1) arterial - jet, pulsating or bubbling outflow of scarlet blood from a wound,
2) venous - a smooth, non-pulsating discharge of dark blood,
3) capillary - diffuse, smooth release of red blood over the entire surface of the wound,
4) parenchymal - (typical of an injury to the liver, spleen, lung), in which blood of a different color (scarlet and dark red) is secreted over the entire surface of the wound,
5) mixed bleeding - a combination of venous with arterial, capillary and venous, etc.
Temporary stop of bleeding is most often carried out outside the hospital with accidental injuries and is in the nature of first aid to the victim, which is a necessary condition for transporting him to a place where the final stop of bleeding can be made. Measures to temporarily stop bleeding can also be carried out in the operating room when it is resumed, for example, when a tourniquet is removed, if a blood vessel is damaged during the operation and in other situations.
Ways to temporarily stop bleeding.
1. Directly pressing the bleeding area (pressure bandage) can be used for non-intensive bleeding (venous, capillary, mixed) mostly on the upper and lower limbs. It is performed in the following way: a sterile napkin or a piece of fresh, clean linen is placed on the wound surface, a roller is made of cotton wool or clothes, and the whole thing is tied up tightly or pressed by hand.
2. Elevated limb position stops bleeding with small superficial wounds of the hands or feet, fingers, with bleeding from varicose nodes on the tibia. This method is well combined with a pressure bandage.
3. Pressing the main arterial trunks with your finger apply in cases when the immediate arrest of arterial bleeding is necessary. The compression is produced in certain anatomical places where the arterial trunks are located more or less superficially and closely adjacent to the bones. These places are typical and are used not only to stop bleeding, but also for vascular palpation in the diagnosis of various diseases.
Common carotid artery pressed against the transverse processes of the cervical vertebrae in the middle of the inner edge of the nodding muscle. When the patient is lying on his stomach (assisting is on the side of the victim's back), his head is turned in the direction opposite to the wound. The thumb is placed on the back of the neck, and the rest of the fingers are pressed against the carotid artery.
Subclavian artery pressed in the supraclavicular fossa to the I rib in the place where it passes over it between the stair muscles. When the victim is lying on his back (assisting is facing the victim), his head is retracted to the opposite side from the place of pressure, with four fingers cover the back of the neck and the thumb is pressed against the artery.
Axillary artery press in the depth of the armpit to the head of the humerus on the border between the anterior and the two posterior thirds of the axilla in the posterior surface of the pectoralis major muscle.
Brachial artery can be felt at the edge of the biceps muscle of the shoulder and pressed by the fingers of the brush, covering the shoulder from the outside.
Femoral artery they are pressed to the horizontal branch of the pubic bone immediately under the pupart ligament in the middle of the distance between the anteroposterior iliac spine and the pubis joint. Pressing is done with two thumbs with a thigh girth or fingers of a right hand clenched into a fist, enhancing their action with the left hand. In the case of the ineffectiveness of these activities, especially in obese people, you can use the following technique: assisting presses the artery in a typical place with the knee of his leg.
Abdominal aorta press the fist of the right hand to the spine in the epigastric region, increasing the pressure by gripping the right wrist with the left hand.
4. Circular tug of the limb (harness). The basic rules for applying a tourniquet are: a tourniquet is applied only in case of arterial bleeding, imposition should be made above the bleeding site only on the shoulder or on the thigh with an obligatory tissue lining. In the absence of an elastic tube or strip (tow), you can use a rope, a strip of cloth or a bandage, twisted into 4-5 layers in the form of a twist, the lever of which, after tightening, must be fixed with a separate bandage. The tourniquet is imposed for a period of not more than 2 hours, and in winter up to 1 hour. The time for applying a tourniquet or twist is noted on the free skin of the limb, on a bandage or on paper attached to the dressing.
Upon admission of a patient with a harness to the operating room after treatment of the surgical field, the harness applied during the evacuation steps is removed, the sterile harness is again applied and the surgical field is re-treated. A sterile tourniquet in the operating room is sometimes also applied before the onset of amputation to reduce blood loss during surgery. In this case, after the treatment of the stump, the tourniquet is removed, additional hemostasis is produced before the skin is sutured.
5. Forced limb flexion: in order to stop bleeding, strengthened flexion is made in the joints that are above the wound - the elbow, knee, hip, fixing the strongly bent joint in this position with bandages.
When bleeding from the brachial or axillary arteries both elbows with bent forearms reduce the patient's back and hold in this position with a few turns of the bandage passing horizontally above the condoms, these turns are pulled downwards by two pieces of bandage that are pulled down from the elbow to the perineum, are held under it and lifted through the inguinal regions again to elbows, where they are attached to the horizontal moves of the bandage.
Bleeding and how to stop them
Bleeding occurs as a result of disruption of the integrity of the vessel, which may occur due to injury, disintegration of the vessel wall during tumors and purulent processes. It is known that in the human body the average volume of circulating blood is 5 liters. It is believed that the loss of about 10% of this volume does not have harmful effects on health, 20% can be a threat to human life, if there was a loss of blood in a volume of more than 20%, then the life of the victim can be saved only by emergency replacement of blood loss.
• external, while blood through the wound of the skin or mucous membrane enters the environment,
• internal, which are subdivided:
a) obvious, when blood is poured into the hollow organs (for example, the intestines, stomach, bladder, bronchi) and only after accumulating in them, it is excreted out through natural openings,
b) hidden, when blood enters a closed body cavity, for example, the abdominal, chest or cranial cavity and does not pour out anywhere due to the absence of natural openings. This type of bleeding occurs as a result of damage to internal organs and can only be recognized by a change in the general condition that is caused by blood loss, and by symptoms of fluid accumulation in one or another cavity.
Bleeding into the abdominal cavity leads to the development of acute anemia, while the patient quickly turns pale, his pulse quickens, but weak filling, he complains of painful thirst, darkening in the eyes, drowsiness, may faint.
Bleeding into the chest cavity also leads to anemia, with the patient having shortness of breath, breathing becomes fast and difficult.
Bleeding into the cranial cavity primarily leads to compression of the brain, while the victim complains of an unbearable headache, can faint, breathing disorders are observed, paralysis and other neurological symptoms are possible.
Hemarthrosis, or hemorrhage into the joint, occurs due to damage to the articular surfaces or ligaments, which can occur with hemorrhagic diseases such as scurvy or hemophilia. In the articular cavity, blood is mixed with synovial fluid and coagulates. At the same time, the patient experiences severe pains not only when moving, but at rest, therefore he tries to restrict movement in this joint, occupies the forced position of some flexion in it. An external sign of the disease is a tumor in the area of the joint that follows the contours of the articular torsions. Determined effusion in the composition. Resorption of hemarthrosis is long, after it mobility limitations are possible,
c) interstitial, in fact, hemorrhages in which the blood moves apart soft tissues, forming a hematoma accumulation, or infiltrates them. At the same time, in the area of injury, a large, unsteady swelling appears, with a localization closer to the surface, which is manifested by visible hemorrhage in the subcutaneous tissue (otherwise - a bruise). The reverse process is slow. It may be complicated by suppuration with fever, increased pain, the appearance of redness and the formation of an abscess.
Hygroma - hemorrhage in the mucous bag, which developed as a result of injury, or - repeated mechanical injury resulting from pressure on the mucous bag. Most often, such injuries occur in the anterior surface of the patella, elbow area, under the deltoid muscle, in the greater trochanter of the thigh, in the popliteal region, or under the Achilles tendon. As a result of injury, a serous effusion appears in the bag, it thickens, villi grow in it, free fibrinous bodies appear, and lime is deposited.
On examination, an elastic, rounded tumor is revealed in a typical location. This tumor is painless, but can cause severe pain when moving. The base of the tumor is tightly connected with the deep-lying tissues, the skin retains its mobility. Improvement of the condition is possible without treatment, but cases of exacerbation are possible.
The origin of bleeding may be different.
1. Traumatic - The most common type of bleeding. Such bleeding occurs as a result of mechanical damage to the blood vessels and it happens:
• primary, when bleeding occurs immediately after injury,
• secondary, when bleeding is resumed a few days after injury. Such bleeding occurs during suppuration of wounds, while the purulent process leads to the melting of blood clots that closed the lumen of the damaged vessel. Bleeding is possible with reduced blood clotting, on which its duration and intensity depends.
Damage to blood vessels occurs as a result of trauma or injury, the nature of which depends on the object with which the injury was inflicted. Among the injuries emit:
• incised wound, which has smooth edges without damaging the surrounding tissue. Its characteristic feature is that it is considered the most bleeding and gaping,
• a stab wound is dangerous for the possibility of damage to internal organs, including the heart, as well as large vessels, organs of the abdominal cavity, etc. Such wounds are always accompanied by heavy bleeding and are more susceptible to such complications as infection,
• The chopped wound is a bruise of soft tissue of various depths. With such a wound, tissue crush and bone damage are possible.
• bruised has uneven blood-soaked edges that constitute a favorable environment for the development of infection in it,
• A torn wound is different from other detachments of skin grafts, damage to the blood vessels, tendons and muscles.
Injuries involving a violation of the chest, abdominal, cranial or articular cavities are called penetrating. With this type of injury, loss of internal organs is possible.
2. Nontraumatic. This type of bleeding occurs when pathological processes that destroy blood vessels, increased permeability of the vascular wall in certain diseases, such as hemophilia. In this disease, even with a minor injury or injury, persistent hemorrhages and bleeding occur on the skin, joints, and muscles from the mucous membranes.
Aneurysm, or dilation of the artery, can also cause arterial bleeding. In this disease, changes occur in the vessel wall, during which it stretches and forms a protrusion, called a true aneurysm. When an artery is wounded, blood is poured into the surrounding tissues and partially coagulates, the wall of the bag is formed from these convolutions and surrounding tissues, which is connected to the vessel and contains liquid blood - a traumatic or false aneurysm occurs. In addition to arterial, arteriovenous aneurysm is distinguished when there is communication between the vein and artery. Symptoms of this disease are a swelling of a round or oval shape, corresponding to the position of the artery, pulsating and giving a noise when listening. When the artery is pressed centrally than the aneurysm, the pulsation disappears and the tumor decreases. In the process of growth, the aneurysm squeezes the veins, which causes difficulty in blood circulation, which is determined by cyanosis and edema below the aneurysm. At the same time, nerves can suffer from compression, as a result of which trophic changes in tissues and disorder of sensitivity develop. If thinning of the adjacent tissues occurs, rupture of the aneurysm with massive bleeding is likely, resulting in the death of the patient.
Depending on the type of bleeding vessel secrete:
• arterial bleeding, with the blood having a bright red color, pouring out with a strong pulsating jet. Arterial bleeding is considered particularly rapid, significant and life threatening. The danger of it, and of other abundant bleeding, is that a sufficiently rapid decrease in circulating blood occurs, acute anemia occurs, which leads to a violation of hemodynamics, heart work worsens, therefore, the process of supplying oxygen to vital organs such as the brain, liver , kidneys, this, in turn, leads to a sharp disruption of metabolic processes in the body, while the victim loses consciousness. Severe blood loss without appropriate assistance to the victim leads to his death. By the way, a hemorrhage from large blood vessels, especially arterial ones, can lead to fatal blood loss in a few minutes. Especially dangerous blood loss in children and the elderly,
• venous bleeding occurs due to damage to the veins, while the outflowing blood has a dark cherry color and flows evenly, only when large venous vessels are damaged, a pulsation of blood can be observed, while the pulsation corresponds to the act of breathing and not the heart rhythm, as in arterial bleeding . In the case of bleeding from the veins of the neck or chest as a result of the negative pressure that has arisen during inhalation, air is sucked into the veins, and an air embolism may develop - the vessels are blocked with air,
• mixed bleeding, or mixed, usually parenchymal, which is manifested by a combination of signs of arterial and venous bleeding and is observed in case of damage to the liver, kidneys, spleen,
• capillary bleeding, in which blood is evenly distributed over the entire surface of the wound drop by drop.
The severity of blood loss depends on two factors: the speed and duration of the outpouring of blood. The duration of bleeding depends largely on the clotting factor, which is especially important for some diseases in which blood clotting is lowered, therefore, due to its duration, even the scarce bleeding sometimes becomes a threat to the life of the patient. These diseases include hemophilia and radiation sickness.
Thus, the aim of the care provider and the victim himself (if possible) is to stop the bleeding.
If the bleeding is not abundant or capillary, then in most cases the healthy body itself can cope with the bleeding due to its protective forces, under the action of which a blood clot forms, narrowing the lumen of the damaged vessel or small capillary vessels. Thus, the bleeding stops on its own. But this is not always the case; therefore, without rendering urgent assistance, bleeding of the brain and other vital organs can occur, followed by the death of the victim. In most cases, with injury and large blood loss, the victim falls into a state of shock. At the same time, although his consciousness is preserved, he becomes completely indifferent to his surroundings, in some cases in the initial stage of shock he becomes emotionally and mentally agitated, it is difficult to stop, his voice becomes quiet, the pallor of the skin appears, they become covered by sticky cold sweat, the heart rate drops, the pulse becomes weak, the breathing is shallow, rapid, the facial expression of the victim becomes immobile, and by external signs it becomes similar to the deceased. В этом случае ему может помочь только срочное переливание крови, которое возможно начать в машине «Скорой помощи» или в стационаре. Транспортировка пострадавшего в данном случае осуществляется в положении лежа.As long as the patient remains at the scene of the incident, it should be laid on a flat horizontal surface, and with significant blood loss it is recommended to lay it so that the head is below the level of the body, which will help avoid or halt the development of blood starvation of the brain, leading to death.
As it now became known, bleeding can occur not only as a result of injury. Thus, the discharge of blood through the mouth occurs most often due to bleeding from the upper respiratory tract, esophagus or stomach. Pulmonary hemorrhages are mainly of tuberculous origin, but can occur with bronchiectasis, abscesses, lung gangrene, lung actinomycosis, and several other lung pathologies that cause a complication in the form of a heart attack, and even with various diseases of the hematopoietic system. In case of pulmonary hemorrhage, frothy red blood is released. With severe bleeding, anemia occurs, cardiovascular activity declines, manifested by abrupt pallor of the skin and mucous membranes, general weakness, dizziness, fainting, nokholadnymi extremities, cold sweat, small and frequent pulse until the disappearance.
One of the most common bleeding is nose bleeding, the causes of which are: injuries, removal of hard crusts, picking in the nose, bleeding tumors and ulcers in the nose, as well as infectious diseases, diseases of the blood-forming organs, and diseases of the heart, liver and kidneys, hypertensive disease, arteriosclerosis. Sometimes bleeding from the nose occurs due to changes in atmospheric pressure, temperature and humidity, as well as the result of prolonged irritation of the nasal mucous membranes with chemicals. In some persons, nosebleeds may occur in hot weather, which is due to the drying up of the nasal mucosa, and in some, as a result of a blood rush to the head during prolonged exposure to the sun. As a rule, the bleeding area is located on the front-lower part of the nasal septum - 1 cm above the entrance to the nose.
Parenchymal bleeding occurs when a mixed injury of the small arteries, veins and capillaries of the internal parenchymal organs, which are the liver, spleen, kidneys, and lungs. Such bleeding can be profuse and prolonged, and result in the death of the victim.
With gastric ulcer and duodenal ulcer, when the ulcerative process destroys a blood vessel, bloody vomiting appears. Sometimes it is the very first sign of a peptic ulcer that was asymptomatic before. Gastric bleeding can be accompanied by acute gastritis and stomach tumors. Quite often, gastric bleeding occurs as a result of the expansion and rupture of the venous vessels of the esophagus and stomach, caused by cirrhosis of the liver.
Bloody vomiting, in appearance resembling coffee grounds, is a diagnostic sign of bleeding from the stomach and duodenum (the blood takes on this appearance as a result of the action of hydrochloric acid of gastric juice on it). Vomiting of fresh blood or decayed dark red blood with a small admixture of “coffee grounds” blood is observed during rapid gastric hemorrhage. Prolonged and significant bleeding causes anemia, general weakness, weight loss. Significant bleeding often leads to collapse.
In case of peptic ulcer 1-2 days after bloody vomiting, tarry stools with a foul odor appear due to the admixtures of digested blood.
Small stomach bleeding can go unnoticed, as blood from the stomach enters the intestine and is digested there.
Blood in the feces is generally evidence of bleeding in any part of the gastrointestinal tract. By its color, it is only possible to determine from which parts of the intestines there was bleeding, for example, tarry feces indicate that bleeding occurs from the upper sections. As a result of such bleeding, general anemia develops, accompanied by dizziness, weakness, thirst, dullness, the pulse quickens and weakens, blood pressure drops, the skin abruptly turns pale, the patient has abdominal bloating and intestinal pain. Tarry stools usually appear 1-2 days after bleeding. Unchanged blood, not mixed with feces, indicates a bleeding from the lower parts of the colon.
Blood may be excreted in the urine or as an impurity to it. It can be visible or determined only under a microscope in the study of urinary sediment. Hematuria can occur with nephritis, Verlgof's disease, leukemia, bleeding, tuberculosis and kidney tumors, as well as damage to the kidneys and urinary tract, kidney stones and bladder. The excreted long blood clots indicate that there is an inflammatory process in the nights and ureter.
The apparent absence of blood in the vomit, sputum, urine, feces or other laboratory materials does not mean that the inflammatory process in the gastrointestinal tract, kidneys and other organs, accompanied by bleeding, is completed, as a small amount of blood can be detected microscopic examination of materials or using special chemical reactions.
Functional uterine bleeding is a symptom of many gynecological diseases: inflammation of the uterus, uterine tumors, abortion, blood diseases, accompanied by a violation of its clotting. Uterine bleeding can also occur in liver diseases. Sometimes abundant and scarce. Excessive bleeding can lead to a life-threatening condition in which blood pressure drops, and the amount of hemoglobin sharply decreases.
Only women can have atonic and hypotonic bleeding, which happens mainly after the birth of the afterbirth, when the tone of the muscular and vascular system of the uterus is sharply reduced or completely absent. The causes of bleeding in this case may be: overstretching of the uterine walls during pregnancy, poor labor due to endocrine, autonomic nervous system disorders, the presence of uterine fibroids, etc.
In total, physicians distinguish five types of blood loss:
- Capillary. It is characteristic of damage to small vessels of the circulatory system, for example, with an abrasion or a shallow cut. Blood is released in the form of drops, and the bleeding stops most often on its own.
- Venous. In this case, the injury concerns the deep layers of the skin with damage to the veins. Blood flows out very slowly, visually representing a continuous stream of dark red color. If the veins of the upper half of the body were injured, then the blood is released in the form of an intermittent stream synchronously breathing.
- Arterial. The cause of bleeding in this case is damage to the arteries. The rate of bleeding and the risk of bleeding are directly proportional to the size of the damaged vessel. In particular, damage to the femoral or iliac artery can be fatal in just a few minutes. Arterial damage is characterized by the discharge of blood by a stream. The stop of bleeding in this case is provided by clamping the affected artery above the site of the injury.
- Mixed. With such a blood loss, there is simultaneous damage to both the veins and the arteries.
- Parenchymal. It is characteristic of damage to internal organs, while the wound surface is continuously bleeding. The independent stop of bleeding in this case is almost impossible. It is important to seek qualified assistance as soon as possible.
A temporary stop of bleeding will be required if the affected person needs to be delivered to the nearest hospital. It is produced directly at the place where the accident occurred.
There are the following ways to temporarily stop bleeding. Let's get acquainted with them in more detail.
Flexion of damaged limb
Methods to stop bleeding can be different and depend on where the wound itself is located. So, it is possible to temporarily stop the blood with the help of maximum limb flexion and its subsequent fixation in this position.
The described method has proven itself in situations where the wound is located below the joint or directly in the articular fossa itself. At the same time, it is necessary to impose on the joint area a tight roller formed of cotton and bandage. Further, the injured limb is flexed as much as possible and fixed in this position with the help of bandages.
Ways to stop bleeding are quite varied. One of the oldest means - the imposition of a hemostat. The technique was first tested in 1873.
This option to stop bleeding is widely used in violation of the integrity of the arteries, as well as in situations where other methods to stop bleeding do not produce results. Contraindications to the use of harness is pronounced vascular sclerosis.
Rules to stop bleeding with a tourniquet must be observed. The injured limb needs to be lifted, the surface above it is wrapped with any cloth. Best for this purpose suitable terry towel. A harness is applied to the surface prepared in this way. As the latter, the standard version (Esmarch harness) or a belt, rope, etc. can be used. Allowed the use of any improvised means, which can drag the limb.
If a rubber product is used, it must be stretched before use. The correctness of the overlay can be determined by the disappeared pulse.
It should be borne in mind that the harness can be applied for no more than two hours. That is why it is recommended to attach a note with the exact overlay time under it.
Above, we looked at ways to temporarily stop bleeding.
Ways to stop bleeding
Types of bleeding and ways to stop bleeding are directly related. Some methods are good, if the blood from the artery splashes a fountain, others are suitable only for capillary or minor "local" bleeding.
Watch the video of KyivNauchFilm 1990, which shows all the ways to stop blood
Types of stopping bleeding are divided into temporary and final. Temporary methods are needed to quickly prevent loss of circulating blood volume in order to have time to transport the patient to a medical facility, where he will be finally stopped bleeding. The final methods allow restoring the integrity of the damaged vessel and / or normal blood supply to the tissues fed by the damaged vessel.
First aid for bleeding includes all methods of phased temporary bleeding, namely:
- immobilization of the limb and its elevated position,
- finger pressure vessel
- pressure wound dressing
- the imposition of harness (always effective when bleeding from the artery).
Find out all about how much bleeding lasts after giving birth in the article on our website.
Finger pressing of the bleeding vessel
It is necessary to strictly observe the duration of the cessation of blood flow to the tissues. The time of the bundle is written on a piece of paper attached to the bundle itself, or indicated directly on the bundle.
Important! On average, the harness should remain on the limb for no more than 2 hours, and in summer in the heat - no more than 1.5. Otherwise, there will be tissue necrosis followed by infectious-toxic shock.
The table "First Aid for Bleeding" clearly demonstrates the visual picture of various bleeding and the technique of applying a tourniquet:
Surgical ways to stop bleeding
The final ways to stop bleeding can be divided into surgical and medical. The first include:
- clamp with the subsequent imposition of ligatures on the vessel,
Imposition of ligatures on blood vessels
- ligation of the vessel for or circular (circular) suture. The latter method is technically difficult and only forceful virtuoso vascular surgeons
- electrocoagulation (thermocoagulation, it is electrothermal coagulation). The mechanism of action is to coagulate proteins under the action of high temperature to form a stable thrombus,
- the effect of low temperatures - cryolysis (liquid nitrogen). Very effectively this method is practiced in aesthetic surgery, namely, when removing benign skin tumors (nevi, warts and papillomas),
- shunting or installation of a vascular prosthesis - is done when the vessel wall is damaged over a large distance.
Note. Ligation and ligation of the vessel throughout - the most common ways to permanently stop acute and rapid bleeding from a large artery.
Medical ways to stop bleeding
Used for capillary, small parenchymal and "local" bleeding.
Drugs to stop bleeding are divided into:
- liquid applied directly to the wound (hydrogen peroxide, adrenaline or mesatone solution),
- systemic - increase the processes of fibrinogenesis (epsilon-aminocaproic acid, Vikasol, vitamin K),
- non-liquid local - often used in hollow organs. Collagen hemostatic sponge is used for minor gastric bleeding, eliminated during endoscopy, as well as during dental operations.
Important. Collagen sponge not only stops bleeding, but also contributes to the speedy regeneration of damaged tissues.
Hemostatic sponge allows you to stop the blood and regenerates tissue
Bleeding and acute massive blood loss are life-threatening conditions. Therefore, everyone should clearly represent the principles and stages of first aid for injuries of blood vessels.
This species appears at the stage of sexual development of 12-18 years. They occur in adolescents with abnormal ovarian function. In the imbalance of hormones, infectious diseases (flu), psychological problems, excessive exercise and unhealthy diet play a role. Sometimes low coagulability of blood, tumors and genital tuberculosis become factors.
They are characterized by seasonality (usually in winter and spring), different duration and abundance. Severe bleeding causes weakness, pallor, shortness of breath. For proper diagnosis and treatment, it is desirable to be treated in a hospital.
Bleeding at reproductive age
In childbearing age, hemorrhages often appear with hormonal disorders after abortions, due to endocrine diseases, and stress. The causes are infectious diseases, hormonal medications and diseases of the reproductive system:
- uterine tumors
- hormone-producing neoplasms.
A special group at this age is bleeding in pregnant women.
Bleeding during pregnancy and childbirth
Pregnant women in the early period of bleeding occur in connection with the threat of termination and ectopic pregnancy. At the same time, the woman is worried about the sudden appearance of abdominal pain, bloody vaginal discharge, and delayed menstruation, which requires urgent gynecologist consultation.
Placement of the placenta, its early detachment or rupture of the uterus causes bleeding in the middle stages of pregnancy. In childbirth, severe bleeding is also usually associated with a violation of the location of the placenta or its early detachment.
After birth, the main factors are the atonic uterus, reduced blood clotting. If parts of the ovum remain in the uterus after childbirth or abortion, this does not stop the bleeding and has to be scraped.
In the period of formation of menopause, the concentration of sex hormones decreases and menstruation stops. The reappearance of bleeding is considered a sign of impairment. The cause of bleeding is hormonal changes, but more often they occur due to gynecological diseases.
If the menstruation stopped, but then bloody vaginal discharge appeared again, then this is most often the case for uterine tumors.
If the use of birth control pills causes uterine bleeding, they are usually associated with a period of addiction to the drug. At the beginning of the reception or after the cancellation of contraceptives hormonal changes occur, and the bleeding itself is usually minor.
That is why it is important that hormonal contraceptives are used only after consulting a gynecologist. With undesirable effects, the doctor adjusts the dose or changes the drug.
Methods of treatment depend on the severity and duration of blood loss. In each case, the gynecologist individually decides what to do when uterine bleeding. It is not always necessary to hospitalize a woman, for example, if the blood is not sufficiently excreted and the general condition of the woman is not disturbed.
Urgently stop uterine bleeding is necessary in case of severe weakness, loss of consciousness, a sharp drop in blood pressure. Только квалифицированный специалист знает, как сделать это быстро. Самостоятельно проводить лечение в этом случае опасно, нужно срочно вызывать скорую помощь.
Before the doctor arrives, emergency care consists in putting a woman in, you need to lift her legs with a roller from a blanket or pillow. The method used to stop parenchymal hemorrhage is used: cold is applied to the lower abdomen. To do this, ice from the freezer, food, a bottle of cold water, which you need to wrap in a towel, will do.
You can start stopping blood loss by taking one Tranexam tablet. After the arrival of the doctor, it is necessary to tell him how much and what drugs the woman has taken. To make up for blood loss before the arrival of an ambulance, you need to drink as much as possible any liquid.
In the hospital, uterine bleeding treatment is performed with such drugs:
- Hemostatic means: Vikasol, Tranexam, Ditsinon,
- oxytocin to reduce uterus,
- replacement therapy.
Medicines are available in different forms: candles, tablets and solutions. If blood loss cannot be left with therapy, emergency surgery is necessary.
With uterine bleeding, Tranexam acts faster and more efficiently than other drugs, and therefore is a first aid measure. This medicine directly improves the blood coagulation process by acting on a special protein, plasminogen. The drug is available in tablets and solutions for intravenous administration.
Indications for appointment Tranexam:
- bleeding from internal organs
- stop bleeding after surgery,
- allergic conditions
- inflammatory diseases of the mouth and throat.
The drug is contraindicated in case of hypersensitivity to it and intracranial hemorrhage. Of the side effects observed nausea, heartburn, drowsiness, rarely thrombosis, itching. This is one of the few drugs used in pregnant women.
Dicine is a hemostatic drug that reduces capillary fragility, normalizes blood clotting in the place where small vessels are damaged. There are two ways how to take Ditsinon can be used in tablets and injections. With the introduction of a vein, it acts after 5-10 minutes, and is effective from 4 to 16 hours.
Dicine can be used for:
- operating blood loss
- uterine and intracranial hemorrhage,
- retinal hemorrhage in diabetes.
The drug is not used for asthma, leukemia, individual intolerance and thrombosis.
Admission Ditsinona causes side effects in the form of nausea, skin rash, headache, lower blood pressure, allergies and weakness. Pregnant women dicinone prescribed with caution. By selecting the drug used, the doctor takes into account the risk to the mother and fetus.
This is a synthetic analogue of vitamin K, which plays an important role in the process of blood coagulation. Vikasol when uterine bleeding is not used in the acute period, as it begins to work no earlier than 12 hours after administration.
Vikasol prescribed for combination therapy for bleeding and their prevention after childbirth. To do this, the drug is administered to women at the beginning of the first contractions.
The drug is contraindicated in case of increased blood clotting. Side effects are infrequent in the form of allergy, lowering blood pressure, jaundice in newborns.
Types of bleeding
The danger of an open wound on the human body, leading to blood loss, exists both in industry and in everyday life. If the threat is ignored, infection of the vascular bed and subsequent infection of the body can occur. There are several types of bleeding, to stop which apply different methods:
- Capillary. It is distinguished by a slow and uniform release of blood that has a scarlet color. With normal blood clotting, stopping occurs independently.
- Venous. Differs in uniformity of an outpouring of an uninterrupted flow of blood of dark color.
- Arterial. The outgoing jet pulses with jolts. It has a scarlet color. The volume of blood loss is very large. The danger of arterial bleeding is fatal in cases of damage to large arteries.
- Mixed typearising from extensive damage. Accompanied by abundant blood loss.
In practice, several types of vessels are often injured at once, because they are very close. For this reason, bleeding is divided into types according to the strength of the jet:
- Weak. The final stop of which occurs during the treatment of the wound.
- Strong. The blood flows out of the wound very quickly, therefore, first they achieve a final stop, and only then the wound is treated. A long duration of blood loss can be fatal.
Temporary and definitive ways to stop bleeding
Temporary methods are used in the first minutes of wound formation before the arrival of specialists, as well as during the transportation of the victim. Temporary methods include:
- Applying a pressure bandage,
- Giving a part of the body a sublime position
- The maximum bend of the joint in order to squeeze the blood vessels
- Pressing the vessels with your fingers,
- Overlay harness
- Overlaying the clamps on the bleeding vessel.
Ways to stop temporarily bleeding
In order in an emergency situation to properly assist the victim in case of blood loss, you need to firmly remember the algorithm of necessary actions and the ways of its implementation, which are listed in the Table below.
First aid measures for bleeding should be initiated 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 for a short period of time a significant amount of blood flows out of the wound injury.
Rapid and abrupt blood loss (more than two liters) can be fatal, especially if bleeding is combined with combined traumatic injuries.
For obvious reasons, first aid for bleeding is usually performed outside the walls of a medical facility. Therefore, this procedure is temporary, and is to stop the bleeding for the speedy transportation of the injured person to the conditions of a medical hospital.
Ways to temporarily stop bleeding:
- Pressure bandage. Used to compress the immediate site of bleeding. A sterile gauze bandage is applied to the wound surface (in the absence of a piece of any pure natural fabric) and tightly pinned (in the absence of bandaging material, simply press the bandage to the wound with the hand). Apply with capillary, venous and mixed bleeding of moderate intensity.
- With insignificant bleeding with wound injuries of the feet, lower leg, fingers, etc. use the method of giving the injured limb a raised position. It is good to combine this method with the imposition of a pressure bandage.
- In the case of arterial bleeding and the need to immediately stop the bleeding (when there is no time to search for suitable means) use the method of pressing the bleeding artery with your finger. Arteries are pressed in certain anatomical points, where they can be pressed tightly against the bones and thereby temporarily stop the bleeding.
First aid for bleeding
Bleeding is the outpouring of blood (that is, its outflow) through the blood vessels as a result of the integrity of their walls.
The nature of bleeding can be traumatic, which is caused by vascular damage, as well as non-traumatic, which is caused by the destruction of blood vessels when exposed to a particular disease process.
Types of lesions determine, respectively, the types of bleeding, first aid for which is decisive in the speed of its delivery, which is reflected in the consequences of the influence of the pathological process on the entire body.
First aid for arterial bleeding
The main thing that is necessary to save the life of the victim, regardless of the types of bleeding - first aid, which is to temporarily stop the discharge and loss of blood.
The easiest way is to press the artery by finger, which is not produced near the lesion itself, but above it, that is, in the accessible area near the bone or under the lesion.
In the example shown in the figure, points are indicated in the region of which finger presses should be made. It should be noted that it is precisely due to the finger pressing that the possibility of almost instantaneous and complete arrest of the bleeding arises.
Meanwhile, even a strong person can hold the desired point for more than 15 minutes, because the hands experience a certain fatigue because of this, and therefore the degree of pressure is weakened.
Given this, it can be noted that this technique is important because it allows you to win a certain time, which is necessary to search for and implement other measures to stop bleeding.
Pinching of artery bleeding
- Next, a tourniquet is applied to the injured limb, which is also done in the area above the damage to the vessel.
- The maximum time determined for applying a harness for adults is about two hours, for children - up to 50 minutes.
- Holding the harness over a longer period of time can lead to tissue necrosis. During this period, the victim should be taken to a hospital.
First aid for venous bleeding
In considering the types of bleeding and first aid for them, in addition to arterial bleeding, which is the most dangerous of the possible options, venous bleeding should not be missed.
The danger of this bleeding, in addition to significant blood loss, is the possibility of air being absorbed through the damaged places into the vessels.
The air trapped in the vessel may subsequently be in the heart, leading to a deadly condition known as an air embolism.
Stopping venous bleeding is best done using a pressure bandage. So, clean gauze is applied to the damaged area, over which a bandage is put (or, again, folded gauze several times).
In the absence of these materials fit a clean scarf. In the absence of any type of pressure bandages and with severe bleeding, it is necessary to press the bleeding area with the fingers.
Bleeding of the vein in the upper limb can be stopped by raising the arm up.
First aid for capillary bleeding
Capillary bleeding, unlike other types of bleeding and first aid, necessary for them, is characterized by relatively small blood loss.
Moreover, it can be quickly stopped using the clean gauze applied to the affected area. Cotton wool is laid over this gauze, after which the wound is tied.
In the absence of these materials, a bandage can be used.
A variety of bleeding in humans
Under the bleeding understand the outflow of blood from damaged vessels. Most often, bleeding occurs as a result of injury. With the outflow of blood through the wound of the skin to the outside they speak of external bleeding. In case of internal bleeding, leaked blood accumulates in the body cavities.
External bleeding can be: Capillary - blood flows drop by drop, they are observed with abrasions, superficial skin cuts, Venous - occur with cut, stabbed wounds, blood of dark cherry color, flows in a continuous stream,
Arterial - occur when chopped, stabbed wounds, the blood is bright red, it follows a strong pulsating stream.
When blood loss occurs a violation of the activity of the brain, heart, lungs. Very dangerous is the loss of 1-1.5 liters of blood. A one-stage loss of 2-2.5 liters of blood is fatal. First aid for a bleeding wound is to stop the bleeding.
A temporary stop can be achieved by raising the injured limb above the level of the body. The final bleeding is achieved by applying a dressing to the wound in the following sequence:
Clean gauze on the wound, a layer of cotton wool, bandaging with a bandage. It is impossible to impose cotton wool on an open wound.
Bleeding from the arteries is the most significant and life threatening. In case of injury of large arteries and in the absence of timely assistance, death can occur. The blood is streamed from the arteries, it is bright red.
In case of small arterial bleeding, the circumference of the wound is smeared with tincture of iodine, a pressure bandage is applied.
The quickest and easiest way to stop arterial bleeding is to press the vessel to the underlying bone above the bleeding site by the blood flow.
Simultaneously with the pressing of the vessel to the bleeding give a raised position. Significant arterial bleeding is stopped by applying a tourniquet above the bleeding site.
In the absence of a harness, you can use a thick rubber tube, suspenders, belts, towels. Every hour and in the winter time every half hour the harness must be removed. If bleeding continues, the tourniquet is applied again.
Nosebleeds are frequent companions of many diseases of the blood, heart, blood vessels, kidneys, liver, and may occur suddenly. They can occur with injuries of the mucous membrane of the nose, from a strong blowing of the nose, picking in the nose, as well as during agitation, overheating, and other cases.
Aid for nosebleeds can not be delayed, nosebleeds should be stopped immediately. First of all, you need to calm the patient, because when agitated, palpitations are noted, which increases blood loss. The patient should be given a half-sitting position with a slightly bowed head.
The cause may be various injuries, diseases of the blood, heart, blood vessels, foreign bodies. A blood disorder such as hemophilia is sometimes accompanied by severe and even fatal bleeding from the throat. When throat bleeding is necessary to calm the patient.
The best remedy is not verbosity, a confident tone and skillful assistance actions. The patient should not hang his head down and throw back, he is forbidden to sudden movements. You can not talk. Provide access to sufficient air.
- Rarely observed. The cause is tuberculosis, pneumonia, foreign bodies and traumatic injuries. Blood in pulmonary bleeding has a foamy character, rarely clotted.
- With abundant pulmonary bleeding, the patient is frightened, pale. There is a weakness, dizziness. The patient must lie in bed in such a way that the upper half of his body is raised.
- Such patients should be urgently taken to the hospital.
Bleeding from the esophagus and stomach
Occur when the wound of the esophagus, with a stomach injury. One of the main signs of gastric bleeding is vomiting with fresh or clotted blood.
It is recommended to swallow small pieces of ice, ice cream, cold milk with raw eggs. Inside prescribed infusion of cherry fruit. The patient is placed in a half-sitting position with legs bent at the knees. On the stomach put an ice pack.
Observe complete peace, do not eat, do not drink. Urgently to deliver to the hospital.
Wounds are formed by mechanical damage to tissues with a violation of the integrity of the skin. In addition to the skin, muscles, bones, nerves, tendons, ligaments, and blood vessels may be damaged. When injuries occur bleeding, pain, wound discrepancy.
First aid for injuries includes stopping bleeding and wound healing. Wound dressing must be done with clean hands. The edges of the wound are treated with disinfectants - tincture of iodine, hydrogen peroxide.
Cover the wound on top with clean gauze, put cotton wool, and then tie it up with a bandage.
With extensive injuries of the limb, along with the treatment of the wound, the limb is immobilized. In case of violation of the integrity of the skin and tissues, bandages are applied to this part of the body. Their goal is to stop bleeding, prevent, prevent wound infection, create rest for the injured organ.
Bandages can be ordinary - protecting the wound from external influences, pressing - used to stop bleeding, immobilizing - to ensure the immobility of the damaged part of the body, occlusive - hermetically closing the body cavity. There are soft and hard dressings. Soft there are three types: glue, kosynochnye and bandage.
The adhesive bandage is an adhesive plaster that adheres firmly to the surface of the skin and thereby holds the dressing.
The strap is applied with a piece of fabric in the form of a triangle.
Bandage bandages impose with a bandage. When performing bandaging, the following should be remembered: bandages should be applied firmly, they should not stray, slide off, hurt, and bandage from left to right.
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It uses both low and high temperatures. Холод провоцирует спазм сосудов, а нагрев повышает скорость свертывания крови. Данные виды остановки кровотечения способствуют его быстрому прекращению.For example, on postoperative wounds when hematomas occur, it is common to impose blisters filled with ice.
Diffuse or parenchymal bleeding can be stopped by applying a gauze napkin, previously soaked in a hot solution of sodium chloride, on the wound surface.
In this case, it is assumed the use of drugs that are made either from blood or from living tissues. Intravenous transfusion is quite common. Both fresh donor blood and blood products can be used here.
The following can be used as local hemostatic agents:
- Thrombin. A sterile napkin is impregnated with its aqueous solution, which is then applied to the surface of the bleeding wound. Used when stopping parenchymal or capillary bleeding.
- Fibrin sponge Also intended for local use. Pre-soaked with thrombin solution.
- Hemostatic sponge. For its production using blood plasma. Also included are thromboplastin and calcium chloride. Visually, this is a dry porous mass of light yellow color. It not only absorbs blood, but also contributes to its early clotting. The sponge can not be removed, because it is completely absorbed.
- Fibrin film. For its manufacture used human blood plasma. Used when stopping capillary and parenchymal hemorrhage is required. Also absorbed without residue.
- BAT (biological antiseptic swab) produced from blood plasma. Additional ingredients are gelatin, antibiotics, antiseptics and hemostatic agents.
Stopping external bleeding may include a combined method. In this case, several different stopping methods are used simultaneously.
Not superfluous will be the information that allows to determine, by accompanying signs, which particular vessel or organ was damaged. Symptoms are divided into two types: general and local.
The general symptoms for any type of bleeding are of the same type. The victim has the following:
- strong weakness
- dizziness with fainting
- dry mouth and great thirst
- pale skin color,
- blood pressure instability
- weak and unstable pulse.
But the local symptoms characteristic of internal bleeding are quite diverse. When blood is poured into the cavity of the cranium, signs of compression of the brain substance will be clearly manifested.
Blood filling of the pleural cavity is accompanied by signs of hemothorax. In this case, the victim is experiencing severe shortness of breath. He has a weakening of breathing, trembling voice, and also decreases the depth of inhalation. To confirm the diagnosis will help x-ray of the chest, as well as the puncture of the pleural cavity.
Blood accumulated in the abdominal cavity can provoke signs of peritonitis. These are pain, vomiting, nausea, tension of the anterior abdominal wall, general signs of peritoneal irritation. Confirming concerns will be able to ultrasound.
Clinic of blood flow into the joint cavity depends on the size of the damaged vessel. Local manifestations include the following:
- severe swelling of the joint
- feeling of bursting
- pains of varying intensity.
If no action is taken, then the development of gangrene is possible.
Now you are familiar with not only the symptoms and types, but also ways to stop the bleeding. We hope that in a difficult situation, this knowledge will be useful to you.
Types of bleeding
To begin, consider what bleeding is and how dangerous it is. In medicine, there are several classifications. In this case, the familiar bleeding from an injured arm or leg is just a special case.
Types of bleeding. First aid for bleeding depends on what the vessel was damaged, in what place and how intense the bleeding.
Separation at the site of blood flow:
Separation by type of damaged vessels:
By the nature of the process that caused the bleeding:
- light - up to 500 ml
- average - up to 1 l,
- heavy - up to 1.5 liters,
- massive - up to 2.5 liters
- 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 young children, blood loss of about 250 ml is considered dangerous.
Ways to assist with external bleeding
In the provision of first aid used the so-called temporary methods of stopping. Depending on what types of bleeding, first aid for bleeding may include the following techniques.
- Overlay harness. Use a rubber band. It is applied in case of damage to the main arteries of the extremities or extensive bleeding that is not stopped by other means. The first round impose tight, a few cm above the site of bleeding. Under a plait enclose fabric not to injure a extremity. The following turns do with the minimum tension, fix a plait, leaving it in a visible place. They attach a note indicating the time - you can not pinch the artery for more than 2 hours.
- Before applying a tourniquet or if the damage is in an inaccessible place, the artery is squeezed, pressing the thumb or fist against the bone protrusion above the injury site.
- Maximum bent limb, pinch the vessel. At the same time, a cloth cushion, a bandage or a small cylindrical object are placed in place of the bend for better compression.
- Ice is applied to the damaged area through the tissue to cause the narrowing of all vessels.
- A tampon and a pressure bandage are used for minor bleeding. Swab if necessary, moistened with cold water, a solution of 3% hydrogen peroxide or use a hemostatic sponge. When the dressing is soaked with blood, a new one is placed on top of the old one.
If serious bleeding occurs, first aid should be provided as soon as possible. Sometimes the bill goes on for minutes. How to understand how dangerous the situation? For this, it is necessary to distinguish one type of bleeding from another.
There is such a pathology in various systemic diseases, injuries, fever, sunstroke, overexertion, circulatory disorders, diseases and defects of the nasal cavity. Perhaps with anxiety and stress. Often occurs in young children and adolescents during the hormonal adjustment of the body.
If someone has nosebleeds, first aid for bleeding, the types and methods of stopping it are as follows.
- Breathe only through the mouth.
- Do not swallow blood.
- Pinch the nostrils for 5–10 minutes.
- Put a cold compress on the nose, on the back of the head.
- Carefully put a fleece moistened with 3% hydrogen peroxide solution into the nose.
When applying a cold compress, tampons keep your head in a slightly upturned state. In other cases, tilt slightly to allow blood to flow from the nose, rather than fall into the throat.
If the bleeding does not stop within 15 minutes, you must call the ambulance.
Types of bleeding, first aid for bleeding into the internal cavities of the body, their signs.
- Blood enters the lungs - causes pulmonary edema, coughing up blood. When bleeding into the pleural cavity - difficulty breathing due to compression of the lung. The victim is given a half-sitting position, the legs are bent, and a roller is placed under the knees.
- When blood enters the abdominal cavity, there are general signs of bleeding, pain in the abdomen. The position of the victim - lying on his back, legs half bent.
- In both cases, put ice on the place of the alleged bleeding, to ensure a sufficient amount of fresh air. Keep the victim still.
- When blood flows into the muscles, bloating and hematoma are formed.
All cases of internal bleeding require immediate hospitalization.
Different types of bleeding and first aid for violations in the reproductive system of the female body require skilled medical care. The uterus is richly supplied with blood vessels, and stopping the bleeding is not so easy. This requires the introduction of drugs and often surgery.
Uterine bleeding is possible with inflammatory and degenerative processes in the uterus, hormonal disorders, and pregnancy.
Measures to provide first aid:
- Take a prone position, lift the legs, putting a pillow under them.
- On the lower abdomen put an ice pack or a bottle of cold water through a cloth. Keep ice for 10–15 minutes, then take a break for 5 minutes. Just keep the cold about 1-2 hours.
- To replenish blood loss, it is recommended to drink plenty of fluids.
In field conditions, first aid for bleeding is very important. Extreme medicine involves the provision of competent assistance in conditions where it is impossible to quickly consult a doctor. When planning hiking trips, practicing various sports, hunting, fishing, you should have an accessible minimum set of medicines - a first aid kit.
To stop bleeding requires a tourniquet, bandage, disinfectants. A three-percent solution of hydrogen peroxide not only disinfects the wound, but also helps to stop the bleeding. To compress the limb vessels, you can use the available tools: a clean cotton cloth, handkerchiefs, a scarf, a belt, and clothes.
Instead of a harness, you can apply a twist using a strip of cloth and a stick.
In any case, if bleeding occurs, its type and degree of danger should be determined, if necessary, pinch the vessel with a finger and prepare means to stop the bleeding. In case of serious injuries, deliver the victim to the medical center and then to the hospital.
Relying 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, an ambulance may arrive only after a few hours, and sometimes it is necessary to deliver the victim to the nearest settlement on his own.
The brachial artery is pressed against the humerus on the inside of the shoulder, on the side of the biceps.
The radial artery is pressed directly to the underlying bone in the wrist area of the thumb in case of damage to the arteries of the hand.
The femoral artery is pressed in the groin and pubic bone by squeezing with a clenched fist (this is done when the femoral artery is damaged in the middle and lower third).
In case of arterial bleeding from a wound located on the lower leg or foot, the popliteal artery is pressed in the region of the popliteal fossa.
Having performed the finger pressing of the vessel, it is necessary to quickly apply, where possible, a tourniquet or twist and a sterile dressing on the wound.
Applying a pressure bandage for venous bleeding
The method of pressing the artery with the bones of the extremities is the maximum pressing by the joint, above the bleeding site.
Overlap of the tourniquet (twist) - the main way to temporarily stop the bleeding. An Esmarch harness is a rubber band or a tube, on the one hand a chain with a hook, and on the other hand a chain with large links (length - 1, 25). The tourniquet is applied only on one bone (shoulder, thigh).
The procedure for applying a harness:
We try to bleed the limb by raising it up for 3 minutes. At the same time, finger pressing of the artery against the bone is applied, then we flex the limb as much as possible in the shoulder or hip, etc. joint with simultaneous imposition of a tight roller under the bending surface,
we take the lining (gauze, napkin, towel, clothes) and we wind the limb above the injury site (where there is one bone),
we wind the rope in the following way:
the tourniquet is brought under the limb, strongly stretched, and without reducing the tension, the first round is made around the limb, so that it overlaps,