Signs of internal bleeding are a medical emergency. Signs of internal bleeding: symptoms of the condition and treatment

Since trauma, and therefore bleeding due to it, can happen anywhere and anytime, every adult should know how to provide first aid for bleeding.

Types of bleeding and their features

Depending on the type of injured vessel, the following types of bleeding are distinguished:

arterial;
Venous;
Capillary.

Also, bleeding is distinguished by location. The most commonly injured hands are bleeding upper limbs this is the most common type. In second place are leg injuries, and nosebleeds are in third place. by the most dangerous view are bleeding of internal organs, since it is difficult to notice them in time, it is even more difficult to keep the situation under control. Below we will consider the principles of first aid for arterial, venous, nasal and internal bleeding.

First aid for arterial and venous bleeding

Many people vaguely remember that first aid for arterial bleeding consists in applying a tourniquet to the vessel, but few people know how to do it correctly. Doctors warn: the application of a tourniquet can be no less dangerous than the loss of blood, an ineptly applied tourniquet can lead to the need for amputation of a limb, and, alas, often leads. How to provide first aid for arterial bleeding without causing harm? Remember, with an injury to a large artery, there is not much time left, only 3-5 minutes. The algorithm of actions is as follows:

Do not wash or in any other way try to decontaminate the wound, do not remove small fragments that have got there;
Apply a pressure bandage as follows: directly on the wound, apply a sterile bandage or a clean cloth folded in several layers (it is desirable that the dressing be sterile, if one is not at hand, use any). Put another roller made of fabric on top. Then bandage everything tightly, after which the limb must be placed above the level of the body. If done correctly, the bleeding should stop;
If there was nothing at hand that could serve as a dressing, you can try to stop the bleeding by maximum flexion of the joint located above the wound;

First aid for bleeding and wounds with a tourniquet. This method is resorted to if it was not possible to stop the blood in another way. The rules are as follows:

A tourniquet (or any long piece of rubber, such as a rubber hose) is applied 5-7 cm above the wound, but not on bare skin, but on the fabric that should be wrapped around the limb, it can be on a sleeve or leg;
After stretching the tourniquet, lay it in several turns without gaps between them, the first is not too tight, each subsequent turn is tighter. A sign of a correctly applied tourniquet is to stop bleeding;
The tourniquet should not be applied too tightly so as not to injure the nerves. If the tourniquet causes strong pain, the injured vessel must be pressed with a finger, and the tourniquet removed, give the victim a break from the tourniquet, then apply again;
Be sure to record the time of applying the tourniquet! This is extremely important condition which can save a person from possible disability. It is advisable to write the time of applying the tourniquet with a pen directly on the skin or clothing of the victim. Max Time, on which a tourniquet can be applied, is one and a half to two hours in summer and one hour in winter. During this time, the patient should be taken to the hospital, if this is not possible, and the time has elapsed, the tourniquet must be removed very carefully and slowly, if the bleeding has resumed, press the vessel with your finger above the wound.

First aid for venous bleeding occurs according to a similar algorithm, the only difference is that the vessel should be pressed below the wound.

First aid for nosebleeds

As a rule, nosebleeds are not life-threatening, although they look frightening. However, blood loss can be significant. To prevent this, you must take the following actions:

Into the nostril from which there is blood, you need to insert a small swab of cotton, bandage, napkin or handkerchief. The tampon should not cause pain;
The person must be seated with his head slightly tilted down. A common mistake is made by people who, as first aid for nosebleeds, lay a person on his back or make him throw his head back. This can cause blood to flow down the back wall pharynx;
Put a cold compress or any cold object on the nose area;
Slightly squeeze the wings of the nose.

First aid for internal bleeding

Internal bleeding is difficult to recognize on its own. An indirect sign of it after an injury that has occurred is a deterioration in a person’s condition, blanching of the skin, cold sweat, darkening in the eyes. In this case, blood may be excreted with vomiting or feces, but not necessarily. If you notice these signs, the following should be done as first aid for internal bleeding:

In case of a chest injury, give the person a semi-sitting position, in case of an abdominal cavity injury - lying down;
Ensure inflow fresh air;
Apply cold to the abdomen or chest;
Forbid the victim to eat, drink, move and talk;
Take the person to the hospital immediately.

The last point is relevant not only for injuries of internal organs. In case of massive blood loss, the main point of first aid for bleeding of any kind will be the delivery of the victim to the clinic for the provision of qualified medical care.

Internal bleeding is blood loss inside the human body, where the outflow of blood occurs in the cavity structures of natural origin (gastric, pulmonary, renal and various other cavities) or in subspaces of artificial origin (retroperitoneal type of space, spaces between muscles and other zones). Internal bleeding is not available for observation; at the first stages of blood loss, the patient will not always feel signs of internal bleeding, he will feel as usual. The patient complains when hemorrhagic conditions have reached critical limits.

If there is no treatment for internal bleeding, then a fatal outcome is possible. Symptoms of internal bleeding depend on the location and size of hemorrhages. Often, the symptoms of internal bleeding contain a general character.

About the types of hemorrhagic conditions

Details in medicine internal type hemorrhages are not classified. Based on the cause of internal bleeding, there are such types:

mechanical type. This condition occurs in case of trauma to the vascular tissues through which blood flows. Occurs due to injury (often in men) or due to surgery.
The arrosive type of hemorrhage is considered a consequence of necrosis affecting the vascular tissue, or if newly formed structures germinate and disintegrate.
diapedetic type. In this state, the vascular tissue is not destroyed, but due to different pathological processes(hemorrhagic vasculitic changes, phosphorus poisoning and many other processes), the capillary network becomes highly permeable.

By type of vascular tissue, there are:

Arterial type, where the destruction of the arterial vessel is diagnosed.
Venous type, in which the veins are damaged.
capillary type. The blood medium spreads evenly from the capillary vessels. If blood is poured from various organs, then this is a parenchymal type of hemorrhage.
Mixed type. It occurs with destructive changes in venous, arterial and capillary vessels.

If we take into account localization, then there are:

Gastric and intestinal species hemorrhages. Possible due to ulcerative processes in the stomach and duodenum, gastritis changes, inflammation of the intestine, also if the mucous membrane is cracked and there are newly formed structures. If hemorrhages of the esophagus are observed, then the cause is hepatic dysfunction. With intestinal hemorrhages or intraperitoneal bleeding, the cause lies in hemorrhoid changes or rectal fissures.
Hemorrhages localized in the cavity spaces of the pleura due to ruptured vascular tissues between the ribs (hemothorax). This condition occurs with a closed injury to the chest.
Hemorrhages pouring into the pericardium (pericardial sac), which compresses the heart muscle (hemipericardium). If this condition is ignored, then it can manifest itself as heart failure with subsequent death. Such hemorrhage can be with a mechanically damaged chest in front, surgical intervention on the heart muscle.
Intra-articular hemorrhages (hemarthrosis). Often manifested this species bleeding in case of damage to articular tissues (usually knee joints).

According to the localization where blood accumulates, there are:

Hemorrhages in the cavities. They are divided into bleeding of the abdominal cavity (in case of injury to the abdominal zone, chest and various organs), pleural membrane (if the ribs are broken), cranium.
Hemorrhages within tissue structures, where blood accumulates in deep tissues that stratify, causing hematomas.

According to the amount of blood loss there are:

Easily expressed hemorrhages, where the total blood loss is not more than 15% of the total volume of blood circulation.
Moderately expressed hemorrhagic conditions, where 20% of the total volume of blood circulation is lost.
Severe bleeding where the patient has lost approximately 1.5 liters of blood
Massively manifested hemorrhagic condition. The total volume of blood circulation is reduced by more than 30%.
Fatal blood loss is observed when the total volume of circulating blood decreases above 60%.

Hemorrhages can occur:

Obviously. After a certain time, the blood enters the external environment through the natural type of openings of the patient.
Is hidden. The main symptomatic manifestations are not observed, they may be mild.

Considering the time period, there are:

Initially detected blood loss. Signal themselves after vascular wall torn.
Secondary hemorrhages. They are observed after a certain time after the traumatic factor that provoked them. This type of hemorrhage is divided into early, where manifestations occur after a period of 1 to 3 days due to the fact that the embolus came out of the damaged vascular tissue or the suture was incorrectly applied. Late secondarily detected hemorrhages appear after a three-day period after the vessel has been damaged as a result of infection attaching to the wound.

About the reasons

Internal bleeding is characterized by the following circumstances:

As a result of a head injury, a cerebral type of hemorrhage occurs.
Costal fractures, both multiple and single, where the arterial vessels between the ribs and the pleural membrane are affected.
Severe trauma to the abdominal region, leading to the destruction of organs located in the abdominal cavity, which will cause intra-abdominal bleeding.
Fractured intra-articular tissues. These hemorrhages are not dangerous, but treatment must be carried out, otherwise exacerbated conditions will occur.
Seriously pronounced dysfunctions of the stomach and intestines in the form of ulcerative processes, malignant tumors, which will cause bleeding into the abdominal cavity.
Cirrhosis of the liver also contributes to the fact that the patient may experience intra-abdominal bleeding.
Aneurysmal vascular change causing the aorta to dissect.
The presence of esophageal cracks in the mucous tissue.
Defective conditions of the reproductive system: cystic and polyposis changes. Power Mode physical activity, active species sports contribute to the fact that the cyst will burst. Hemorrhages can be due to the fact that the pregnancy takes place outside the uterus, in case of abortion, premature placental detachment or the placenta is delayed at the exit. Sometimes women bleed after giving birth.

About the symptoms of hemorrhages

The symptomatic picture of hemorrhagic conditions is determined by the stage of the pathology. With this diagnosis, there is a general nature of the symptoms that determine the presence of internal hemorrhages, including intra-abdominal bleeding. It is possible to recognize this condition by the symptoms that caused hemorrhage:

Pale skin tone.
General weakness of the patient with low blood pressure.
The feeling that the head is spinning, the characteristic dark "flies" will also be visible to the patient.
Rapid heartbeat.
Dry state oral cavity, also the patient will be very thirsty.
Cold sticky sweat of the patient.

When bleeding into the abdominal cavity, the symptoms correspond to the general manifestations described above. At varying degrees severity, the following occurs: with easily flowing hemorrhage, the heart rate is slightly accelerated, blood pressure is lowered.

Other states do not appear.

Moderately severe hemorrhage is characterized by:

Reduced systolic type of blood pressure up to 80-81 mm Hg. Art.
Increased heart rate up to 100-101 beats per 1 minute.
Hands and feet are cool.
The skin is pale.

Severely flowing hemorrhages are manifested by the fact that:

The skin of the patient bluish tint. The nasolabial zone with a characteristic triangle is clearly visible.
The patient constantly wants to sleep.
There is trembling in the hands.
Sometimes the patient may feel sick and vomit.
The patient rarely urinates.
The patient has no reaction to the environment.

Massively flowing hemorrhage is characterized by the fact that:

BP is 60-61 mm Hg. Art.
The pulsation is accelerated to 159-160 beats per 1 minute.
Conscious activity is absent or confused.
Under each eye a circle of a dark shade is pronounced, the eyes sink.
The patient is covered with a cold sticky sweat.

Fatally severe hemorrhage is characterized by the fact that the patient is in a coma. Blood pressure cannot be determined, the act of defecation with urination passes uncontrollably. Each pupil is greatly dilated, it is impossible to feel the pulsation.

It is important to understand that this leads to an agonal state and lethal outcome sick.

How to determine internal bleeding? If hemorrhages are localized in the stomach and intestines, then the patient vomits with brown vomit, and blood is also present in the stool. This may indicate that the patient has intra-abdominal bleeding.

When stool have a rich red tint, it is likely that the patient has hemorrhages of the lower segments intestinal tract, there are hemorrhoidal processes. It is also possible to bleed into the abdominal cavity (intra-abdominal), which causes pain in this area, which decreases with a change in the position of the patient. Palpation examination of the abdominal area also showed pain.

About diagnostics

When diagnosing internal bleeding, the following procedures are performed:

Measure blood pressure with pulse. In various hemorrhagic conditions, also if the patient has bleeding into the abdominal cavity, then these parameters will change from the norm.
Palpation examination of the abdominal area is performed with a changed position of the patient's body.
Diagnose laboratory vomit (if any), feces, blood.
Perform rectal diagnostics. The stomach is probed, which is required for dysfunctions of the stomach and intestines.
Bronchoscopy is performed if the patient has pathological conditions body system responsible for breathing or chest injuries.
Cytoscopic examination is performed with dysfunction of the urinary system.
To obtain confirmation or refutation, indicating that the patient has bleeding into the abdominal cavity, a laparoscopic examination is performed.
X-ray examination of the cranium is performed with cerebral hemorrhages.
A woman needs a gynecological examination.

Why is it dangerous and how to help the patient

How to provide first aid? With internal bleeding, first aid must be carried out immediately. Competently performed first aid for internal bleeding will save human life, you will learn the procedure for performing actions.

How to stop internal bleeding, what to do? Stopping internal bleeding consists of the following steps:

When internal bleeding is suspected, emergency care should be given to the patient, who must lie horizontally.
Performance emergency care in case of internal bleeding, if it is suspected that the patient has bleeding into the abdominal cavity, they lie in the fact that it is necessary to cool the abdominal area (put a bubble inside which there are pieces of ice or a chilled heating pad on the lower part of the abdominal area, hypochondrium and lower back, which depends on the location hemorrhages);
We need to call an ambulance, call her quickly. The patient is transported in the same position in which he was given first aid to the hospital. This must be done immediately.

It is dangerous and endangers human life.

AT surgical department the patient is prescribed therapeutic measures:

With minor hemorrhages with moderate blood loss, stopped on their own, if there are no severe injuries and blood does not accumulate in the abdominal cavity, then the patient is monitored. The main measures are that solutions containing salt are administered intravenously. Treat with Ringer, Rheosorbilact, Refortan, saline. Of the hemostatic agents, they treat with Etamsylate, aminocaproic acid. This stops the bleeding.
In severe hemorrhagic conditions of any nature, independent of the underlying cause and damage to internal organs, the patient is urgently operated on with infusion therapeutic measures.

It is worth remembering that this type of hemorrhagic condition requires immediate medical measures. If the moment is missed, then the person will die.

In contact with

Opened internal bleeding is a condition that is dangerous to health and life, which occurs due to different reasons. Most often, blood penetrates into the cavities of the body, as well as the spaces formed by it.

Internal bleeding - what is it?

This is a rapid loss of blood, in which it does not flow out of the body, but enters into certain places inside. This may be the uterus in women, the space between the joints, the stomach, bladder, lungs, intestines.

The symptomatology of this condition depends on the location of its localization. Hemorrhage can occur in the abdominal cavity, intermuscular, etc.

The causes of pathology are, as a rule, of two types: mechanical damage(trauma, stroke) and chronic illness.

The danger of such a phenomenon is enhanced by untimely first aid, ignoring signs to patients, and late diagnosis.

If you seek medical help in time, you can minimize serious complications, determine the localization of bleeding and stop it.

Symptoms of pathology

Intra-abdominal bleeding is one of the most common in mechanical injuries. The symptoms of this form are quite serious.

The patient is very sick, bloody vomiting opens, if the pathology is in the gastrointestinal tract. Diarrhea occurs when there is internal bleeding in the upper esophagus or small intestine. With a lesion in the large intestine, red discharge will be from the anus.

Gastrointestinal bleeding is one of the most dangerous. Symptoms include fever, the patient may feel pain in the abdomen. If, then a person is tormented by a strong bloody cough, and the place of accumulation of secretions is the pleural cavity. There is shortness of breath, not enough air.

At uterine blood goes in the middle of the cycle, pours out of the vagina. However, many symptoms in a number of species are not pronounced, which makes it difficult to diagnostic measures and worsen the patient's condition.

So, the symptoms of bleeding that occurred inside the body:

Deterioration of well-being.
Sudden weakness, lethargy, apathy.
Chills, fever, fever, sweating, pallor.
Acute feeling of fear.
Nausea, vomiting.
Thirst.
Loss of self control.
Dizziness, fainting.
Severe cough with blood.
Dyspnea.
Sudden pains inside or their complete absence.

If no one is around, you need to call the ambulance service, then take a horizontal position. If possible, you should also call your loved ones, if they are nearby. In this case, being alone is not only scary, but also dangerous..

You can not take any pills, drink water. It is necessary to apply ice to the head, chest, stomach. It is important to try not to panic and not make sudden movements.

Common signs of bleeding

The main signs for all forms of bleeding that occurred inside the body: weakness in the body, lethargy, blood pressure (BP) is significantly reduced, skin turn pale, cold sweat appears.

Suspicion of similar condition should occur if there were provoking factors (shocks with blunt, stabbing objects; injuries), diseases of the internal organs were diagnosed.

The patient may lose his appetite, feel intense thirst even lose consciousness. How serious a person's condition can be recognized by certain signs.

If the bleeding is insignificant, then the pulse is intense - up to 80 beats per minute, and blood pressure decreases, the rest of the symptoms may be absent.

If moderate bleeding top pressure drops to 90 mm. rt. Art. and below, the heart rate increases. In this case, the skin turns pale, hands and feet become cold, breathing quickens, nausea, weakness, dizziness appear, all psychomotor reactions slow down.

In severe cases, the patient's pressure drops significantly, the pulse speeds up, intermittent breathing, cold sweat appears, drowsiness appears, trembling of the hands and feet, it darkens in the eyes, vomiting begins, the skin turns pale, cyanosis develops, the person's condition is critical.

If the blood loss is massive, then the pressure drops sharply, the pulse is very fast - up to 160 beats per minute, the patient's consciousness is confused, pale skin, delirium, cold sweat are observed, facial features are sharpened.

Fatal blood loss: slow pulse, low blood pressure, respiratory arrest, convulsions, dilated pupils, dry and pale skin, agony and death.

Kinds

There are several types of bleeding: arterial, capillary, venous. The cause of arterial - damage to the artery with a sharp, cutting object, a gunshot wound; injury resulting from a blunt blow.

It is very difficult to stop bleeding on your own. Blood is poured into the organs and out in a fountain, the victim can lose a critical volume of blood in a few minutes, which will lead to death.

Capillary - common. In this case, the surface of the internal organs may bleed, these include the liver, kidneys, spleen.

Symptoms at the very beginning are mild, which complicates the diagnostic process. A stomach ulcer can cause it, and hemorrhage occurs in the brain tissue. In this case, it is urgent to provide assistance to the patient.

Venous is formed if the walls of the veins are damaged. The patient instantly develops symptoms of anemia, anemia, state of shock. With venous bleeding, dangerous conditions can occur in which the outgoing fluid accumulates in the pleural and retroperitoneal cavities.

The reasons

Why does such a pathology occur? The factors of its formation can be different, at first glance, even impossible. Among them:

poor blood clotting (heredity);
rib fractures, mechanical injuries, wounds;
infections, pathologies, liver cirrhosis, ulcers, tuberculosis, improper location of internal organs, their displacement, increase due to illness;
during pregnancy - rupture of the ovary, cysts, ectopic location of the fetal egg;
decay malignant tumor;
arterial hypertension, atherosclerosis.

There can be many more reasons, so it is important to respond in time to sudden changes in well-being, especially if there were provoking factors, and also diagnosed chronic diseases intestines, stomach and other vital organs.

Methods for determining the location of internal damage

If a person is ill, how to find an objective sign of internal bleeding and recognize its source?

If a hemorrhage occurred in the abdominal cavity, followed by a rupture of the spleen or liver, then common symptoms include dizziness, weakness, low blood pressure and tachycardia. The patient develops heaviness in the abdomen, pain in the left and right shoulder, palpation of the peritoneum has pain in the upper part.

It is difficult to determine the bleeding and its nature on its own, but it is possible.

If there is a rupture of the tubes or ovaries, then there is pain in the lower abdomen, in anus, deterioration of health, there is red discharge from the genitals.

With bleeding that occurred in the retroperitoneal space (ruptures of the kidneys, aorta), the patient has general symptoms, which are not very pronounced.

Feeling pain in lumbar If you knock lightly on the spine, then it will intensify.

If the lesion is in the stomach, intestines, then there is hematemesis or diarrhea, no pain in the abdomen.

How to stop bleeding

If there is a suspicion of internal hemorrhage, then the first health care play at home important role for the outcome of the situation. Before the doctors arrive, the patient should be laid down so that the muscles relax. If the victim has a cough, then his body is given a semi-sitting position.

Be sure to open the window in the room, apply cold to the alleged damage site.

It is important to control a person's breathing, pulse. If he gets worse, you need to do and carry out artificial respiration.

You can not give painkillers, water, medicines, knead the body, tightly bandage the injury site, move the victim.

Drug therapy

The best treatment for internal hemorrhages is timely help and surgery. Therapy of this pathology is carried out in a hospital, in the departments of gynecology, surgery, neurosurgery - depending on the source of blood loss.

Doctors first stop the blood, compensate for its loss, improve circulation. Use physical solutions, glucose, the rest medical preparations assigned according to the condition of the patient.

When is an operation required?

Surgical intervention is necessary if the patient's condition is critical. After the person was given first aid, he was hospitalized. Specialists take into account the source of bleeding, and then take action.

If the place of fluid concentration is the pleural cavity, then traumatologists are involved in the treatment, if the lungs - surgeons, with intracranial damage - neurosurgeons, with uterine damage - gynecologists.

Surgery will be required if the source is in the gastrointestinal tract.

The main task of the doctor is to stop bleeding, compensate for the volume of loss and improve blood supply. Patients often experience shock, in which the internal organs receive less oxygen.

In such cases, patients are given a transfusion, glucose and saline are administered. If the case is severe, the bleeding is stopped by cauterization, but surgery is most often required.

With pulmonary hemorrhage, tamponade of the bronchus is performed. If the abdominal part is filled with blood, then a laparotomy is urgently performed. If the damage is intracranial, then trepanation is done. With an ulcer, damaged vessels are removed, with cracks in the intestine, an operation is performed and they are sewn up.

If a woman has an ectopic pregnancy (a tube rupture has occurred), then the pathology is eliminated only by surgery.

Internal bleeding during pregnancy

This condition is also called premature placental abruption, and it requires urgent intervention by a specialist.

Clinical manifestations of this condition:

discharge can be plentiful, medium, absent altogether;
pain in the lower abdomen, the uterus "hardens", it is easy to feel it on palpation;
the cardiac activity of the fetus is disturbed, hypoxia occurs (determined by ultrasound);
the woman's body temperature rises.
feeling worse.

Provoke detachment maternal alcohol consumption, drug addiction, smoking, anemia, low red blood cell count, abdominal trauma, allergy to medications, fluctuations blood pressure.

Effects

Any bleeding poses a threat to a person, and internal bleeding is even more so. In this state, blood pressure suddenly drops, hemoglobin decreases.

If blood enters the cavities of the internal organs, their activity is disrupted. If at the same time the vessels are compressed, then tissue necrosis occurs. Blood that has been in the cavities of organs for some time (not circulating) becomes suitable place for bacterial growth and infection.

If the patient was not provided with timely assistance, then there is a high probability of death. The body is bled, the activity of the heart and brain is disturbed. If a person manages to help, then a long recovery period awaits him, and it all depends on the severity of the condition.

Internal bleeding is hidden and may not always be recognized with an inattentive attitude towards the victim.

Accumulation of blood in the sac around the heart (hemopericardium) can cause compression of the heart and stop it, and its accumulation in the cranial cavity can lead to compression of the brain. Bleeding in pleural cavity(hemothorax) will compress the lung and reduce it respiratory function. Pleural or abdominal cavity (hemoperitoneum) can easily contain all the blood circulating in the body, so internal bleeding can sometimes cause death of the victim from blood loss.

Leakage of blood into tissues (muscles, subcutaneous tissue etc.), into the intermuscular and interfascial spaces leads to the formation of bruises, or hematomas.

Lung injury or disease may cause pulmonary hemorrhage, When the victim coughs, along with sputum, scarlet foamy blood is released, i.e. appears hemoptysis.

When blood appears in the sputum, the victim is given a half-sitting position, clothes that make it difficult to breathe are removed, and fresh air is provided. The victim should not strain and talk. He is advised to take deep breaths and suppress coughing. Cold should be applied to the chest.

Any pulmonary bleeding is a sign of a serious injury or lung disease, so the speedy delivery of the victim (preferably by ambulance in a half-sitting position) to medical institution is the primary task of rescuers and doctors.

Bleeding into the cavity of the stomach or intestines may occur due to abdominal trauma or as a complication of certain diseases ( peptic ulcer, tumors of the stomach, etc.). This kind of bleeding is hidden, can be significant and life-threatening.

Symptoms stomach bleeding similar to the symptoms of acute anemia. In addition, such victims or patients develop hematemesis or vomiting of the contents of the color of "coffee grounds", frequent liquid stool black (melena).

Victim with suspected stomach bleeding or if there are obvious signs of it, rest should be ensured, given a horizontal position, put cold on the stomach. Gastric lavage, food and water intake, and laxatives are prohibited. It is necessary to organize its immediate delivery to the nearest medical institution in the supine position with the foot end of the stretcher raised, which improves the blood supply to the brain.

When suspected of having intra-abdominal bleeding which is characterized by pallor, weakness, dizziness, cold sweat, weak and frequent pulse, severe abdominal pain, drop in blood pressure, tension in the abdominal muscles, retraction and tenderness of the abdomen when it is probed, urgent surgical care. One of the characteristic manifestations of this condition is the symptom of "roly-poly". The victim seeks to take a half-sitting position, since in the horizontal position in which he should be, the blood moves into the abdominal cavity and the pain increases sharply. Intra-abdominal bleeding may be the result of blunt abdominal trauma that has caused a rupture of the spleen, liver, or other internal organ. One of the reasons for women is the gap fallopian tube with an ectopic pregnancy.

As first aid need to provide the victim rest, put cold on the stomach (ice pack or cold water, hypothermic package). No food or water is allowed . The main task is to immediately transport the victim in the supine position to the nearest medical facility. Any delay is deadly.

Internal bleeding is one of the most serious surgical and trauma problems. This is a hemorrhage, invisible from the outside. Only an experienced, qualified specialist can suspect the appearance of internal bleeding in time and provide assistance. In the article we will explain in detail why this pathology can occur and how to save a person's life.

Danger of internal bleeding

The insidiousness of the bleeding internal cavities in that the person himself does not notice it. Often the first manifestation is loss of consciousness when the volume lost blood has become too big. If a person has time to deliver to surgery and operate on the source of bleeding, then he will find out about his illness after the operation.

Women are less sensitive than men to blood loss. This is due to physiological monthly bleeding during menstruation.

Therefore, men are more difficult to recover from blood loss, even if help was provided on time.

Symptoms

Signs of internal bleeding are divided into two groups:

Symptoms of anemia - anemia;
Symptoms of direct entry of blood into the cavity or tissue.

The cause of the first group of symptoms is the loss a large number erythrocytes and hemoglobin - anemia. Hemoglobin provides oxygen to every cell in the body. Therefore, hemorrhage is manifested by signs of anemia, which is called posthemorrhagic. This means that it arose against the background of blood loss.

Manifestations of anemia are nonspecific and are similar to a number of other diseases:

Dizziness;
severe weakness;
Dry mouth and thirst;
Nausea, vomiting;
Shortness of breath, difficulty breathing;
Frequent heartbeat;
Low pressure;
Paleness of the skin and mucous membranes.

internal bleeding

If the bleeding is very slight, drip, but continues for many years, then chronic iron deficiency anemia develops.

In this case, a person has:

Perversion of taste or smell: desire to eat earth, chalk, etc., inhale gasoline vapors;
Symptom of "blue sclera", when vessels appear through the shell of the eye;
Dry skin;
Brittle hair and nails.

The second extensive group of symptoms of internal bleeding is associated with the ingress of blood into the cavity, for example, the abdominal or chest. These manifestations are important to know how to determine the source of the hemorrhage.

Place of blood loss	Symptoms
intracranial	Loss of consciousness, convulsions, coma
Pulmonary	Cough with pink foam
into the pleural cavity	Difficulty breathing, heaviness in the chest
Into the abdominal cavity	Abdominal pain, additional objective symptoms
From the esophagus	Vomiting bright red, scarlet blood
From the stomach	Vomiting dark, almost black blood
From the small intestine	Black chair - melena
From the rectum	Red blood streaks in stool
intra-articular	Joint pain, swelling

Varieties

Types of internal bleeding are divided not only depending on the place of blood loss.

The classification necessarily includes a division according to the volume of blood lost:

Lung– up to 500 ml;
Average- 500-1000 ml;
heavy- 1000-1500 ml;
massive- more than 1500 ml.

These are average volumes calculated for a person weighing 70-80 kg. Naturally, for a teenager or a child, the numbers of blood loss will be much smaller. For them, the calculation is carried out based on the volume of circulating blood (BCC). This is the total amount of blood in the body - 7% of body weight. A loss of up to 10% of BCC is considered mild, while a loss of more than 30% is considered severe and life-threatening.

There is a division of bleeding depending on the cause of rupture of the vessel:

mechanical- as a result of a blow, injury;
Arrosive- due to damage to the vessel wall by a tumor or necrosis.

The reasons

The source of internal bleeding can be any vessel damaged by injury, tumor or ulcer. One of the most common is gastrointestinal bleeding. Blood loss may be due to pathologically dilated veins in the esophagus, which quickly rupture. This condition occurs with cirrhosis of the liver.

Similar symptoms of blood loss from the vessels of the esophagus appear in Mallory-Weiss syndrome. This condition is associated with repeated, repetitive vomiting, such as with alcohol abuse. From frequent vomiting movements appear ruptures of the mucosa of the esophagus.

Hemorrhage in the stomach occurs from an ulcer or tumor. If blood flows out of the ulcer in small portions, drip, then it comes out with feces, staining it black. If it bleeds from lower divisions intestines - large intestine or rectum, then in the stool you can see scarlet blood. The most common source in this case is hemorrhoids. Bleeding tumors and colon polyps are less common. Day after day, without noticing blood loss, a person can reach a severe degree of anemia - this is why such latent gastrointestinal bleeding is dangerous.

Bleeding in the abdominal cavity often occurs after abdominal trauma.. This may be damage to the parenchymal organ - the liver, spleen. Then the surgeon reveals specific features, for example, a symptom of a vanka-vstanka. It is characteristic of bleeding from the spleen when a sick person lies curled up on his left side.

When you try to change position - turn around, sit down - there is severe pain in the abdomen. It makes a person return to the previous position again, like a child's toy roly-poly.

In women, bleeding is often caused by apoplexy - rupture of the follicle in the ovary. There is pain in the lower abdomen, radiating to the perineum and general symptoms blood loss. Often there is an ectopic pregnancy, with a rupture of the tube and the appearance of intra-abdominal hemorrhage. With apoplexy, the ovary usually bleeds slightly, but with an ectopic pregnancy, blood loss is critical.

A rare type of internal bleeding is pulmonary. It arises from the small vessels of the lungs, but there are episodes of severe blood loss from large vessel bronchi.

The reasons are:

Tumors of the lung;
Abscess;
Tuberculosis.

The main and frightening symptom that the lung tissue is bleeding is frothy, pink sputum when coughing.. This sign allows you to recognize where the blood loss comes from: from the lungs or from the esophagus. Blood can also accumulate in the chest cavity, which occurs with injuries with rib fractures.

The most dangerous internal bleeding accompanies a traumatic brain injury. The skull protects the brain, and, at the same time, does not allow to accumulate in its cavity excess fluid. Even a small amount of blood compresses the tissue and causes severe symptoms. Hemorrhage into the ventricles of the brain can cause rapid death due to cerebral edema.

Slightly less dangerous is hemopericardium - the accumulation of blood around the heart due to a chest injury. With internal bleeding of a small volume, a person feels a strong heaviness in the chest and pain. With further accumulation of blood, the heart is compressed from all sides. Without timely treatment this can lead to cardiac arrest.

First aid

When the first signs of bleeding appear, it is important to quickly determine the source and provide first aid. For gastrointestinal bleeding, food or medicine should not be offered. Only a small amount of water is allowed. If bleeding is expected in the abdominal cavity, then an ice pack should be applied to the sore spot.

When symptoms of bleeding appear in chest cavity all squeezing clothes are unbuttoned - shirts, ties, belts. It is important to ensure calm breathing and move the victim as little as possible. Pulmonary bleeding needs similar care.

Regardless of the source of the suspected bleeding, qualified medical assistance should be provided as early as possible. With every minute, the hemorrhage will only increase. The more blood is lost, the less chance of a favorable outcome. The loss of half of the volume of circulating blood will be considered critical.

Treatment in a hospital

After the clinic determines the source of the hemorrhage, complex therapy. For chest and abdominal cavity surgery to remove the source of the hemorrhage. With pulmonary bleeding or a small hemorrhage in the stomach or esophagus, help is provided with an endoscope. The volume of fluid is replenished with solutions, for example, Ringer, Reopoliglyukin, Hemodez.

After stopping the bleeding, it is imperative to restore the number of red blood cells. This will allow a person to get rid of the debilitating symptoms of anemia in the future. Depending on the degree of anemia, different drugs will be used.