First emergency aid for bleeding. How to provide first aid for bleeding. Help with nosebleeds

From this article you will learn: that correctly provided first aid for bleeding helps save the life of the victim; what assistance should be provided in case of heavy or slight bleeding; about types of bleeding; how to properly provide assistance in certain cases.

Article publication date: 05/19/2017

Article updated date: 05/29/2019

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Types of bleeding

If large arteries and veins are injured, life-threatening blood loss can occur. Therefore, it is necessary as much as possible short term stop the bleeding and call emergency help immediately. With minor damage to blood vessels, it is also very important to stop the bleeding in a timely manner. Even with mild but ongoing blood loss, a person can lose consciousness.

Incorrectly provided first aid can cause harm to the victim, namely: large blood loss, infection and inflammation of the wound.

If the bleeding is not very severe, after providing assistance, you should also urgently contact a surgeon, since the loss of blood can be completely stopped only after the wound has been treated and sutured or surgery has been performed. Depending on the source of the bleeding, a consultation may also be required. narrow specialists such as: gastroenterologist, oncologist, pulmonologist, gynecologist.

Briefly about first aid:

If the bleeding is severe, the victim should be laid down and his legs elevated.
You can temporarily stop the bleeding by squeezing the damaged vessel or by strongly bending the limb or applying a tourniquet.
Call emergency services immediately.
The wound must not be touched, washed, or foreign bodies removed from it.
If the wound surface is dirty, then its edges must be cleaned in the direction away from the wound; Apply an antiseptic such as iodine, chlorhexidine, hydrogen peroxide around the damage; Iodine should not get inside the wound.

Four main types of bleeding

Depending on the source, the following main types of bleeding are distinguished:

1. First aid for arterial bleeding

The damaged artery must be immediately pressed against the adjacent bone to temporarily stop the bleeding.

Methods of pressing arteries:

Carotid artery – press your palm to the back of the victim’s neck and press the fingers of the other hand on the artery.
The brachial artery is easily accessible; it must be pressed against humerus.
It is quite difficult to stop bleeding from the subclavian artery. To do this, you need to take the victim’s hand back and press the artery located behind the collarbone to the first rib.
You have to press hard on the axillary artery with your fingers to squeeze it, because it is located quite deep.
The femoral artery is very large and must be pressed against femur fist. If this is not done, the victim may die within 2-3 minutes.
The popliteal artery must be pressed into the knee fossa, which does not require much effort.

The location of some arteries on the human body and where they stop

Areas on the human body that supply arteries and places where they need to be clamped during bleeding

First aid for bleeding from the arteries of the extremities is performed by compressing them, strongly bending the limb and applying a tourniquet. If you cannot squeeze the vessel of the limb with your fingers, you need to bend the limb as much as possible, after first placing a thick gauze roller on the inside of the joint.

If the blood continues to flow, a tourniquet must be applied. It must be provided quickly, since the blood flows out very intensely.

The tourniquet can be kept for up to half an hour. winter time and up to an hour in summer. If the doctor does not arrive within the specified period of time, you must slowly remove the tourniquet and wait until blood circulation is restored. After that, apply it again. In this case, the pulse on the injured limb should not be palpable. Then the bleeding will stop.

We must remember that a tourniquet is used when misuse is great danger than the bleeding itself.

If there is no special tourniquet, it can be replaced with materials such as a towel, belt, bandage. They are twisted with a stick and secured to prevent unwinding. Shoelaces, thin rope and similar materials must not be used.

2. Assisting with bleeding from a vein

Such blood loss occurs with deep injuries. Providing first medical care in case of venous bleeding, it is carried out immediately. Injured veins can suck in air because the pressure in them is lower than atmospheric pressure. In this case, air bubbles can clog blood vessels in various organs, which can lead to the death of the victim.

When providing assistance, the wound should not be washed or cleaned of dirt and blood clots. You need to do the following:

In order to apply a bandage correctly, you need to:

When bandaging your hand, you need to bend it.
If a leg is bandaged, it must also be bent at the knee.
When applying a bandage, cover half of its previous turn.
The position of the bandaged limb must be left the same as it was before bandaging.

Bandage for venous bleeding

3. First aid for capillary bleeding

It often stops on its own. Characteristic is the slow leakage of blood from the entire wound surface. However, there are also serious injuries accompanied by significant blood loss. The greatest danger is caused by internal capillary bleeding.

The main causes of bleeding from capillaries:

Blood diseases accompanied by impaired blood clotting.
Various traumatic injuries.
Vascular diseases (tumors, purulent inflammation skin affecting capillaries).
Common diseases affecting the walls of blood vessels such as neoplasms, atherosclerosis, rheumatoid arthritis.
Hormonal disorders.

More often, capillary bleeding does not cause large blood loss; its danger lies in infection with pathogenic microbes.

When providing medical care for bleeding from the capillaries of the extremities, the following actions must be taken:

Elevate the injured limb above the heart area, which helps reduce blood loss.
For minor injuries, it is necessary to treat the skin around the wound with antiseptics. Cover the top with a bactericidal plaster.
If blood is flowing strongly, you need to apply a pressure bandage.
If there is very strong bleeding, it is necessary to bend the limb as much as possible over the wound. If this does not help, apply a tourniquet.
Apply cold to the wound, which will help stop blood loss and reduce pain.

When bleeding from numerous capillaries of the nose, which is quite common, you also need to be able to provide assistance. The reason for this may be weakening of the vessel wall during colds. It can also be contributed by a hypertensive crisis, traumatic injuries to the nose and other negative factors. First you need to calm the patient down, because when a person is worried, his heart beats faster, which contributes to increased bleeding.

Steps to help with nosebleeds:

It is necessary to press the wings of the nose with your fingers, this helps to compress the bleeding vessels and stop the bleeding. The patient's head should be tilted slightly forward and not thrown back, since this will make it impossible to control the intensity of blood loss.
Apply ice or a cold object to the bridge of the nose so that the blood vessels narrow under the influence of cold. This will help reduce bleeding.
If the bleeding continues, folded pieces of bandage, previously soaked in 3% hydrogen peroxide, should be inserted into the nasal passages. Leave the ends of these tampons outside and secure with a bandage.
Six hours after the bleeding has stopped, remove the tampons very carefully, after moistening their tips, being careful not to tear off the formed blood clot.
To stop the bleeding faster, the patient must be given a medicine that strengthens the walls of blood vessels - calcium preparations, Ascorutin, Rutin.
If blood loss continues, the patient must be given a hemostatic medicine (Ditsinon, Vikasol), and urgently contact an otolaryngologist or call emergency help.

Correct head position to stop nosebleeds

4. First aid for internal bleeding

Such bleeding can be caused by diseases or injuries to internal organs. It is very insidious because blood loss cannot be controlled. Also, there is no pain syndrome signaling danger, therefore internal bleeding long time may go unnoticed. And only when the patient’s condition deteriorates sharply is attention paid to it.

The most dangerous of bleedings is the outflow of blood from parenchymal organs, which usually do not have a cavity, and in which the arterial-venous network is well developed. These include organs such as the lungs, pancreas, and liver.

Damage to these organs can cause severe bleeding. It practically cannot stop on its own, since the vessels of these organs are fixed in the tissues and can collapse. Therefore, first aid for bleeding from parenchymal organs is carried out immediately. The causes of this type of blood loss are injuries, infectious diseases such as tuberculosis; decay or rupture of tumors.

Bleeding from internal organs may be accompanied by the gradual appearance of general subjective symptoms and objective signs, namely:

weakness;
bad feeling;
dizziness;
fainting;
lack of interest in everything;
drowsiness;
pressure drop;
paleness;
frequent pulse.

The main task of first aid for bleeding from internal organs is urgent hospitalization of the patient. Before the ambulance arrives you need to:

Lay the patient down and provide him with peace.
Apply cold to the abdomen or chest, depending on the location of the source of the suspected bleeding.
Hemostatic drugs (Aminocaproic acid, Vicasol) can be administered.

In case of parenchymal bleeding with sharp decline pressure, it is necessary to raise the patient’s legs above the heart area by about thirty to forty centimeters. Monitor your breathing and heartbeat at all times. If necessary, perform resuscitation. The patient should not be given painkillers or any other medications. Do not give food or water; rinsing the mouth with water is acceptable.

With quick and correct first aid different types bleeding, the prognosis is favorable, quick first aid will contribute to a faster recovery of the victim.

Internal bleeding is usually understood as the flow of blood into body cavities or spaces. This could be the stomach, joints, uterus, bladder, lungs, pleural cavity, retroperitoneal space.

First aid for internal bleeding may be needed against the background of any disease affecting the internal organs.

Often the cause is bruises, closed-type injuries under the influence of a certain external factor. Thus, effusion into the pleural niche occurs due to injury to the lung, rib fractures, and damage to the integrity of the vessels located between the ribs. Medical assistance may also be needed for pulmonary hemorrhage caused by tuberculosis or progression of cancer.

The described pathology develops with a closed lesion of the pancreas, kidneys or liver, spleen, or any area of the intestine. The most dangerous in medicine is considered to be profuse bleeding, which is a complication of gastrointestinal diseases, in particular:

Malignant formations.
Peptic ulcer, etc.

Internal bleeding, which requires first aid, can be caused by an ectopic pregnancy, damage or torsion of the ovaries, or rupture of a cyst.

Symptoms

The condition indicated above is accompanied by the leakage of blood into the parenchymal organs, as well as internal cavities. To the early characteristic symptoms relate:

Pallor of the skin.
Constant weakness and malaise.
Dizziness and fainting.
Drowsiness and fatigue.
The presence of bloody impurities in the vomit.
Cough with bloody discharge.
Stools that are too dark.
Pain in the abdomen, especially when trying to take a horizontal position.
Regular formation of cold sweat.

In case of internal bleeding, first aid will really be needed if anemia increases, a person experiences a rapid pulse, and blood pressure drops to critical levels.

As for minor blood loss, it is accompanied by a slight change in blood pressure, while the pulse may remain normal. Excessive blood loss, in addition to the symptoms indicated above, is also characterized by delirium, the victim experiences confusion, and facial features may become sharpened.

With fatal blood loss, coma develops. The patient's breathing becomes labored, the pupils dilate unnaturally, involuntary excretion of feces and urine occurs, and bradycardia develops. In some cases, convulsions make themselves felt, followed by agony.

The most common are pulmonary, gastric, and esophageal blood losses. The release of bloody masses into the cavity of any part of the gastrointestinal tract is accompanied by the main symptoms:

Vomit with dark blood.
Constant feeling of nausea.
The development of hemorrhoids, in which anus light scarlet blood is released.
Tarry stools - melena.

Pulmonary blood flow is manifested by the following symptoms:

Breathing becomes difficult.
The man lacks air.
Foamy sputum mixed with blood is produced.

What actions to take

How to stop internal bleeding and properly provide emergency care to the victim. The person providing assistance must understand that a person with the described pathology must immediately get into inpatient facility healthcare. There is a certain algorithm of actions that should be followed:

Absolute peace is created for the victim; he must be completely immobilized.
The person is positioned in a sitting position (if symptoms indicate hemothorax, pulmonary hemorrhage). In all other cases, it is placed on a horizontal, moderately hard surface.
Cold should be applied to the site of possible injury in the form of a regular heating pad with cold liquid, a towel with crushed ice.
First aid for internal bleeding involves the use medications, ensuring a stop and reduction in the release of blood into the internal cavities of the body.
If possible, you should transport the victim yourself to the nearest medical department to carry out urgent measures.

Inadmissible events

There is also a list of actions that pre-medical care does not include:

Application medicines, characterized by a laxative effect, conducting cleansing enemas.
Warm compresses should not be applied to the damaged part of the body, which can only increase the release of blood masses.
Administration of intravenous/intramuscular drugs that in any way affect the activity of the heart.
Carrying out any massage at the site of possible internal bleeding.

If the abdomen or other areas are wounded with subsequent bleeding, the victim should not be given drink or any food. If there is unbearable thirst, rinsing is allowed oral cavity regular cool water.

Measures carried out in hospital settings

The provision of first aid ends with the patient entering the walls of the medical institution, where he will undergo an immediate examination. After determining the type of bleeding, the victim is sent to a specific department for further treatment. Doctors of various profiles provide assistance with the described pathology:

If hemothorax occurs, the patient is treated by a traumatologist or thoracic surgeon.
A neurosurgeon will help with various injuries heads.
A gynecologist will be needed for bleeding in women.
Blunt abdominal trauma resulting in damage to the gastrointestinal tract requires placement of the victim in the general surgery department.

A patient with internal bleeding often needs surgery

This information will be useful for the person accompanying the patient. Depending on the characteristics and severity of bleeding, specialists take the following measures:

Pleural puncture to evacuate blood from this cavity.
Lapartomy followed by suturing of bleeding vessels.
Thoracotomy for pulmonary problems.
Trepanation of the skull for traumatic hematomas of the head.
FGDS for bleeding of the stomach and esophagus, followed by endoscopic injection of hemostatics into the problem area.

IN recovery period It is important to follow all doctor’s recommendations. If possible, adhere to bed rest, abstain from any kind of physical activity. Recurrent bleeding may become an aggravation.

Emergency care in case of internal bleeding involves the urgent creation of conditions that will help to minimize and stop the release of blood. With the development of this pathology, every minute is important; intense blood loss can lead to the death of a person.

First aid for sudden bleeding is to reduce or stop it as much as possible. A loss large quantity blood can lead to the death of the patient. Often from competent provision first aid It depends on whether the victim can hold out until the ambulance arrives.

External (open) bleeding is easy to detect by the flow of blood from a wound or. However, it is not always possible to notice it. Rapidly increasing pallor of the victim's skin and mucous membranes, weakness, shortness of breath, decreased heart rate or loss of consciousness are the signs by which it can be determined that a person is losing blood.

Arterial

Arterial bleeding poses a particular danger to the patient: it leads to large loss of blood, and it is possible death. A person’s life depends on how correctly first aid is provided.
A pressure bandage may help stop minor bleeding. It is usually made from gauze, cotton wool and bandage, which are laid in layers. The bandage is tightly bandaged to the surface of the wound.

Before applying a bandage, it is necessary to reduce blood flow. To do this, you need to find an artery, guided by the pulsation of the vessel, and closer to the heart along the blood flow, press it to the bone with two fingers. If the place for compression is chosen correctly, the bleeding should decrease or stop altogether.

However, this is a temporary measure, since it will be difficult to clamp the vessel for a long time. In addition, this complicates the transportation of the wounded. If you have all the necessary materials at hand to make a bandage or if help should arrive in the next few minutes, then this is the right decision.

The first measure is to apply a tourniquet

To stop arterial bleeding, use a rubber tourniquet. If a pharmaceutical tourniquet is not found, it is replaced with a belt, tie or handkerchief. In this case, something hard must be applied to the intended location of the artery. Neither wire nor rope should be used for bandaging.

Place it on the shoulder, lower leg, thigh or forearm and always above the wound.
A bandage or soft cloth so as not to damage the skin and cause unnecessary suffering to the wounded.
Next, the limb is raised and a tourniquet is placed under it.
After several turns tightly adjacent to each other, each of which is weaker than the previous one, the tourniquet is secured.
You cannot hold the tourniquet for more than 2 hours in the warm season or 1.5 in the cold season.
If the wounded person could not be quickly taken to the hospital, the tourniquet is removed for five minutes, and the artery is pinched with the fingers. Afterwards, the tourniquet is reapplied, higher up the blood flow.

If, after applying a tourniquet, you were unable to stop the bleeding, it means that the place for compression was chosen incorrectly, or the tension is too small (high). Bleeding may increase if veins are accidentally compressed. And if the tourniquet is too tight, paralysis of the limb can occur.

How to stop bleeding without a tourniquet

Its essence lies in strong flexion of the wounded limb, but this method is not applicable in the presence of a fracture.

If the wound is located below the elbow or knee, then the limb is bent at the joint until it stops.
If the person is wounded in the thigh, help him bend his leg and press it against his stomach.
When wounded under the armpit or in the part of the arm between the shoulder and elbow, the limb is brought behind the back and pressed against the back.
It will be difficult for a wounded person to hold it in this position for a long time, so you should bandage it so that it remains motionless.

Venous

In case of venous bleeding, while waiting for the ambulance to arrive, it is necessary to position the patient so that the wounded area of the body is higher than other parts.

Capillary

If you cut your finger or receive another superficial injury, you need to rinse the wound as thoroughly as possible under cold running water. If the wound is minor, this can stop the bleeding that has started.

The skin around the damaged area is lubricated with iodine. After this, a swab soaked in 3% hydrogen peroxide is placed on the wound to remove any remaining dirt and disinfect the wound. Then the wound is covered with a bandage, gauze, or clean cloth.

If a person hurts himself, a hematoma forms at this place. This is internal capillary bleeding. Applying cold to the hematoma is usually sufficient. But if the swelling and blueness continue to increase, you should see a doctor.

Internal

It is not easy for a non-specialist to detect the presence of internal bleeding in a patient. It often manifests itself as increasing weakness, dizziness, increased heart rate, and a drop in blood pressure and pulse. Sometimes the blood loss is so severe that only a few minutes are allotted for rescue.

Stomach bleeding

The fact that a person has gastric bleeding can be guessed by vomiting mixed with blood and black stools.

The first thing to do is call an ambulance immediately.
Carefully place the patient on a sofa or bed, on the abdominal area (top) place a heating pad with ice, wrapped in a cotton rag, or a bag filled with ice, also wrapped in a cloth.
Provide the patient with complete rest until the ambulance arrives.
If he begins to lose consciousness, moisten a piece of cotton wool with a small amount of ammonia and hold it near the patient’s nose.

Under no circumstances should you:

offer the patient something to eat or drink;
try in any way to induce vomiting in the patient;
give an enema.

Pulmonary hemorrhage

Call an ambulance immediately.
Then sit the patient on a chair and ask him to tilt his head to where you think the lung is bleeding.
Before the ambulance arrives, give the patient small pieces of ice to swallow.

Royal

Call an ambulance and immediately begin providing first aid.

Place the woman on a hard horizontal surface: the floor, a fairly long table, a door taken off its hinges.
Raise your feet higher by placing a couple of pillows or a folded blanket under them.
Place an ice pack on your stomach, wrapped in an absorbent cloth. If there is no ice, you can pour frozen berries into a bag, wrap them in a towel and apply them to your stomach.

What can't you do?

Warm the patient's stomach with a hot water bottle or other warm objects.
Out of false modesty, remove everything soaked in blood. This will make it difficult for doctors to assess the degree of blood loss.

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

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

Depending on the area of bleeding, it can be:

external- blood comes from the vascular bed into external environment. Its outpouring occurs on the surface of the skin from wounds, which are of various types, based on the damaging factor: cut, torn, punctured, bruised, chopped, gunshot, bitten, crushed;
internal- when blood is shed inside the body. The causes of its appearance are strokes, diseases of internal organs ( parenchymal bleeding), stab and gunshot wounds, fractures, falls. It can have an obvious and hidden form.

The first option is characterized by bloody issues from natural openings: ears, nose, vagina, anus, mouth, urethra. In the latent form, blood accumulates in a certain cavity (abdominal, pelvic, pleural).

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

capillary- appears as a result of a superficial wound, deep tissues are not affected, the blood is bright red in color. Blood loss in this case is small, there is a danger of infection entering the affected area;
venous– occurs when more deep damage. Blood loss can be quite profuse, especially with trauma large vein. This condition can pose a fatal risk. The outpouring of blood occurs at a measured pace, continuously, without gushing;
arterial– most dangerous look bleeding, especially when large arteries are injured. Blood loss develops at a rapid pace, often massive, which poses a mortal danger. The release of scarlet-colored blood occurs in pulsating impulses (gushing), since it is under high pressure in the vessel, moving in the direction from the heart;
mixed- typical for deep wound, appears when blood losses of various types are combined.

Symptoms

To determine the necessary measures to help the victim, sometimes it is necessary to know the clinical manifestations of blood loss. At outdoor form of bleeding, diagnosis does not cause difficulties. Pallor, dizziness, fainting, a feeling of thirst and dryness in the mouth are observed, blood pressure decreases, the pulse quickens, but its filling is weak, difficulty breathing, and a state of shock may be present.

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

First aid for bleeding

When a situation arises, life threatening a person, in particular in case of blood loss, you need to know the basics and some nuances of providing first aid. This will save precious minutes until doctors arrive and will help preserve the person’s health and life.

The table shows general methods stopping and reducing blood loss during various types bleeding.

Type of bleeding	First aid
Capillary	hold the wound with your palm or cloth; raise a limb; wash and disinfect the wound area (excluding the wound itself); application of a sterile bandage, possibly applying pressure (if blood is oozing)
Venous	pressing the wound with fingers or palm; raising the affected limb upward; applying a pressure bandage
Arterial	finger pressure on the artery above the damaged area; application of a tourniquet above the lesion; limb flexion
Internal	give a comfortable position based on the location of blood loss; apply cold; cover the victim; not allowed to move, eat, drink

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

For capillary bleeding

For minor damage, a simple sterile bandage made from a bandage or napkin is often sufficient. The wound must be washed and the edges treated antiseptic(iodine, brilliant green, alcohol). A pressure bandage may be used if blood continues to ooze. In this case, a sterile napkin with an antiseptic is placed on the wound, tightly bandaged, a cotton swab is placed on top and again tightly secured with a bandage.

For venous bleeding

With this type of blood loss, the use of a pressure bandage is most justified. Its purpose is to accelerate thrombosis of the vessel; often this is enough to stop blood loss. If it is soaked in blood, there is no need to change it; you need to put an additional bandage on top.

ATTENTION! If you do not have the means to make a bandage, you can apply pressure to the wound with your fingers or palm.

Elevating the limb helps reduce or stop blood loss.

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

ATTENTION! It is forbidden to remove blood clots from a wound, as this can cause massive blood loss!

For arterial bleeding

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

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

Flexing the limbs can help stop blood loss. If the popliteal artery is damaged, it is necessary to bend the leg all the way knee joint, in case of defeat femoral artery– Bring your thigh as close to your stomach as possible. The subclavian artery is compressed using arms bent at the elbows, placed behind the back and securely fixed. When the brachial artery is injured, the arm is bent all the way elbow joint.

The use of a tourniquet is advisable in extreme situations, when other methods are unsuccessful, since its prolonged use leads to nerve atrophy and tissue necrosis. The tourniquet is stretched and wrapped several times around the leg or arm above the affected area like a bandage, the first wrap (tour) is the tightest and needs to be secured, subsequent rounds (3-4) are weaker. It is applied exclusively to clothing or any available material to avoid pinching the tissue. You can make a tourniquet yourself from rope, belt, twisted fabric (twist). In this case, the arm or leg is tightly bandaged, a stick or other similar objects (pen, spoon) are inserted into the knot, secured with an additional knot and wrapped several times until the blood loss stops. The correct use of the tourniquet is determined by the pronounced pallor of the limb and the absence of a pulse. It is necessary to indicate the time of application of the tourniquet.

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

For internal bleeding

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

in case of blood loss in the chest, in the stomach area, or in case of miscarriage, the patient takes a semi-sitting position;
if the abdominal cavity or pelvic organs are affected, the legs are given an elevated position;
for traumatic brain injury, a position with the head slightly elevated is used.

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

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

First aid in special cases

In some cases bleeding is required special approach to provide first aid in compliance with certain rules.

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

If serious bleeding occurs, seek medical attention immediately. The danger of blood loss is that the deterioration of the condition increases sharply and without the provision of high-quality first aid, the prognosis in most cases is disappointing. Correct and prompt application of methods to stop bleeding can preserve the health and life of the injured person.

The entire human body is penetrated by countless blood vessels. Most large vessels The blood moving from the heart is called arteries, and to the heart is called veins. The thinnest blood vessels in humans are called capillaries.

Bleeding is the flow of blood from an injured blood vessel, most often resulting from its damage. Bleeding can be traumatic and in some diseases (tuberculosis, peptic ulcer stomach, cancer, etc.). In the second case, the vessel is corroded by disease. The main symptom of any wound is traumatic bleeding. A blow, cut, injection, bite breaks the walls of blood vessels, which causes bleeding from them.

Blood has important protective property– coagulability. Thanks to this, any small, mainly capillary bleeding spontaneously stops. A clot of coagulated blood clogs the opening of the vessel caused by injury. With insufficient coagulation, manifested by prolonged slow coagulation, increased bleeding occurs.

Persons suffering from decreased coagulability may lose a significant amount of blood, even with bleeding from small vessels, with the development of general changes in the body.

Objects of blood loss in conditions emergency can be approximately determined:

a) according to the location of the damage:

for severe chest injury - 1.5 - 2 l, abdomen - up to 2 l;

with an open hip fracture – 1.5–1.8 l, closed fracture hips – 2.0 l;

for a fracture of the tibia - up to 0.8, shoulder - 0.6, forearm - 0.5 l;

for multiple fractures of the pelvic bones - 2.5 - 3 l. blood.

b) by the size of the wound surface:

with a superficial wound area: less than one palm – 10% of the circulating blood volume (CBV); two palms – 30% bcc; three palms – 40% bcc; five palms – 50% bcc.

General changes in the body during bleeding. Acute anemia develops with the loss of a significant amount of blood - 1-1.5 liters and is expressed by a sharp circulatory disorder, the development oxygen starvation, because one of the main functions of blood is to saturate the organs and tissues of the body with oxygen. This condition can develop with small blood loss, but occurring quickly.

The symptoms of acute anemia are very characteristic and do not depend on whether the victim has internal or external bleeding, but the brain and general metabolism suffer most from blood loss.

The patient complains of increasing weakness, dizziness, tinnitus, darkening and flickering “goosebumps” in the eyes, thirst, nausea, and vomiting. When examining the victim, you can notice that the skin and visible mucous membranes are pale, facial features are pointed, the patient is inhibited or excited, breathing is rapid, the pulse is weak or not detected at all, arterial pressure low.

If at this moment the victim is not given help and the blood loss is stopped, then he will experience loss of consciousness due to bleeding of the brain, the pulse disappears, the blood pressure cannot be determined, convulsions and involuntary urination appear. If not accepted emergency measures, then death occurs.

First aid. A patient who has lost a lot of blood can be saved, but for this it is necessary to take urgent measures.

First, the bleeding should be stopped if it does not stop spontaneously. With significant bleeding, the blood vessels lose their tone, which can result in spontaneous cessation of bleeding. Even if the bleeding has stopped, a pressure bandage must be applied to the wound.

Secondly, lay the victim on a flat surface; if the victim is in fainting, he is placed in such a position that his head is lower than his body; in some cases, all limbs of a lying victim are raised, and there is a temporary increase in blood flow to the lungs, brain, kidneys and other vital organs. If there is no damage to the abdominal organs and consciousness is preserved, the victim must be given hot tea, mineral or plain water. In the event of a terminal condition of the victim and cardiac arrest, he should be revived by chest compressions and taken to the hospital as quickly as possible. medical institution.

Types of bleeding

Depending on the place where the blood is poured out, there are:

a) interstitial bleeding: blood flowing from a blood vessel spills into the surrounding tissue, forming a bruise. For example, when hitting with a fist.

b) External bleeding: blood from a damaged vessel flows out. Such bleeding is visible and easily determined, both its location and nature.

c) Internal bleeding: the outpouring of blood from a damaged blood vessel into closed cavities (for example, the pleural, abdominal, cranial cavity). These bleedings are extremely dangerous, since they occur secretly, are very difficult to recognize and can be easily missed if the victim is not carefully examined. The pleural cavity can accommodate all the blood circulating in the body. Therefore, such bleeding can be fatal. It must be remembered that blood spilled into the chest or abdominal cavity loses its ability to clot, so spontaneous stopping of blood does not occur. Internal bleeding is observed with penetrating wounds and with closed injuries, when as a result of a strong blow, a fall from a height or compression, internal organs rupture without damaging the skin. It occurs in diseases of various internal organs, for example: stomach ulcers, pulmonary tuberculosis, aneurysm of blood vessels.

Internal bleeding can only be recognized based on common symptoms acute anemia (blood loss), namely:

severe pallor of the skin;
frequent weak pulse;
severe shortness of breath;
dizziness;
flashing “flies” before the eyes;
drowsiness;
fainting.

In some cases, bleeding becomes dangerous not because of the large amount of blood spilled, but as a result of the spilled blood compressing vital organs. Thus, the accumulation of blood in the heart sac (pericardium) can lead to compression in the heart and its stopping. When squeezing the spilled blood into cranium compression of the brain will occur and, as a result, death.

The source of bleeding, as mentioned above, is a vessel whose wall is broken. Depending on the type of damage, bleeding is distinguished:

1) capillary;

2) venous;

arterial;

Capillary bleeding occurs with all kinds of damage to the skin, mucous membranes, and muscles, while the bleeding vessel is not visible. If this is external bleeding, then blood oozes evenly from the entire surface of the wound, like from a sponge.

First aid: apply a pressure bandage to the wound (this can be a gauze swab, a piece of cotton wool wrapped in a bandage, or just a clean cloth) and bandage it tightly. If a limb is injured, it is necessary to create an elevated position for it, but usually with capillary bleeding A pressure bandage is sufficient.

Venous bleeding - blood pouring out of a vein is dark cherry in color and flows out in a continuous stream slowly and evenly. Venous bleeding is less intense than arterial bleeding, and therefore rarely threatens the life of the victim. However, when the neck is wounded, air may be sucked into the vessels through the wounded area. Air entering the blood vessel can also enter the heart. In this case, the air bubble blocks the heart and blood vessel, causing an air embolism, which causes instant death. Due to the peculiarities of the human vascular system, when veins and arteries of the same name are located nearby, isolated damage to a vein is rare, so most injuries are of the mixed arterial-venous type.

External venous bleeding is easy to recognize. Most often it occurs when the upper and lower extremities of the neck and head are damaged.

External bleeding includes bleeding into the lumen of a hollow organ, for example, into the stomach, intestines, bladder, trachea - since after a certain time, sometimes after several hours, the blood poured into the hollow organ is released out.

Venous external bleeding is best stopped with a pressure bandage - gauze folded in several layers or an unrolled bandage, or a handkerchief folded in several layers is applied to the bleeding vessel or wound and bandaged tightly. Means used in this way act as a pressure factor that presses the gaping ends of damaged vessels, their lumens are compressed and bleeding stops.

When bleeding from the upper limb, sometimes it is enough to raise your arm up and then apply a pressure bandage to the wound. If the bleeding is profuse, from a large vein, for example the femoral, and there is not enough dressing material at hand to make a pressure bandage, then the bleeding area should be immediately pressed with your fingers; bleeding can also be reduced by lifting the limb upward.

Bleeding is also dangerous because with a decrease in circulating blood in the body, the activity of the heart worsens, the supply of oxygen to tissues and vital functions is disrupted. important bodies(brain, liver, kidneys). As a result, a violation occurs metabolic processes in organism.

Arterial bleeding is the most dangerous of all types of bleeding, because... with it, bleeding of the body can quickly occur, and as a result, death. If there is bleeding from the carotid, femoral or axillary artery, the victim may die within 3 minutes. The main thing in similar situation– don’t get confused and provide first aid to the victim as quickly as possible.

Arterial bleeding, like venous bleeding, occurs when bleeding from small arteries can be successfully stopped with a pressure bandage. If there is bleeding from a large artery, it is necessary to immediately stop the flow of blood to the wounded area. It is not difficult to identify this bleeding. The gushing blood is bright red in color and is ejected in a pulsating stream.

First aid: to stop arterial bleeding, it is necessary to artificially stop the blood flow, using mechanical methods, which are based on the principles of stopping the flow of blood to the site of damage to the vessel. You need to know in advance that bleeding stops only as long as the factor that stopped it is in effect.

Methods to temporarily stop bleeding

Temporary stoppage of bleeding during first aid can be performed using the following methods:

a) application of a tourniquet;

b) maximum flexion of the limb at the joint;

c) compression of the vessel along its length;

d) applying a pressure bandage;

d) wound tamponade.

Stop bleeding by applying a tourniquet. The Esmarch tourniquet is a rubber band 1.5 meters long, which has a metal chain at one end and a hook at the other for fixation after application. It is possible to apply an improvised tourniquet, i.e. a tourniquet created from improvised means. For this purpose, a headscarf, trouser belt, tie, scarf, suspenders are used, and the tourniquet is fixed using the “twist” method or by applying a tight knot.

The tourniquet can only be applied (!!!) to the upper or lower limb. To do this, the intended place of application of the tourniquet must be wrapped in cloth (a piece of clothing, a towel, a handkerchief) so as not to compress the skin at the site of application of the tourniquet.

The tourniquet is applied above the injury site, not very tightly, but not weakly either. The correct application of the tourniquet is determined by the cessation of bleeding and the disappearance of the pulse in the peripheral artery. In this case, the skin below the application of the tourniquet gradually turns pale. When applying a tourniquet, you must remember that it cannot be kept on the body for more than 2 hours. With a longer cessation of blood supply to the tissue below the site where the tourniquet is applied, necrosis (tissue death) may develop. Therefore, after applying a tourniquet, you must insert a note behind the tourniquet indicating the time it was applied. If there is a long-term transportation of the victim with a tourniquet, it is necessary to periodically remove the tourniquet for a short time, while holding the wound with a tampon.

Maximum flexion of the limb at the joint leads to compression of the vessel, blood flow stops at the site of the defect in the vascular wall and bleeding stops. Thus, if the subclavian artery is injured, it is possible to stop the bleeding if the arms bent at the elbows are pulled back as far as possible and secured at the level of the elbow joints using a hand belt, suspenders, or tie.

The femoral artery can be compressed by pressing the thigh against the abdomen as much as possible.

The brachial artery in the area of the elbow joint can be blocked by maximal flexion of the arm at the elbow joint. This technique is more effective if a gauze or cotton roll is placed in the flexion area of the limb. It must also be remembered that in case of any bleeding, the injured part of the body must be given an elevated position and ensure rest.

The lower leg artery can be compressed by fixing the leg with maximum flexion at the knee joint.

When fixing the joint, you need to place pads (gauze or cotton) in the area of flexion of the limb.

Compression of the vessel throughout. Pressing the artery with a finger is very known method. It is used only to temporarily stop arterial bleeding. The method is based on compression main vessel at certain anatomical points between the finger and the inert formation. This method is used for minor arterial bleeding due to trauma. On the extremities the vessels are pressed above the wound, on the head and neck below.

Long-term stopping of bleeding by digital pressure on the artery is impossible, because requires great physical strength. It is tiring for the person providing assistance and completely eliminates the possibility of transporting the victim. The method ensures the cessation of bleeding in order to gain time to prepare more convenient way install it.

You can press the artery thumb, palm, fist. The femoral and brachial arteries can be especially easily compressed; the carotid artery is the most difficult to compress.

Bleeding from wounds of the neck and head is stopped by applying general pressure with your fingers. carotid artery to the sternoclavicular joint.

For bleeding from upper limbs needs to be pressed subclavian artery to the first rib. The axillary artery is pressed against the head of the humerus in the axillary fossa.

After clamping the bleeding vessels, the victim should be given some kind of non-alcoholic drink, preferably sweet tea (not hot) or coffee, and taken to a medical facility as quickly as possible.

Often, first aid must be provided not only for bleeding from wounds, but also for other types of external bleeding (for example, pulmonary, in chest cavity and etc.). Let's consider these types of bleeding and first aid for them.

First aid for bleeding from internal organs

Pulmonary hemorrhage - occurs when the lungs are damaged as a result of a strong blow to the chest, compression chest, accompanied by rib fractures, and a number of lung diseases, primarily: tuberculosis, cancer, lung abscess.

In these cases, the victim or patient may experience bleeding or hemoptysis. Sometimes pulmonary bleeding is quite intense and can even lead to death. A patient with sputum and coughing produces scarlet foamy blood - this is called hemoptysis.

In this case it is necessary:

free the chest from clothing;
place the patient in a semi-sitting position in bed;
ventilate the room, create access to fresh air;
calm the patient, limit his movement, create maximum peace;
Place an ice pack or cold water on your chest.

Bleeding into the chest cavity occurs as a result of trauma to the chest and damage to internal organs - the heart, blood vessels, lungs. Erupted blood fills one or both pleural cavities, compressing the lung and limiting breathing, leading to the development of respiratory failure. The patient's condition quickly deteriorates, breathing quickens, becomes shallow, the skin has a bluish tint, lips turn blue - symptoms are characteristic of the development of asphyxia due to the entry of a large amount of blood into the respiratory tract.

This condition of the patient requires rapid transportation to a medical facility for emergency surgical care.

The patient is transported in a semi-sitting position, lower limbs knees bent, cold applied to the chest.

Bleeding from the digestive tract can occur due to various diseases.

There are bleeding types:

from the esophagus;
from the stomach and duodenum;
from the intestines;
for diseases of the liver and biliary tract;
due to pancreatic disease;
due to a blood disease;
due to injury or burn of the gastrointestinal tract.

Bleeding from the esophagus occurs when it is injured or when dilated veins rupture. The leading symptom is a sudden, abundant, strong, i.e. profuse, bleeding as a result of gaping of the descending nodes of dilated veins; the blood is dark cherry in color, sometimes vomiting occurs like a fountain with jelly-like contents.

Bleeding from the veins of the esophagus is deadly because... lead to the rapid death of the victim.

First aid is aimed at creating conditions that help reduce bleeding; absolute rest and cold on the chest area are indicated; you can allow small pieces of ice or snow to be swallowed; it is necessary to quickly transport the patient to a medical facility.

Gastric bleeding – occurs due to a disease (hemorrhagic gastritis, peptic ulcer of the stomach and duodenum), erosion of the blood vessel wall is observed, malignant tumor stomach, stomach trauma (foreign body, burn).

The leading sign of gastric bleeding is vomiting of stomach contents coffee grounds, there are symptoms of anemia - pale skin, severe weakness, cold sticky sweat. Sometimes there may be no vomiting, but such a patient will definitely have dark, tarry stools.

To improve the patient's condition, it is necessary to create peace, give him a horizontal position and apply cold to the stomach area. It is strictly forbidden to give the patient anything to drink! Transportation of such patients is carried out in horizontal position with a raised foot end to prevent bleeding of the brain.

The leading sign of bleeding into the abdominal cavity is severe pain, up to the development state of shock, nausea and even vomiting are often observed. The victim is pale, cannot stand, sometimes there is a short-term loss of consciousness (fainting), cold sticky sweat on the forehead, breathing and pulse are accelerated, the pupils are dilated. Intra-abdominal bleeding is characterized by large blood loss - 2-3 liters of blood, the impossibility of spontaneous stopping, and the most dangerous thing is the development of peritonitis (inflammation of the peritoneum).

First aid should be provided quickly, but without unnecessary fuss. The patient should be laid down, but the abdominal area should be placed in an ice pack or cold water and immediately transported to a medical facility while lying on his back.