oxygenated; the wound is serious because the arteries lie close to the bones; spontaneous cessation of blood flow. This is explained by the fact that the lining of the artery consists of muscles; injury causes them to spasm.
venous	flows from the venous vessels from tissues and cells to the heart and lungs; the blood contains carbon dioxide and metabolic products; due to their superficial location, damage to them is more frequent than to arteries; They do not have the property of contracting if they are injured, but due to their thin walls they are capable of sticking together.
mixed	from which vessel the blood flows cannot be seen, since the organ has all varieties and, as a rule, all are damaged; occurs with injuries to the arms and legs, since the veins and arteries are located close to them.
parenchymal	the type of blood flow occurs during operations, due to the fact that all internal organs are considered parenchymal; it is impossible to determine, since organs consist of different types of tissues and vessels, everyone gets injured.

2. In addition, the classification of bleeding includes dividing it according to the place of blood flow and is:

• internal, when internal organs or vessels located inside the body are injured. Signs of bleeding become visible over time, so this flow of blood is considered dangerous. First aid for bleeding of this type should be provided as quickly as possible. Signs of this bleeding are indirect;
• external bleeding, when the skin surface of the body, mucous membranes or soft tissues located near the surface are damaged. Wounds, cuts and other injuries are expressed by external blood flow. The strength of the current depends on the damaged vessel. In addition, external blood flows are also divided, in addition to skin ones, into uterine, pulmonary, gastric, intestinal, and urinary system bleeding. In this regard, they are divided into hidden (discovered after some time) and obvious. Blood clots can be classified as obstructed external blood flow, as well as internal if blood is retained inside the human body.

3. The type of bleeding is also classified according to its intensity and can be:

• acute, when a large loss of blood occurs over a short period of time. As a rule, this situation is associated with injuries. This leads to anemia;
• chronic, when blood loss occurs in small portions over a long period of time, which gradually causes chronic anemia in a person.

4. Depending on the causes of bleeding it occurs:

• traumatic;
• pathological;

5. Depending on the intensity of the blood flow, it is classified as follows:

• if the blood loss is up to 0.5 liters, then this blood flow is called light;
• on average, the loss is up to one liter;
• for severe cases – up to one and a half liters;
• with massive – up to two and a half liters;
• in case of death - up to three liters;
• Absolutely lethal - up to three and a half liters.

For a child, this figure should not exceed 0.25 liters, otherwise it becomes dangerous to their health.

Symptoms

Depending on which vessel is damaged, the symptoms of bleeding vary.

1. The symptoms of capillary are as follows:

• red blood;
• her losses are small;
• stops flowing on its own.

2. Symptoms of venous blood flow:

• it is dark red, may have a burgundy color;
• characterized by fast flow in the form of stripes;
• if you press lower from an injury, the flow of blood decreases;
• poses a danger if first aid is not provided in time;
• it rarely stops flowing.

3. Symptoms of arterial blood flow:

• it is bright red in color;
• The peculiarities of this type are that the blood flows quickly in the form of pulsating impulses;
• if you press above and below the injury, the flow continues the same;
• very dangerous due to its intensity, it can lead to shock. First aid should be provided immediately.

4. Symptoms of internal blood flows:

• a person feels sleepy and exhausted;
• your stomach starts to hurt;
• blood pressure decreases;
• increased heart rate is observed;
• the skin takes on a pale tint;
• a person experiences a painful sensation on the right or left in the cervical region. If he lies down, the pain intensifies;
• They are very insidious due to the fact that they manifest themselves when a large loss of blood has already occurred, and in the initial period it is difficult to detect the flow of blood. A person may suddenly become ill a few days after the onset of the injury.

5. Symptoms of hidden blood flows:

• when foamy blood of a bright red color appears, accompanied by a cough, blood flow in the lungs can be suspected;
• With stomach problems, the blood is brown and occurs in the form of clots. In this case, the person is exhausted, his pulse rate increases, his blood pressure decreases, his skin color becomes pale, vomiting begins with brown blood, feces are black or bloody liquid;
• with intestinal stool, a change in color to dark, brown or black is detected in the feces;
• if the blood flow occurs in the kidneys or from the urinary system, the color of the urine changes to red;
• when flowing from the reproductive system, its color is red with pieces of mucus;
• scarlet blood in the form of droplets on the feces indicates bleeding in the rectum;
• a person may suddenly become ill a few days after the onset of the injury. Calling emergency help in case of bleeding in this case is mandatory.

About the reasons

Why is there blood? For different types, the causes of bleeding are different. In case of traumatic bleeding, the causes are as follows:

• thermal effects can cause bleeding;
• mechanical impact. Why is there bleeding in this situation? For example, fractures and bruises that occur in road accidents, during air travel, fights, and this can also include household and work injuries, can cause bleeding.

In the pathological form, the causes are as follows:

• vascular diseases;
• diseases associated with the circulatory system;
• diseases that can be classified as general. Why is there blood flowing? It is associated with diseases. These include diseases of the endocrine system, for example, diabetes, diseases associated with viral infections, and various diseases of internal organs.

Help before doctors arrive

What to do if there is bleeding, if this happens, how to stop the bleeding at home? What is first aid for bleeding? Providing first aid for bleeding requires speed. Types of bleeding and first aid are interrelated.

The following describes the types of bleeding and how to stop them:

1. If the bleeding looks like mild capillary bleeding, then the first first aid to stop the bleeding at home is as follows:

• treat the affected area with iodine solution, after rinsing it with clean water;
• ways to stop bleeding are to bandage the damaged area with a pressure gauze bandage; you can use any clean cloth;
• Methods to stop bleeding when a limb is injured are to lift the injured limb slightly upward.

2. How to quickly stop bleeding if it is venous bleeding:

• The first first aid in this case will be to apply a thick, tight bandage. If a limb is injured, then it must be raised.

3. How to stop arterial blood flow:

• you can stop it by applying a bandage, which should compress the wound;
• if a large artery is damaged, methods to stop bleeding in this case consist of pressing the vessels against the bones. As a result, blood stops flowing to the injury site. But we must remember that these are methods of temporarily stopping bleeding;
• how to stop the heavy bleeding that is possible with this type? Methods to temporarily stop bleeding include applying a tourniquet. This can be any item such as a belt or tie that is at hand. This method is applicable if there is heavy bleeding in the extremities. At the same time, you must remember and know that it is necessary to apply a tourniquet in a place that is located above the injured area, it is tightly knitted into a knot, and for a greater compression effect, a stick or something like it is placed under the improvised means. This achieves a temporary stop of bleeding. It is necessary to note the exact time of application of the tourniquet and upon arrival of the doctors, be sure to tell them or put a sheet with the time of application of the bandage under the fabric;
• methods of stopping the flow of blood, consisting of bending an arm or leg at the joint, will help with wounds under the knee or at the elbow. In this case, it is necessary to apply a tight bandage to fix the arm or leg. If the femoral artery is damaged, the thigh must be pulled up to the abdomen as much as possible and clamped. Blood will no longer be able to flow in this state;
• if there is severe bleeding and how to stop it if there is nothing at hand? You can find yourself in such a situation anywhere. First aid here is to simply press down the damaged vessel with your hand, fingers, or fist above the area of ​​injury. In this way, the flow of blood is stopped for a short period of time until you can get your bearings and find another way. If the brachial or femoral artery is injured, then this method is applicable. Everyone should know how to call an ambulance.

4. With the internal form of blood flow, you need to know its symptoms:

• the skin has a pale appearance;
• the pulse quickens and is barely audible;
• lips turn blue;
• the patient complains that he is dizzy and his vision is getting dark;
• the patient breathes quickly and shallowly;
• may faint;
• the patient is in a lethargic state.

How to provide first aid for this type of bleeding? It is impossible to provide first aid for bleeding at home. For this type of bleeding, treatment will consist of resting and applying cold to the injured area, if identified. In such a situation, support for the victim is also important.

In this case, do not forget about such an important matter as calling the ambulance doctors.

5. I would especially like to talk about the flow of blood from the nose. How to stop bleeding in this case. Why is there blood? These cases can occur due to various ailments, overheating in the sun, etc. These bleedings are not uncommon in children. It stops like this:

• breathing should be done only through the nose;
• Swallowing blood is strictly prohibited;
• close the nasal openings for about ten minutes, no more;
• apply cold to the back of the head and nose;
• place cotton swabs in the nasal openings;
• When applying cold and using tampons, the head should be thrown back a little, otherwise you should not bend down much. There is nothing left to do but call a PMP if the bleeding has not stopped within a quarter of an hour.

In contact with

It is known that correct and timely assistance for bleeding can save a person’s life if his condition is extremely serious. However, there are also less tragic cases in which it is necessary to stop the bleeding: for example, with minor glass. If the wound is not bandaged and disinfected in time, this can lead to complications in the victim’s condition, including loss of consciousness and the development of infection.

Types of bleeding and first aid

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:

1. The blood is dark in color.
2. Intense current.
3. 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:

1. The blood is a rich scarlet color.
2. 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

1. 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.
2. 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

1. 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.
2. 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.

Timely first aid for bleeding can save a person’s life, regardless of the location of the damaged vessel and the type of acute blood loss.

First aid for bleeding is a set of urgent preventive and therapeutic measures in case of violation of the integrity of blood vessels (capillaries, veins and/or arteries), carried out before the arrival of qualified assistance or the victim’s admission to the hospital. The total volume of circulating blood in an adult is about 5 liters. In this case, a loss of more than 30% of this volume is a threat to life, especially in a short time (with rapid blood loss). Depending on the location, external and internal bleeding is distinguished, according to the type of damaged vessel - capillary, arterial and venous. First aid for bleeding has its own characteristics for each of the above types.

General rules for providing first aid for bleeding:

first of all, you need to make sure that neither the victim nor you are in danger (if necessary, remove or carry the victim out of the affected area or danger, put on rubber gloves, a mask, etc.);

the victim should be laid down (if possible) with his legs elevated;

with the help of others or yourself, call an ambulance;

Do not touch the wound with your hands;

wash the wound if rust, sand, etc. gets into it. it is impossible (this can cause even more harm and increase bleeding);

do not remove glass fragments, etc. from the wound;

if the wound is contaminated, the dirt around the wound should be carefully removed (in the direction away from the wound) and the cleaned edges should be treated with an antiseptic;

First aid for capillary bleeding

Capillary bleeding, as a rule, is not accompanied by significant blood loss and is quite easily stopped. A sign of damage to small blood vessels (capillaries) is that the entire wound surface bleeds, but not too profusely (like a sponge). The first aid for bleeding of this type is to treat the edge of the wound with an alcohol-containing antiseptic (iodine tincture, for example) and apply an aseptic gauze bandage. In this case, cotton wool is applied to the wound itself under a bandage. It should be remembered that the bandage should not be tight. In most cases, capillary bleeding does not require going to the hospital, except in cases with a large area of ​​​​the damaged surface.

First aid for venous bleeding

A sign of venous bleeding is the dark color of blood flowing out at high speed, but in a uniform stream (without pulsation or gushing). In addition, the formation of blood clots is possible, which in no case should be removed, as this will provoke increased blood loss. As first aid for bleeding from venous vessels, apply a pressure aseptic bandage to the wound. If this method is ineffective, it is necessary to apply a tourniquet below the injury site. In this case, a soft pad is placed under the tourniquet to avoid additional trauma to the skin and soft tissues, as well as a note indicating the time of application of the tourniquet. The maximum time during which the tourniquet can be left in place is 1 hour in cold conditions (winter) and up to 2 hours in the warm season. Exceeding this time limit can lead to tissue death in the bloodless limb. In the absence of a tourniquet, it is possible to use a twist (twisting a towel, bandage, belt, tie or any available fabric using a short stick, handle, etc.). The time frame remains the same.

Temporary stop of arterial bleeding

Arterial bleeding is more dangerous than capillary and venous bleeding. A sign of damage to the artery is the bright scarlet color of the blood flowing out at high speed in a pulsating stream (pulsating in time with the heart contractions), and if large arteries are damaged, the blood can flow like a fountain, intermittently. First aid for bleeding from arterial vessels consists of raising the limb (if there are no fractures) and applying a hemostatic tourniquet above the site of injury (closer to the body). You can also use a twist. The time limits are the same as for venous bleeding. In the absence of a tourniquet and twist (or searching for them), it is necessary to stop the bleeding by finger pressing the artery above the damaged area (at the pulsation point). In case of bleeding from the femoral, popliteal, ulnar and brachial arteries, it is also possible to fix the maximally bent limb in an elevated position.

First aid for internal bleeding

Internal bleeding is dangerous because it cannot be visually diagnosed. This type of bleeding can be suspected by the following signs: pallor of the victim’s skin, dizziness, fainting, cold sticky sweat, shallow breathing, frequent weak pulse. In this case, first of all, it is necessary to call an ambulance, and the victim should be placed in a semi-sitting position, ensure complete rest and apply a cold compress or ice to the suspected site of bleeding.

Thus, the main goal of first aid for bleeding is to temporarily stop it (1-2 hours) at the pre-medical stage, which will allow the patient to be transported to a medical facility to provide qualified assistance.

| First aid for bleeding

Basics of life safety
Grade 11

Lesson 5
First aid for bleeding

Fundamentals of medical knowledge and rules of first aid

Every citizen should know the rules of first aid, which are studied in the course “Fundamentals of Life Safety.” In this chapter, we will look at the rules for providing first aid for wounds and bleeding, some types of injuries, as well as for traumatic shock, acute heart failure, stroke and cardiac arrest.

Bleeding

Bleeding is the flow of blood from blood vessels when the integrity of their walls is violated.

Types of bleeding and their characteristics are given in scheme 3.

Types of bleeding and their characteristics

The reasons that cause bleeding of one type or another are different. External bleeding occurs when a sharp object, such as a knife or a piece of glass, damages blood vessels in the skin and deep-lying organs. Internal bleeding occurs with a closed injury, with a sharp blunt impact, for example, in the case of a car accident, when the driver is thrown against the steering wheel, or when a person falls to the ground after tripping over an object. The cause of internal bleeding can be lung diseases (pulmonary tuberculosis) or gastric ulcer (when a bleeding ulcer forms in the stomach wall), damage to internal organs - liver, kidneys, rupture of the spleen. In this case, internal parenchymal bleeding occurs. It is extremely difficult to stop him. Surgeon intervention is required.

External bleeding

External bleeding is caused by damage to a blood vessel and is manifested by the leakage of blood onto the surface of the skin.

Signs of external arterial bleeding:

Rapid and pulsating bleeding;
severe pain in the injured part of the body;
blood is bright red;
blood gushes from the wound;
weakness.

Signs of superficial venous bleeding:

The blood flows calmly from the wound, and does not flow like a fountain;
blood is dark red or burgundy. First aid for bleeding depends on its nature and consists of temporarily stopping the bleeding and transporting the victim to the nearest medical facility. This must be done quickly: the loss of even a small amount of blood disrupts the functioning of the heart and breathing. Help must begin to be provided right on the spot.

There are several ways to temporarily stop bleeding:

Finger pressing of a superficially located arterial vessel slightly above the bleeding wound;
applying a tourniquet 3-5 cm above the wound;
applying a pressure bandage to the bleeding site;
maximum limb flexion;
giving the injured limb an elevated (slightly above the chest) position.

Arterial bleeding from the vessels of the upper and lower extremities is stopped in two stages: first, the artery above the site of injury is pressed against the bone to stop the flow of blood to the site of injury, and then a standard or improvised tourniquet is applied.

It is best to press the arteries to the bony protrusions at certain, most convenient points for this (Fig. 1), where the pulse can be easily felt.

Temporal artery press with your thumb on the temple in front and just above the auricle.

Carotid artery pressed to the left or right (one side only!) on the side of the neck. This must be done as quickly as possible: even a second’s delay is dangerous for the life of the victim. Pressure with the fingers should be applied towards the spine, while the carotid artery is pressed against it.

Subclavian artery pressed in the hole above the collarbone to the first rib.

Axillary artery (when bleeding from a wound in the area of ​​the shoulder joint and shoulder girdle) is pressed against the head of the humerus along the anterior edge of hair growth in the armpit.

Brachial artery (for bleeding from wounds of the middle and lower third of the shoulder, forearm and hand) pressed against the humerus on the inside of the biceps muscle.

Radial artery (when bleeding from wounds of the hand) is pressed against the underlying bone in the wrist area near the thumb.

Femoral artery (when bleeding from wounds in the thigh area) is pressed in the area of ​​the inguinal fold, in its middle part. Pressing is done in the groin area in the middle of the distance between the pubis and the protuberance of the ilium.

Anterior tibial artery (for bleeding from wounds of the leg and foot) press in the area of ​​the popliteal fossa.

Arteries of the dorsum of the foot (when bleeding from a wound on the foot) is pressed against the underlying bone.

Finger pressure makes it possible to stop bleeding almost instantly. But even the strongest person cannot continue it for more than 3-5 minutes, as his hands become tired and the pressure weakens. Nevertheless, this technique is important: it allows you to gain some time to use other methods of stopping bleeding.

In case of arterial bleeding from the vessels of the upper and lower extremities, bleeding can be stopped using maximum flexion of the extremities. So, if there is bleeding from the artery of the forearm, you need to put a small cushion of soft tissue, for example a pack of bandage, into the elbow bend, and bend your arm at the elbow joint as much as possible. The same can be done in case of bleeding from the artery of the leg: place a soft tissue roller in the popliteal area and bend the leg at the joint as much as possible (Diagram 4).

After pressing the artery, they begin to apply a hemostatic tourniquet. The tourniquet is applied to clothing or to a fabric placed under it (towel, piece of gauze, scarf). Applying a tourniquet to bare skin is unacceptable. The tourniquet is placed on the limb above the bleeding site, approximately 3-5 cm from the wound, stretched strongly and, without reducing the tension, tightened around the limb and its ends are secured. When the tourniquet is applied correctly, bleeding from the wound stops, the limb below the site where the tourniquet is applied turns pale, and the pulse in the artery disappears. A note must be placed under the tourniquet indicating the date, hour and minutes of its application (Diagram 5).

The limb below the site of application of the tourniquet remains viable for 2 hours, and in winter outside the room for 1-1.5 hours, therefore, after the specified time, the tourniquet must be removed and after a few minutes applied in another place - a little higher. In this case, the victim will inevitably lose some blood. During this time, it is necessary to take measures to deliver the victim to the nearest medical facility, where he will receive qualified medical care.

Possible errors when applying a tourniquet:

Too little tightening causes compression of only the veins, resulting in increased arterial bleeding;
too much tightening, especially on the shoulder, leads to damage to the nerve trunks and paralysis of the limb;
Applying a tourniquet directly to the skin usually leads, after 40-60 minutes, to severe pain at the site of its application.

In the absence of a tourniquet, a belt, scarf, strip of durable fabric, i.e., any suitable material, is used to stop bleeding. The belt is folded into a double loop, put on the limb and tightened. A scarf or other fabric is used to apply a tourniquet (Fig. 2).

Applying a pressure bandage is another simple and reliable way to stop bleeding, reduce pain and create rest for the injured part of the body. At the same time, the bandage will protect the wound from secondary infection (Diagram 6).

In all cases of superficial wounds of the upper or lower extremities, one of the possible ways to stop venous bleeding is to elevate the extremity. This is quite easy to do. The injured arm should be raised up, slightly above the head. Under the injured leg you need to place a small cushion rolled up from some kind of fabric (you can also use a bag, backpack, blanket, pillow, or armful of hay). The leg should be slightly higher than the chest. Of course, the wounded person must lie on his back.

Capillary bleeding occurs when the smallest blood vessels are damaged. It is characterized by the fact that blood oozes from the entire surface of the wound, the color being average between venous and arterial. Most often, such bleeding stops voluntarily in a matter of minutes due to blood clotting. If this does not happen, it is stopped with a pressure bandage. A sterile napkin is applied to the bleeding area, which is then pressed to the injured surface with a bandage. If a limb is injured, then after applying a bandage it must be given an elevated position.

Internal bleeding

With internal bleeding, blood from a damaged artery, vein or capillary does not leave the skin. This is usually bleeding into the chest or abdominal cavity. A special type of internal bleeding is into the cavity of the skull. In this case, an extensive hematoma is formed, which disrupts the activity of the brain and internal organs. Minor internal capillary bleeding causes bruising under the skin and is not dangerous. But deeper arterial or venous bleeding can lead to large blood loss and serious consequences.

Signs of internal bleeding:

Blue skin (bruising) in the area of ​​injury;
soft tissue that is tender, swollen, or hard to the touch;
the victim's feeling of excitement or anxiety;
rapid weak pulse;
rapid breathing;
pale or gray skin that feels cool or damp to the touch;
nausea and vomiting;
feeling of unquenchable thirst;
decreased level of consciousness;
drop in blood pressure;
cough with bloody discharge.

In case of internal bleeding it is necessary:

Provide the victim with absolute rest;
examine the victim, trying to determine whether he has injuries to internal organs;
apply direct pressure to the area of ​​bleeding (this leads to its reduction or stopping);
apply cold to the bleeding area (this relieves pain and relieves swelling); when using ice, you need to wrap it in gauze, a towel or cloth, or even better, place it in a plastic bag; apply cold for 15 minutes; then you need to remove the water and reapply ice to the damaged surface;
If the victim complains of severe pain or cannot move a limb, or if you believe that the injury is very serious and can cause severe internal complications, you should immediately call an ambulance.

Issues 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 allow the correct assistance to be provided. 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, every person is obliged to know what a specific type of bleeding looks like, and what extent of measures should be provided 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 involved in 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 table form.

External bleeding (bleeding with direct contact with the external environment)	Internal bleeding (the spilled blood does not have direct contact with the environment)
Capillary; Arterial; Venous; Mixed.	Into the free abdominal cavity; Hemorrhages into internal organs (intraorgan hematomas); Gastrointestinal bleeding.
According to the amount of blood loss during any bleeding
Mild blood loss; Moderate blood loss; Severe blood loss; Extremely severe blood loss.

Capillary bleeding

The most common type of external bleeding is capillary. They occur with any traumatic injury that disrupts the integrity of the skin. They manifest themselves as a low-intensity, uniform flow of blood from the wound due to damage to the capillaries (the smallest vessels of the body). They rarely lead to severe blood loss, since in most cases they stop on their own. They present no difficulties either for diagnosis or for treatment. 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 compromised. In this case, quite intense bleeding occurs. The following symptoms can clinically recognize venous bleeding:

• Dark blood;
• The bleeding is very heavy, like a constant flow of blood from the wound;
• It decreases when the area below the wound is pressed.

Venous bleeding is extremely dangerous if medical assistance 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 stopping them should not be neglected. Superficial veins bleed less intensely, while damage to deep veins causes profuse bleeding.

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

Arterial bleeding

Given the deep location of the 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 puncture wounds from thin and narrow objects. Clinically, arterial bleeding can be suspected by the following signs:

1. Bright red blood;
2. Flows out in the form of a pulsating stream;
3. Very intense;
4. Does not decrease with normal pressure on the wound or tissues above and below it;
5. The localization of the wound corresponds to the projection of the course of large arteries.

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

Internal bleeding

Unlike external bleeding, in which it is impossible not to notice their symptoms, internal bleeding is more insidious. After all, recognizing them is not so easy. They usually manifest themselves when there is already quite a lot of blood loss. Therefore, it is extremely important to know all the possible signs of this dangerous condition. These include:

1. General weakness and drowsiness;
2. Discomfort or pain in the abdomen;
3. Unmotivated decrease in blood pressure;
4. Frequent pulse;
5. Pale skin;
6. The appearance of pain in one of the halves of the neck, which occurs in a horizontal position and decreases in a vertical position (Vanka-Vstanka’s symptom).

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 internal organs occurs, which causes a violation of the integrity of blood vessels and bleeding. The result is an accumulation of blood in the abdominal cavity, chest, and saturation of the damaged organ or visceral fatty tissue (hematoma).

Such bleeding can progress at lightning speed, but can also increase over several days after the injury. It all depends on their intensity and the extent of damage to the injured organ. Usually the spleen is affected, less often the liver. With a one-stage rupture, bleeding occurs immediately; with a two-stage rupture, an intraorgan hematoma first appears, which ruptures after a few days, causing an immediate worsening of the patient’s condition.

Gastrointestinal bleeding

If you look thoroughly, 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 detecting the symptoms of such a condition. After all, the patient’s life sometimes depends on timeliness. Signs of gastrointestinal bleeding include:

1. General weakness and dizziness;
2. Frequent pulse and low blood pressure;
3. Pale skin;
4. Vomiting blood or brown matter;
5. Thin, bloody or thick black stool.

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

Educational video on first aid for bleeding:

What to do if you are bleeding

Therapeutic tactics must be differentiated and depend on the specific type of bleeding. There is a general scope of activities that must be carried out in any type. All specific manipulations are purposeful, since their incorrect implementation can cause harm to the patient. General measures to help with bleeding include:

1. Place the victim in a horizontal position;
2. Monitor consciousness, pulse and blood pressure;
3. Rinse the bleeding wound with hydrogen peroxide and apply a clean pressure bandage;
4. If possible, apply ice to the source of bleeding;
5. Transport the patient to the nearest facility.

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

Differentiated tactics are presented in table form.

Type of bleeding	Scope of necessary activities
	First aid (temporary stop of bleeding)	Specialized medical care (final stop of bleeding)
Capillary	Wash the wound with an antiseptic; Cover with a sterile, dry or peroxide-moistened bandage.	Stitching the wound if necessary.
Venous	Carry out measures as for capillary bleeding; Apply a pressure bandage, covering 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 deep veins are damaged, the defect in the vein and the skin wound are sutured.
Arterial	Perform general activities; Finger compression of a bleeding vessel in the wound; Tightly pack the wound with a bandage soaked in peroxide; Apply a tourniquet above the wound site.	Suturing or prosthetic replacement of the damaged artery with further suturing of the wound.
Internal and gastrointestinal bleeding	General measures for bleeding, typical for the prehospital stage.	Administration of hemostatic drugs; Infusion therapy to replace blood loss; Observation; Surgical treatment if there are signs of ongoing bleeding.

Rules for applying a tourniquet

A tourniquet should be applied exclusively for arterial bleeding. Its erroneous use for venous bleeding will lead to their intensification. Characteristics of correct application of a tourniquet:

1. It is applied to the affected segment no lower than 20 cm from the wound. It can be higher. A lower location is permissible only if it is impossible to perform the classic manual;
2. A fabric bandage is placed on the skin under the tourniquet;
3. A special hemostatic tourniquet or improvised materials that replace it can be used as a tourniquet;
4. The first circular tours of the tourniquet around the limb are less tight. After them, tighter tours should be applied;
5. After a properly applied tourniquet, bleeding decreases. If this does not happen, this indicates either that it was applied incorrectly or that there is no indication for this;
6. The permissible duration of holding the tourniquet on a limb should not exceed 2 hours in the summer and 1-1.5 hours in the winter;
7. 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 digital pressure on the pulsating vessel above the wound or directly in it.

Correct 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 dangerous complications of any bleeding.