Types of bleeding, characteristic signs and ways to temporarily stop them. Methods for stopping bleeding

The stop of bleeding can be temporary (preliminary or preoperative) and final. A temporary stop is made in cases where it is not possible to immediately make the final hemostasis, which requires operating conditions, and sometimes special tools, and a surgeon who owns vascular operations. Therefore, a temporary stop of bleeding is carried out at the scene to save the life of the victim with his subsequent transportation to a medical institution. Sometimes a temporary stop of bleeding is also carried out in the operating room for bleeding during surgery, until the question of the method of final hemostasis is resolved.

Exist following methods temporary stop of bleeding:
I. Pressing the arteries against the bony prominences. This is the pressing of the brachial artery against the humerus on the inner surface of the shoulder with arterial bleeding in the forearm and lower third of the shoulder. With bleeding from the external carotid artery or its branches, as well as bleeding from the extracranial part of the internal carotid artery, the common carotid artery is pressed against the carotid tubercle of the sixth cervical vertebra at the level top edge thyroid cartilage. When bleeding from the axillary or brachial artery, the subclavian artery is pressed against the first rib at the level of the middle third of the clavicle along its upper edge. With uterine bleeding and bleeding from the femoral arteries, the abdominal aorta is pressed against the spine below the navel with a fist. Bleeding from the femoral artery and other arteries of the lower limb is stopped by pressing the femoral artery against the pubic bone. The temporal artery can be pressed against temporal bone below the antitragus of the ear. The external maxillary artery is pressed against the lower jaw in the middle of its branch at the lower edge. The axillary artery presses against the humerus.

II. Maximum flexion of the limbs at the joints. In case of bleeding from the arteries of the lower limb, a roller is placed in the inguinal fold, the thigh is maximally bent at the hip joint and tied to the body. In case of bleeding from the arteries of the lower leg or forearm, the limb, respectively, is bent at the knee or elbow joints with the roller placed in the fold of the joint. The forearm or lower leg is fixed with a bandage to the thigh or to the shoulder. In case of bleeding from the arteries of the upper limb, to stop the bleeding, both upper limbs are wound behind the back and connected to each other in the area elbow joints. This causes the subclavian arteries to kink through the first rib and stop bleeding.

III. Wound tamponade as a method of temporary hemostasis is used for bleeding during operations, followed by measures for final hemostasis.

IV. The imposition of a clamp on the vessel may be necessary for bleeding, also during surgical interventions followed by a decision on the method of final hemostasis.

V. Applying a tight bandage. This type temporary hemostasis is used both for venous and arterial bleeding and, according to G.N. Zakharova, N.P. Topilina (1974), is an alternative
a tourniquet, over which a tight bandage has a number of advantages: less pressure on the nerve trunks and, as a result, less pain, less disturbance of collateral circulation. Indeed, in this aspect, one should agree with the authors mentioned above, since the pressure of a tight bandage created on an artery is quite sufficient to completely stop the blood flow in it. This method is absolutely indicated for venous bleeding, in which, in addition to the bandage, an elevated position of the limb is created.

VI. Temporary shunting of a vessel is used in case of complete damage to a large artery, when there are no conditions for restoring its integrity, and its ligation threatens with serious circulatory disorders. Often such situations occur when the arteries of the extremities are damaged. In these cases, under operating conditions, a segment of a silicone tube from a disposable system is inserted at one end into the adductor, and at the other end into the outlet end of the damaged artery. The tube is fixed at both ends of the damaged artery with a ligature tied around it. Thus, blood flow is restored, which makes it possible to deliver the victim to a medical institution, where a reconstructive operation on the vessel will be performed.

VII. Stopping bleeding with a rubber tourniquet Esmarch. In this case, it is recommended that the following rules be observed: 1. Apply a tourniquet to the lining without folds. 2. Apply a tourniquet above the wound and closer to it. 3. Before applying the tourniquet, stretch and wrap around the limb 2-3 times. 4. Tie the free ends of the tourniquet or secure with hooks. 5. The correct application of the tourniquet is determined by the pulse and the cessation of bleeding. 6. Wrap a limb with a tourniquet in cold weather with warm objects, but do not warm it. 7. The residence time of the tourniquet is no more than 1 hour, and in the cold season - no more than 30 minutes. After that, loosen the harness, and then tighten it again. If there is a need for further stay of the tourniquet, then after pressing the artery, the tourniquet is removed and transferred. 8. Attach a note to the tourniquet with the date and time of its application, as well as the name of the person who applied the tourniquet. 9. Mandatory transport immobilization. 10. Transportation of victims with a tourniquet is carried out in the first place. 11. Introduction of narcotic analgesics. 12. Patients with a tourniquet should be operated on first.
VIII. Spin overlay. It is used in the absence of a tourniquet. For this, any long soft object (rope, scarf, belt, etc.) is used. In this case, the same rules are observed as when using a tourniquet. An object used as a twist is tied around the limb, its ends are tied. A stick is inserted under it, with which the object used as a twist is twisted until the bleeding stops.

IX. The application of a tourniquet according to Zharov-1 ‘ruff allows maintaining collateral circulation in the limb. When applying J1ut according to this method, a plate is applied to the side of the limb opposite to the neurovascular bundle, around which and around the limb a tourniquet is applied. In this case, only a large vessel, which is the source of bleeding, is squeezed with a tourniquet. The second semicircle of the limb, due to the protective role of the plate, is not squeezed by the tourniquet, which allows maintaining collateral circulation.

X. The imposition of a tourniquet on the carotid artery according to I. Mikulich. The method is used for bleeding from the carotid artery. A tourniquet is applied to the damaged carotid artery in such a way as to preserve blood circulation in the opposite carotid artery. To do this, a Cramer splint modeled along the contour of the head, neck, shoulder girdle and shoulder is placed on the healthy side, fixed with bandages to the head and shoulder. The applied tourniquet compresses only the damaged carotid artery. As a splint, the hand of the victim, opposite to the damage, wound behind the head, or a plank attached to the side of the face opposite to the damage localization, in front of the ear, can be used.

A tourniquet is the most reliable way to stop bleeding. Usually they use a standard tape tourniquet or some kind of elastic stretchable fabric, rubber tube, suspenders.

The tourniquet is applied 5-7 cm above the upper edge of the wound. The limb is lifted up.
- The tourniquet is applied over clothing or some kind of soft padding (bandage, gauze, scarf, etc., folded in several layers and wrapped around the limb).
- A tourniquet is applied only until the bleeding stops.
- Under the tourniquet it is necessary to put a note indicating in it the exact time of application.
- You can’t cover the tourniquet with clothes (bandage), it should be conspicuous.

In the winter season, a limb with a tourniquet applied must be well isolated from the external environment so that frostbite does not occur. The tourniquet can squeeze the vessels for no more than 120 minutes. in summer and 90 minutes in winter. If the specified time is exceeded, the tourniquet must be unwound for 5-10 minutes, firmly press the wound with the palm of your hand through the bandage. Loosening the tourniquet must be repeated every half hour. It is impossible to keep a tourniquet or twist on the limb for more than 1.5-2 hours.

When using a tourniquet or twist under them, it is imperative to put a note where exactly by the hour to indicate the time when they were applied so that the medical worker knows how much time has passed since the bleeding stopped. A tourniquet should be used only in the most extreme cases, in the presence of arterial bleeding from large main vessels hips and shoulders. The vast majority of bleeding can be controlled with a proper pressure bandage.

Methods for the final stop of bleeding. Hemostasis in surgery

Kaluga Basic Medical College

Assisting the doctor in the final stop of bleeding

Rules for the final stop of bleeding

The final stop of bleeding is carried out in a hospital. It is carried out quickly, so the strictest observance of certain rules is necessary:

1. It is necessary to prepare the patient for emergency surgery

2. Strictly observe asepsis

3. Prepare anesthetics

For the final stop of bleeding, mechanical, physical, chemical and biological methods are used. Depending on the nature of the injury, the following methods of mechanical bleeding control are used:

ligation of bleeding vessels

ligation of vessels throughout

stitching of the damaged vessel

wound tamponade

Physical Methods final stop of bleeding

Physical methods to stop bleeding include:

application of high and low temperature and high frequency currents

irrigation of the bleeding tissue area with hot (45-500 C) isotonic sodium chloride solution

cold (ice pack, cold water in the form of compresses)

electrocoagulation (the device is based on the action of high frequency currents)

electroknife during operations on parenchymal organs

Medications to stop bleeding

Ball-and-stick model of vikasol

Chemical-pharmaceutical means of stopping bleeding are used to increase blood clotting and vasoconstriction. These hemostatic substances are divided into internal and external, or local. For this, various medications are used. local action. Vasoconstrictors: adrenaline and ephedrine. Hemostatic agents (hemostatics): 3% hydrogen peroxide solution. Hemostatic agents of general action: 5% aminocaproic acid intravenously, 10% calcium chloride intravenously, 1% solution of vikasol (vitamin K) intramuscularly

Biological methods to stop bleeding

Biological means of stopping bleeding include:

tissue tamponade

vitamin K (vikasol)

hemostatic sponge, gauze

transfusion of a small amount of blood (50-100 ml)

serum administration

In case of bleeding associated with a decrease in blood coagulability, especially in hemophilia, plasma obtained from freshly prepared blood or plasma in a frozen state, as well as antihemophilic globulin (AGG), antihemophilic plasma should be used.

Transportation of a bleeding victim

Stop the bleeding, then:

put the victim on a stretcher, on his back

lower the head end of the stretcher

put a cushion under your feet

control blood pressure, pulse rate, consciousness and other vital functions

control the condition of the bandage

prepare everything necessary for the internal administration of drugs as prescribed by the doctor (correction of BCC)

Note. At internal bleeding the victim is transported half-sitting

TOPIC: Blood type (AB0)

Determines belonging to a certain blood group according to the ABO system.

Functions. Blood groups are genetically inherited traits that do not change during life under natural conditions. The blood group is a certain combination of surface antigens of erythrocytes (agglutinogens) of the ABO system. The definition of group affiliation is widely used in clinical practice in the transfusion of blood and its components, in gynecology and obstetrics in the planning and management of pregnancy. The AB0 blood group system is the main system that determines the compatibility and incompatibility of transfused blood, because its constituent antigens are the most immunogenic. A feature of the AB0 system is that in the plasma of non-immune people there are natural antibodies to the antigen that is absent on erythrocytes. The AB0 blood group system consists of two group erythrocyte agglutinogens (A and B) and two corresponding antibodies - plasma agglutinins alpha (anti-A) and beta (anti-B). Various combinations of antigens and antibodies form 4 blood groups:

Group 0(I)- there are no group agglutinogens on erythrocytes, agglutinins alpha and beta are present in plasma.
Group A(II)- erythrocytes contain only agglutinogen A, agglutinin beta is present in plasma;
Group B(III)- erythrocytes contain only agglutinogen B, plasma contains agglutinin alpha;
Group AB(IV)- antigens A and B are present on erythrocytes, the plasma does not contain agglutinins.

Determination of blood groups is carried out by identifying specific antigens and antibodies (double method, or cross-reaction).

Blood incompatibility is observed if the erythrocytes of one blood carry agglutinogens (A or B), and the plasma of the other blood contains the corresponding agglutinins (alpha or beta), and an agglutination reaction occurs.

It is necessary to transfuse red blood cells, plasma and especially whole blood from a donor to a recipient strictly observing group compatibility. To avoid incompatibility between the blood of the donor and the recipient, it is necessary to accurately determine their blood groups by laboratory methods. It is best to transfuse blood, erythrocytes and plasma of the same group that is determined in the recipient. In emergency cases, group 0 red blood cells (but not whole blood!) can be transfused to recipients with other blood types; group A erythrocytes can be transfused to recipients with blood types A and AB, and erythrocytes from a group B donor can be transfused to recipients of group B and AB.

Blood group compatibility cards(agglutination is indicated by a + sign):

Group agglutinogens are found in the stroma and membrane of erythrocytes. Antigens of the ABO system are detected not only on erythrocytes, but also on cells of other tissues or can even be dissolved in saliva and other body fluids. They develop on early stages intrauterine development, and the newborn is already in significant quantities. The blood of newborns has age features- characteristic group agglutinins may not yet be present in the plasma, which begin to be produced later (constantly detected after 10 months) and the determination of the blood group in newborns in this case is carried out only by the presence of antigens of the ABO system.

In addition to situations associated with the need for blood transfusion, determination of the blood group, Rh factor, as well as the presence of alloimmune anti-erythrocyte antibodies should be carried out at the time of planning or during pregnancy to identify the likelihood of an immunological conflict between mother and child, which can lead to hemolytic disease newborns.

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Bleeding is a common injury in which blood leaks from a vessel to the outside or into a body cavity. Depending on the direction of blood flow, hemorrhages are divided into external and internal. In addition, depending on which vessel is damaged, doctors separate capillary, venous and arterial bleeding. The most insidious is parenchymal bleeding, as its symptoms are not easily recognized.

It is important to know how to determine the type of hemorrhage, and what measures emergency assistance undertake. A person who remembers how to act in this or that case can save a person's life. What are the ways to temporarily stop external and internal bleeding, how to stop hemorrhage inside the body - you will learn in our article.

Types of bleeding

Differential diagnosis of bleeding is an important procedure that allows you to save precious seconds during the rescue of the wounded.

Having studied the symptoms of bleeding, you can quickly determine its type and provide competent first aid. So you not only save a person, but also minimize blood loss. Consider the main types of bleeding and how to stop them briefly.

Depending on the damaged blood vessel, the following bleeding is divided:

- this is the least dangerous external hemorrhage. It occurs when the integrity of the capillaries is violated. After an injury, blood of a rich red hue oozes evenly, like from a sponge. The body copes with bleeding on its own, except in cases where the victim has reduced blood clotting or an extensive wound. Tight bandaging is used to stop the blood;
is bleeding that occurs when a vein is damaged due to superficial or deep wounds. After an injury, it flows out of the wound dark blood, hemorrhage is intense and constant. To stop the blood, use the method of finger pressing under the wound or a bandage of a pressing type. If the previous methods did not work, then it is necessary to apply a tourniquet;
is the strongest and dangerous bleeding , which occurs as a result of knife, gunshot or mine-explosive wounds. After an injury, a pulsating jet of bright red blood flows from the wound. The hemorrhage is very strong, if you do not help a person, he will die in 3 minutes. To stop the bleeding, fingers pinch the damaged artery over the wound, after which a tourniquet is applied to the place of pressing.

The danger of internal bleeding is that they appear when blood loss is already large.

Signs of internal bleeding:

Internal bleeding occurs due to closed or penetrating wounds. As a result, blood vessels are damaged internal organs(stomach, intestines, liver, heart, etc.), blood accumulates in its cavity and the condition of the victim worsens. In such cases, it is necessary to urgently hospitalize the wounded and apply cold to the alleged site of bleeding.

Methods for stopping hemorrhages

Temporary methods of stopping bleeding include finger pressing of the damaged vessel, pressure bandage and tourniquet.

Ways to stop bleeding:

Mechanical- ligation of the vessel, vascular suture, pressure bandage, tamponade, vascular prostheses (shunts). In case of damage to small and medium-sized vessels, ligation is performed, different seams, prostheses (treated vessels of the corpse, synthetic prostheses). If the above methods cannot be applied, then the blood is stopped with a gauze swab, but this method threatens with infection. If it is impossible to put a thread on a bleeding vessel, then it is closed with a clamp;
Thermal- Bleeding is stopped with the help of high and low temperatures. Hot sodium chloride solution is used to stop internal bleeding. For cauterization of damaged vessels, an electric knife or a laser is used. To cool the damaged area, use an ice pack or a local cooling apparatus.
Chemical- drugs that constrict blood vessels and increase blood clotting (adrenaline, ergot alkaloids, calcium chloride, etc.);
Biological- tamponade of wounds with animal tissues, blood products, blood transfusion, vitamins that increase blood clotting.

It is important to choose the right method so that the hemorrhage does not resume.

Harness rules

A hemostatic tourniquet, as a method of not only temporarily stopping blood, is used for severe external arterial bleeding, if finger pressure and a pressure bandage were not effective.

Mechanical way to stop the blood

To stop the blood, the vessel is tied up in the wound and throughout, twisted, a tampon is inserted into the wound, the vessel is artificially clogged or a suture is applied to it.

To finally stop the internal hemorrhage, an operation is performed to remove part of the organ or the entire organ.

Most often, bleeding is stopped by ligation of the vessel. To do this, its central and peripheral edges are isolated, fixed with clamps and pulled with a thread (ligature). To prevent it from slipping, the tissue of the vessel is pre-sutured.

If the surgeon cannot detect the ends of the vessel, then ligation is performed throughout. This method is used to prevent hemorrhage during surgery.

In case of damage to small and medium-sized vessels, the twisting method is used. In this case, the end of the vessel is fixed with a clamp, its intima is twisted. As a result, the lumen of the vessel closes and a thrombus forms.

Tamponade is used to stop capillary or internal hemorrhage. To implement this method, a gauze swab is introduced into the wound, which compresses the bleeding vessels.

To stop pulmonary or gastroduodenal hemorrhage, a vessel embolization method is used. To do this, under X-ray control, a catheter is inserted into the damaged vessel, through which a suspension with emboli enters the vessel. The substrate closes the lumen of the vessel and promotes the formation of a thrombus.

Physical Methods

Thermal methods of stopping blood have been used since ancient times. The basis of the method is the impact on the bleeding vessel of temperatures. Low temperature provokes vasoconstriction, and high promotes protein coagulation (gluing of protein particles) and acceleration of blood clotting.

Use an ice pack to cool damaged tissue cold water. With gastroduodenal bleeding, the stomach is cooled with water, the temperature of which is from +4 to +6 °.

To stop bleeding, diathermocoagulation is often used, during which damaged tissues are cauterized using high-frequency current. This method has found wide application during surgery to stop hemorrhage from the vessels of fatty tissue, muscles, as well as gastroduodenal bleeding.

To stop capillary or internal bleeding, the wound is treated with a solution of sodium chloride.

Chemical methods to stop bleeding

Used to stop bleeding medicines which cause vasoconstriction and increase blood clotting.

Popular vasoconstrictors to stop hemorrhage:

Adrenaline (1:1000) is applied topically when blood flows from the internal membranes;
Ergot extract helps stop bleeding from the uterus;
Pituitrin is used to stop bleeding from varicose veins of the esophagus, stomach, uterus, etc.

Hydrogen peroxide increases blood clotting, for this purpose a 3% solution is used. The swab is soaked in liquid and injected into the wound, as a result, a blood clot is formed.

Aluminum-potassium alum has a hemostatic (hemostatic) effect. Hemostatic pencils treat minor wounds and abrasions.

A solution of calcium chloride (10%) also increases blood clotting. The drug is administered intravenously, after which it stimulates blood clotting, reduces the permeability of the walls of blood vessels and increases the tone of peripheral vessels.

Carbozachrome, rutin, vitamin C, rutamine also reduce vascular permeability.

Biological methods

To stop hemorrhages, biological agents are used that have a resorptive (absorbing) and local effect.

For internal bleeding, serums are used that increase blood clotting. In most cases, horse serum is used, which is injected subcutaneously, the standard dose is from 20 to 40 ml.

Anti-tetanus and anti-diphtheria serum will also help stop the blood, it is used in the same dosage. The drugs are stored for no longer than 2 weeks, after which the drug no longer increases, but lowers blood clotting.

To improve coagulation, 100-200 ml of blood is transfused. In chronic bleeding, small doses of blood help stop the bleeding.

With internal hemorrhage, living tissues are transplanted that contain thrombokinase (a substance that accelerates clotting). Muscles, omentum, adipose tissue, fascia are used to stop bleeding. The tissue is applied to the bleeding vessel and secured with sutures.

For local blood arrest, fibrin film, thrombin, hemostatic cotton or sponge are used.

After stopping the hemorrhage, the victim needs rest to regain strength. It is recommended to carry out a blood transfusion, a saline solution is injected under the skin, a glucose solution (5%) is injected into a vein. Heart drugs such as camphor, caffeine, ephedrine are often prescribed. In addition, it is important to keep limbs warm, use an oxygen tent, and eat a high-calorie, vitamin-rich diet.

There are many classifications of this pathological condition and experts teach them all. However, we are interested in dividing bleeding into varieties, first of all, from a practical point of view. For the successful provision of first aid, the following classification is important. It shows the types of bleeding depending on the nature of the damaged vessel.

arterial bleeding

It comes from the arteries, which contain oxygenated blood flowing from the lungs to all organs and tissues. It poses a serious problem, since these vessels are usually located deep in the tissues, close to the bones, and situations where they are injured are the result of very strong impacts. Sometimes this type of bleeding stops on its own, because the arteries have a pronounced muscular membrane. When such a vessel is injured, the latter spasms.

Venous bleeding

Its source is venous vessels. Through them, blood containing metabolic products and carbon dioxide flows from cells and tissues to the heart and further to the lungs. Veins are located more superficially than arteries, so they are damaged more often. These vessels do not contract during injury, but they can stick together because their walls are thinner and their diameter is larger than that of arteries.

capillary bleeding

Blood flows from small vessels, most often the skin and mucous membranes, usually such bleeding is insignificant. Although it can be frighteningly abundant in a wide wound, since the number of capillaries in the tissues of the body is very large.

Parenchymal bleeding

Separately, the so-called parenchymal bleeding is also isolated. The organs of the body are hollow, in fact, - these are "bags" with multilayer walls - and parenchymal, which consist of tissue. The latter include the liver, spleen, kidneys, lungs, pancreas. Typically, this type of bleeding can only be seen by a surgeon during an operation, since all parenchymal organs are "hidden" deep in the body.

Depending on whether blood remains in the cavity of the body or organ or is poured out of the body, bleeding is distinguished:

Internal. The blood does not go outside, lingering inside: in the cavity of the abdominal, thoracic, pelvic, joint (s), ventricles of the brain. A dangerous type of blood loss that is difficult to diagnose and treat because external signs there is no bleeding. There are only general manifestations of its loss and symptoms of significant dysfunction of the organ(s).
External bleeding. Blood is poured into the external environment, most often the causes of this condition are injuries and various ailments striking individual bodies and systems. These bleedings can be pulmonary, uterine, from the skin and mucous membranes, gastric and intestinal, from the urinary system. At the same time, visible outpourings of blood are called explicit, and those that occur in a hollow organ that communicates with the external environment are called hidden. The latter may not be detected immediately after the onset of bleeding, because it takes time for blood to come out, for example, from a long digestive tube.

Usually bleeding with clots is external hidden or internal, when the blood lingers inside the organ and partially clots.

Acute. In this case, in a short period of time is lost a large number of blood, it usually occurs suddenly as a result of an injury. As a result, a person develops a state of acute anemia (anemia).
Chronic. Long-term loss of small volumes of this body fluid, usually caused by chronic diseases organs with ulceration of the vessels of their walls. Cause a state of chronic anemia.

The main causes of bleeding

Why is there blood? With different types of causes of bleeding are different. With a traumatic form of bleeding, the causes are as follows:

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

At pathological form the reasons are as follows:

vascular diseases;
diseases associated with the coagulation of the circulatory system;
diseases that can be classified as common. Why is blood flowing? It is related to illness. These include diseases endocrine system, for example, diabetes, diseases associated with a viral infection, various diseases internal organs.

What can cause bleeding? It is appropriate to note here that two fundamentally different types of them are also distinguished, based on the factor whether a normal vessel is damaged or pathological condition arose against the background of the destruction of the altered vascular wall. In the first case, bleeding is called mechanical, in the second - pathological.

The following main causes of bleeding can be distinguished:

Traumatic injuries. They can be thermal (from exposure to critical temperatures), mechanical (in case of a bone fracture, wound, bruise). The latter occur in various extreme situations: traffic accidents, railway and plane crashes, falls from a height, fights involving piercing objects, gunshot wounds. There are also industrial and domestic injuries.
Vascular diseases, including tumors (purulent tissue lesions with vascular involvement, atherosclerosis, hemangiosarcoma).
Diseases of the blood and liver coagulation system (hemophilia, von Willebrand disease, fibrinogen deficiency, hypovitaminosis K, hepatitis, cirrhosis).
General diseases. For example, diabetes mellitus, infections (viral, sepsis), lack of vitamins, poisoning cause damage to the vascular walls throughout the body, as a result, plasma and blood cells seep through them and bleeding occurs.
Ailments that affect various organs. Expiration of blood from the lungs can cause tuberculosis, cancer; from the rectum - tumors, hemorrhoids, fissures; from the digestive tract - ulcers of the stomach and intestines, polyps, diverticula, tumors; from the uterus - endometriosis, polyps, inflammation, neoplasms.

Classification

What is bleeding in medical terms? Bleeding refers to the release of blood from the walls of injured hematopoietic vessels. This may be due to injury or have another cause. What types of bleeding are there? Bleeding types of bleeding first aid are very interconnected with each other.

Separation into different types in bleeding is necessary, since when providing first aid for bleeding, it will be easy to determine the algorithm of actions that any physician clearly knows. This allows you to quickly help with bleeding and minimize blood loss. But a person who is far from medicine must also have an idea about the types of bleeding in order to Hard time know the rules of first aid and be able to apply them in practice, thus it is possible to save the life of your friends, relatives and yourself.

1. For the correct provision of first aid for bleeding, a table will help, which presents the definitions of injured vessels due to what type of vessel is damaged.

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

2. In addition, the classification of bleeding includes dividing them according to the place of blood flow and there are:

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

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

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

4. From what causes bleeding it happens:

traumatic;
pathological;

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

if the blood loss is up to 0.5 liters, then such a blood flow is called light;
with an average loss of up to one liter;
with severe - up to one and a half liters;
with a massive - up to two and a half liters;
with fatal - up to three liters;
Absolutely deadly - up to three and a half liters.

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

In total, doctors distinguish five types of blood loss:

Capillary. Characteristic for damage to small blood vessels system, for example, in case of abrasion or a shallow cut. Blood is released in the form of drops, and bleeding stops most often on its own.
Venous. In this case, the wound touches the deep layers of the skin with damage to the veins. Blood flows out very slowly, visually representing a continuous stream of dark red color. If the veins of the upper half of the body were injured, then the blood comes out in the form of an intermittent jet synchronously with breathing.
Arterial. The cause of bleeding in this case is damage to the arteries. The rate of blood leakage and the risk of bleeding are directly proportional to the size of the damaged vessel. In particular, injuries to the femur or iliac artery can be fatal in just a few minutes. Arterial injury is characterized by the ejection of blood in a jet. Stopping bleeding in this case is provided by clamping the affected artery above the site of the injury.
Mixed. With such blood loss, simultaneous damage to both veins and arteries occurs.
Parenchymal. It is characteristic of damage to internal organs, while the wound surface bleeds continuously. Self-stop bleeding in this case is almost impossible. It is important to seek qualified help as soon as possible.

In this case, external and internal bleeding is distinguished. With the external type, you can clearly see how the blood is released from the wound.

It is very difficult to self-diagnose internal bleeding because the surface of the skin remains intact. In this case, blood accumulates either in tissues or in body cavities.

The cause of the onset of internal bleeding can be, for example, a fall from a height or a blow with a blunt object.

Bleeding is usually called the outflow of blood from damaged vessels as a result of their injury. Non-traumatic bleeding may also occur. Its causes may be painful foci (ulcerative, cancerous, tuberculosis), which are the cause of corrosive vessels.

Traumatic bleeding is the main sign of injury. Blood has a very important property - clotting. Thanks to it, a spontaneous stop of minor bleeding is possible. Blockage of the opening of the vessel resulting from injury occurs through a clot of clotted blood.

If blood clotting is poor, then even minor bleeding slows down very slowly. Therefore, with insufficient coagulability, there is a loss of a significant amount of blood.

Bleeding is distinguished depending on the type of damaged vessel. So, it is customary to distinguish:

Capillary. It is noted by a slow, uniform release of scarlet blood from the entire wound. Usually they are subject to self-stop (if clotting is normal).

Venous. The blood is poured out in an even, uninterrupted stream. Her color is dark.

Arterial. A stream of blood flows out, pulsing, in the form of shocks. Her color is scarlet. The blood loss is very big. Dangerous if large arteries are damaged.

Determining the type of bleeding in practice is complicated by the fact that all the vessels are located close to each other. In most wounds, they are injured at the same time. Therefore, when determining the type of bleeding, it is worth determining the following types:

Weak. Stops when treating a wound.
Strong. It is characterized by rapid blood loss. Therefore, bleeding is initially stopped, and then the wound is treated. After all, a large blood loss can provoke a fatal outcome.

It is important to know how to determine the type of hemorrhage, and what emergency measures to take. A person who remembers how to act in this or that case can save a person's life. What are the ways to temporarily stop external and internal bleeding, how to stop hemorrhage inside the body - you will learn in our article.

Differential diagnosis of bleeding is an important procedure that allows you to save precious seconds during the rescue of the wounded.

Depending on the damaged blood vessel, the following bleeding is divided:

Capillary is the least dangerous external hemorrhage. It occurs when the integrity of the capillaries is violated. After an injury, blood of a rich red hue oozes evenly, like from a sponge. The body copes with bleeding on its own, except in cases where the victim has reduced blood clotting or an extensive wound. Tight bandaging is used to stop the blood;
Venous is bleeding that occurs when a vein is damaged due to a superficial or deep wound. After an injury, dark blood flows from the wound, the hemorrhage is intense and constant. To stop the blood, use the method of finger pressing under the wound or a bandage of a pressing type. If the previous methods did not work, then it is necessary to apply a tourniquet;
Arterial - this is the most severe and dangerous bleeding that occurs as a result of knife, gunshot or mine-explosive wounds. After an injury, a pulsating jet of bright red blood flows from the wound. The hemorrhage is very strong, if you do not help a person, he will die in 3 minutes. To stop the bleeding, fingers pinch the damaged artery over the wound, after which a tourniquet is applied to the place of pressing.

Signs of bleeding

Patient complaints:

Weakness, unmotivated drowsiness;
Dizziness;
Thirst;
Feeling of palpitations and shortness of breath.

The external symptoms of blood loss that are observed with any type of bleeding are as follows:

Pale skin and mucous membranes;
Cold sweat;
Increased heart rate;
Dyspnea;
Disorders of urination up to the complete absence of urine;
drop in blood pressure;
Frequent weak pulse;
Violations of consciousness up to its loss.

Local

But the spilled blood may not have contact with the environment. In this case, we talk about internal bleeding. It also has several varieties:

hemorrhages in the free abdominal cavity;
gastrointestinal;
uterine, vaginal;
hemorrhages in internal organs.

With blood loss in a person, the following common symptoms appear:

thirst;
dizziness;
weakness, drowsiness;
palpitations and shortness of breath.

With a strong loss of blood of any kind, the following consequences appear:

pallor of the skin;
dyspnea;
increased heart rate;
release of cold sweat;
urination disorder;
frequent and weak pulse;
pressure drop;
disturbance of consciousness up to its loss.

For all types of external bleeding, a common symptom is the presence of a wound or damage to the skin or mucous membrane and a visible outflow of blood from it. However, the character varies depending on the type of vessel.

capillary bleeding covered with dried blood

Capillary hemorrhage is the most common, since it occurs with any injuries and injuries with a violation of the integrity of the skin. This species is characterized by a non-intensive uniform outflow of blood, which usually stops on its own. Difficulties do not arise either in diagnosing the condition or in treating it.

The cause of venous bleeding is deep wounds any size and superficial damage that violates the integrity of the intermuscular and saphenous veins. You can recognize them by the intensity of the blood stream, which is difficult to stop, since there is a constant flow of blood through the vein. The blood has a dark tint, its outpouring can be stopped by pressing on the damaged blood vessel below the wound.

Venous bleeding is very dangerous, and therefore require urgent medical attention. In a short time, a person can lose a large amount of blood. Only in rare cases, venous hemorrhage stops on its own. Superficial wounds bleed less intensively, and if deep veins are damaged, profuse bleeding occurs.

Arterial vessels lie deeper, because their effusion is the least common. As a rule, knife, mine-explosive and gunshot wounds can provoke arterial bleeding. In domestic conditions, such damage can only be obtained with a very thin and sharp object.

Arterial bleeding is characterized by an intense, pulsating hemorrhage of bright red blood. Blood loss cannot be stopped by conventional pressure below or above the wound.

As a rule, with an arterial hemorrhage, a person quickly loses a lot of blood, which causes shock. With a complete rupture of the artery, the blood in the full circulating volume can expire in just 1 minute. Therefore, such injuries require immediate attention.

Mixed external bleeding is typical for extensive wounds and injuries, such as fractures, falls from a height onto sharp objects, etc.

Depending on the location of occult bleeding, characteristic symptoms and signs.

A similar table can be drawn up for internal bleeding. Its difference from the hidden one is that the blood does not come out. You can recognize the localization of blood loss by characteristic signs.

Loss or confusion of consciousness, local disturbances of motor functions, coma

Pain in the abdomen, nausea and vomiting; abdominal muscle tension

Pain in the chest, shortness of breath

Swelling of the joints, pain on probing and movement

A temporary stop is performed before the delivery of the patient to medical institutions. After, in a hospital setting, medical workers finally stop the hemorrhage.

There are several ways to ensure minimal blood loss. This or that method is used depending on the type of bleeding and localization of vascular damage.

Apply direct compression of the bleeding site. It can be used for non-intense hemorrhages (venous, capillary and mixed). It is more effective when the wound is located in the upper and lower extremities.

A temporary stop is performed as follows:

apply a sterile napkin to the wound (in its absence, clean, fresh linen);
make a roller of cotton wool or clothes, press it against the wound;
tighten with a bandage or press with your hand.

For minor bleeding of the hands, fingers, or feet, you can raise the wounded limb. This method can be combined with the use of a pressure bandage.

tourniquet is indicated only for arterial bleeding;
it must be applied above the site of bleeding and only on the shoulder or thigh;
it is necessary to use a fabric gasket;
in the absence of an elastic tube or strip, use a bandage (twist in 4-5 layers), a strip of fabric and or a rope;
tourniquet should be applied for no more than 2 hours in summer and 1 hour in winter;
should be noted on free limb, paper or the bandage itself, the time of applying the tourniquet.

To stop arterial bleeding, you can use the method of violent flexion of the limbs. To do this, they are strongly bent in the joints that are above the wound - the hip, knee, elbow. After that, the limb is fixed with bandages.

To immediately stop bleeding, when there are no conditions and opportunities for applying a tourniquet, you can use another way to stop it. By pressing the main arterial trunks stop arterial circulation. The vessels closest to the bones and surfaces are selected.

The common carotid artery presses against the transverse processes of the cervical vertebrae in the middle of the inner edge of the sternocleidomastoid muscle. If the patient lies on his stomach, then turn his head in the opposite direction. The hand is positioned so that thumb was on the back of the neck, and the remaining fingers pressed the carotid artery.

Compression of the subclavian (a) and carotid artery (b)

When bleeding subclavian artery it is pressed against the 1st rib in the supraclavicular fossa in the place where it lies between the scalene muscles. When the victim lies on his stomach, the caregiver takes his head away from the subclavian artery, places four fingers on the back of the neck, and squeezes the artery with his thumb.

The brachial artery is compressed with fingers at the edge of the biceps brachii. The brush wraps around the shoulder from the outside.

Compression of the brachial (a) and intramuscular artery (b)

To clamp the femoral artery, it is compressed to the horizontal branch of the pubic bone under the ligament located in the middle between the anterior superior iliac spine and the pubic section. For this, two thumbs hands wrapped around the thigh, or clenched into a fist right hand and strenuously squeeze them, acting on top of the left hand. If these methods are ineffective, then the knee is used to press the artery.

Compression of the femoral artery

To stop bleeding abdominal aorta use a fist. They press the artery to the spine in the epigastric region. The force of pressure increases with the help of the left hand.

If a bleeding is coming from the brachial or axillary artery, then the victim's elbows are bent and held in this position with bandages or other dressing

The rules for stopping mixed bleeding depend on which part of the body is damaged. The first aid algorithm is as follows:

1. If a hemorrhage occurs from a limb, then it is lifted and they try to fix it for several minutes until a first-aid kit is brought.
2. With the outpouring of blood in large quantities from the damaged artery, press on the vessel above the wound (methods are described above).
3. If the damage is extensive, then press the wound with the palm of your hand, using a lining from a handkerchief, clean linen.
4. After 3-5 minutes, the limb is placed on a flat surface, fingers or hands are removed from the wound. A gauze bandage or bandage is applied, folded in 7-10 layers.
5. Before the arrival of the ambulance, they carry out local anesthesia(Ketanov, Lidocaine, analgin). These drugs are administered to the victim, who is conscious.
6. After another minute, the bandage is removed, the wound is treated with hydrogen peroxide, and the area around it is treated with brilliant green and iodine.
7. Again apply a squeezing clean bandage on top.

For internal bleeding, apply cold to the injury site. To do this, you can use snow covered in a bag, ice wrapped in a towel, ice-cold water in a bottle.

Give the victim plenty to drink. If he does not have signs of an "acute abdomen", then you need to constantly give him sweet tea. This is necessary to replenish the fluid balance. For anesthesia, you can enter 3 ml of Dexamethasone, and to reduce the intensity of hemorrhage - substances such as Hemophobin, vitamin C, calcium chloride, Vikasol.

To completely stop bleeding, there are also various methods. It is carried out in a hospital setting.

Symptoms

From which vessel is damaged, the symptoms of bleeding are different.

1. The symptoms of capillary are as follows:

red blood;
her losses are small;
stops flowing.

2. Symptoms of venous blood flow:

it is dark red, may have a burgundy color;
characterized fast current in the form of stripes;
if you press down from the injury, then the blood flow decreases;
poses a danger without providing first aid on time;
it rarely stops flowing.

3. Symptoms of arterial blood flow:

she is bright red;
the peculiarities of this species are that the blood flows in the form of pulsating shocks quickly;
if you press higher and lower than the injury, the flow continues in the same way;
very dangerous because of its intensity, can lead to a state of shock. First aid for them should be provided immediately.

4. Symptoms of internal blood flow:

a person is drawn to sleep, from being exhausted;
the stomach starts to hurt;
blood pressure decreases;
there is an increase in heart rate;
the skin takes on a pale shade;
a person has painful sensation right or left in the neck region. If he lies down, the pain intensifies;
are very insidious due to the fact that they manifest themselves when a large loss of blood has already occurred, and in the initial period it is difficult to detect the flow of blood. A person can suddenly become ill a few days after the onset of the injury.

5. Symptoms of latent blood flows:

with the appearance of foamy blood of a bright red color, accompanied by a cough, one can suspect the flow of blood in the lungs;
with gastric blood Brown color, occurs in the form of clots. At the same time, the person is exhausted, his pulse rate increases, blood pressure decreases, the skin color becomes pale, vomiting begins with a brown blood admixture, black or bloody liquid feces;
with intestinal in the feces, a change in their color to dark, brown or black is detected;
if the blood flow occurs in the kidneys or from the urinary system, then the color of the urine changes to red;
when flowing from the reproductive system, its color is red with pieces of mucus;
the scarlet color of blood in the form of drops on the feces indicates bleeding in the rectum;
a person can suddenly become ill a few days after the onset of the injury. Call emergency care in case of bleeding in this case is required.

It will not be superfluous to have information that allows, by accompanying signs, to determine which vessel or organ has received damage. Symptoms are divided into two types: general and local.

The general symptoms for any type of bleeding are the same. The victim has the following:

severe weakness;
dizziness accompanied by fainting;
dry mouth and intense thirst;
pale skin color;
instability blood pressure;
weak and unstable pulse.

But local symptoms characteristic of internal bleeding are quite diverse. With the outflow of blood into the cavity of the cranium, signs of compression of the medulla will be clearly manifested.

Filling up with blood pleural cavity accompanied by signs of hemothorax. In this case, the victim experiences severe shortness of breath. He has a weakening of breathing, trembling of the voice, and the depth of inspiration also decreases. An x-ray will help confirm the diagnosis. chest, as well as a puncture of the pleural cavity.

Blood accumulated in abdominal cavity capable of provoking signs of peritonitis. These are pain, vomiting, nausea, tension of the anterior abdominal wall, common signs of peritoneal irritation. Ultrasound can confirm the fears.

The clinic of outflow of blood into the joint cavity depends on the size of the damaged vessel. Local manifestations include:

severe swelling of the joint;
a feeling of bursting;
pain of varying intensity.

If no action is taken, then gangrene may develop in the future.

Now you are familiar not only with the symptoms and types, but also with ways to stop bleeding. We hope that in a difficult situation this knowledge will be useful to you.

Before sorting out what types of bleeding are and first aid for them, it is important to learn how to recognize this pathological situation. After all, not all damaged vessels can be seen from the outside, and this makes diagnosis very difficult.

So, if large arteries are damaged, the most dangerous bleeding occurs - arterial. The color of blood is bright red, it is thrown out by a powerful and fast jet. The patient quickly loses consciousness, his pulse is rapid, weak. The patient may have nausea, vomiting, dizziness. Death occurs quickly if proper assistance is not provided and the bleeding is not eliminated.
Venous bleeding is slower, uniform, its color is dark cherry. If small vessels are damaged, the blood can even stop itself, as a result of which a blood clot forms. With prolonged bleeding, the blood level drops sharply, which leads to a state of shock and even death.
The most harmless bleeding is capillary. The body itself can achieve its stop, since the vessels are very small, and their damage is not even visible. Capillary bleeding can be dangerous only if there is a clotting disorder.
Parenchymal bleeding is also very dangerous. It can be observed when organs with a huge vascular network (kidneys, liver) are damaged, when not one vessel bleeds, but many. Stopping this bleeding is a difficult task because it is often internal.

Naturally, with different types of bleeding, first aid for them will also be different.

Therapy after stopping bleeding in the hospital

The use of coagulation-improving, blood-substituting drugs, whole blood / plasma / platelet suspensions is mandatory. Intravenous infusion therapy is also needed to restore the balance of ions. Since bleeding is usually far from the only problem after serious traumatic incidents, in parallel with the work to stop it, doctors carry out emergency diagnosis and treatment of concomitant disorders.

The main thing is not to lose your head if trouble happened to one of the people around you, and the person has bleeding. In order to cope with it, you can use materials from the car first-aid kit, things from your own bag, items of clothing or household items.

The task and duty of every normal person is to provide first aid to the victim, which consists in temporarily stopping the loss of blood. And then you should immediately take the patient to a medical institution on your own or urgently call an ambulance.

What methods of temporary stop of bleeding are known? Here they are:

Pressure (pressing the vessel in the wound, applying a pressure bandage).
Applying a hemostatic sponge, ice, irrigation with hydrogen peroxide (for capillary bleeding).
Very strong flexion of the limb.
Dense tamponade with a bandage, gauze, cotton wool (for the nasal cavity, deep external wounds).
Applying a hemostatic tourniquet.

Ways to finally stop bleeding, which can only be performed by a doctor and in a medical institution, are:

Mechanical: ligation of the vessel in the wound, performing a vascular suture, stitching the tissue together with the vessel.
Chemical: anticoagulants and vasoconstrictors (calcium chloride, epinephrine, aminocaproic acid)
Thermal: electrocoagulation.
Biological (to stop capillary and parenchymal bleeding during operations): fibrin films, hemostatic sponges, hemming of the body's own tissues (omentum, muscle, fatty tissue).
Vessel embolization (introduction of small air bubbles into it).
Removal of the affected organ or part of it.

First aid for arterial bleeding

A tourniquet is very effective if the vessel of the limb is damaged. The method of pressure and tight tamponade of the wound is also used.

To stop bleeding, it is important to know what types of bleeding exist and how to stop them. When bleeding is detected, various methods can be used to stop bleeding. For this, the following measures are taken:

The bleeding site must be given an elevated position.
In the presence of capillary, venous bleeding, it is necessary to apply a pressure bandage.
Mandatory compression of the artery.
It is necessary to bend the limb at the joint with maximum force.
If the bleeding on the limbs is strong, it is necessary to apply a tourniquet, twist.

After completing all of the above steps, a sterile dressing should be applied.

Since arterial bleeding is considered the most dangerous for a person, it is necessary to recognize it very quickly and provide urgent assistance. Blood loss is very large and rapid due to the fact that the fluid moves through the arteries with high pressure and pulsation. First aid for this type of bleeding is provided according to the following algorithm:

Find the damaged artery and press it tightly with a tourniquet to the bone above the site of hemorrhage.
A tissue is placed under the tourniquet so that it does not pinch the soft tissues of the body so much. Next, the time is recorded when this tight bandage was applied, since it can be kept for a maximum of 1-1.5 hours. Display this time on a piece of paper and hide under a bandage. If the time limit is ignored and the tourniquet is held for longer, tissue without blood flow can die, leading to amputation of the limb.
If the tourniquet needs to be removed already, and the patient has not yet been delivered to the hospital, the bandage is loosened for a few minutes, holding the wound with his hands.
The patient must be taken to the clinic as soon as possible for further medical treatment.

If arterial bleeding occurs on the feet or hands, a tourniquet is not used. Instead, the damaged area is bandaged tightly and raised above the rest of the limb.

If the carotid, temporal, subclavian and iliac arteries are damaged, it is not possible to apply a conventional tourniquet. Therefore, it is necessary to make a tight tamponade. They take sterile cotton wool, put it deep into the damaged area, make sure that the blood flow has stopped, and then apply a dense layer of bandage on top.

Bleeding is called the outflow of blood from vessels that have been damaged due to injury. In some cases, bleeding is not of a traumatic nature, but corroding blood vessels at the site of an existing painful focus (ulcer, cancer, tuberculosis).

Stopping any bleeding should occur due to an important natural property of blood, which is the main way to stop it - its clotting, which allows clogging the holes in the vessel formed as a result of the wound with a blood clot.

With poor clotting, even after a minor injury, blood loss may be incompatible with human life. The implementation of stopping blood loss in different ways should be used depending on the severity and nature of the hemorrhage.

For this reason, it is important for everyone to remember the basic rules on how to stop venous bleeding, as well as arterial bleeding if it occurs, as well as what types of blood loss exist and how to stop bleeding.

Types of bleeding

The danger of an open wound on the human body, leading to blood loss, exists both at work and in everyday life. If the threat is ignored, infection of the vascular bed and subsequent infection of the body can occur. There are several types of bleeding to stop which different methods are used:

capillary. It is distinguished by a slow and uniform release of blood, which has a scarlet color. With normal clotting, the blood stops on its own.
Venous. It is distinguished by the uniformity of the outpouring of an uninterrupted flow of blood of a dark color.
Arterial. The outflowing jet pulsates in shocks. She has a scarlet color. The volume of blood loss is very large. The danger of arterial bleeding is fatal in cases of damage to large arteries.
mixed type arising from extensive damage. Accompanied by profuse bleeding.

In practice, several types of vessels are often injured at once because they are located very close. For this reason, bleeding is divided into types according to the strength of the jet.:

Weak. The final stop of which occurs during the treatment of the wound.
Strong. Blood flows out of the wound very quickly, so first they achieve its final stop, and only then the wound is treated. A long duration of blood loss can lead to death.

Temporary and permanent ways to stop bleeding

Temporary methods are used in the first minutes of wound formation before the arrival of specialists, as well as during the transportation of the victim. Temporary methods include:

The imposition of a pressure bandage;
Giving a part of the body an elevated position;
Maximum flexion of the joint in order to compress the vessels;
Pressing vessels with fingers;
Applying a tourniquet;
Applying clamps to a bleeding vessel.

Ways to stop bleeding temporarily

In order to properly assist the victim in case of blood loss in an emergency, you need to firmly remember the algorithm necessary action and ways of its implementation, given in the Table below.

Types of external bleeding and first aid methods

View	signs	How to stop bleeding
capillary	Blood flows from superficial vessels in slow drops	To stop it is necessary to treat the wound with hydrogen peroxide. Fast way consists in applying a bandage by any improvised means - a handkerchief, bandage or gauze, observing moderate squeezing of the damaged area. When processing, you can use cotton wool, but do not leave it inside the bandage.
Venous	A deep wound is formed as a result of trauma with a piercing or cutting object. The volume of blood flowing out is large, the color is dark red, while the victim has blanching of the skin	Stopping venous bleeding in case of limb injury is achieved by giving an elevated position. When using this method, the wound is treated with peroxide overlaying a napkin, which is tightly bandaged. If the bleeding is heavy, you will need someone's help to press on the wound or just below it (in case of a limb injury).
Arterial	A deep wound occurs when exposed to piercing, cutting objects. May be chopped. The flowing jet often pulsates, has a scarlet color. The victim turns pale sharply, may lose consciousness.	You can stop the arterial with a bandage, during the preparation of which the bleeding vessel is pressed with your fingers or palm slightly above the wound. For the preparation of harnesses, various materials are used at hand. This method requires accuracy, therefore, a note is necessarily placed under the tourniquet, on which a mark is made about the time of application. The bandage is applied in several layers, allowing the tamponing of the vessels. For wounds in the neck and groin area, the temporary bandage can get very wet, so fingers continue to be kept on the damaged vessels until the doctors arrive.
mixed	It is the result of extensive external damage, accompanied by profuse blood loss.	A temporary stop can be tried in several ways, which were listed above.

With temporary dressing, the use of cold in the form of a heating pad with ice or another object is effective.. The victim is soldered with water to partially compensate for the loss of fluid. A tourniquet is used as the main method for temporarily stopping bleeding.

Photo of stopping different types of bleeding

When applying it, you must follow a number of rules:

More often, a tourniquet is used for arterial bleeding.
The most effective tourniquets when applied to the limb b, having only one bone (shoulder or thigh). When applied to the forearm or lower leg, only the veins are squeezed.
Under the tourniquet, a substrate is required to avoid pinching the skin.
The tourniquet can only be applied to the upper or middle third of the thigh or shoulder to prevent compression of the nerves (sciatic or ulnar).
The maximum tourniquet application period is 2 hours.. In winter, the limb should be additionally insulated to prevent frostbite.
The tourniquet needs to be loosened from time to time, pressing at this moment the vessels with your fingers. In summer, this should be done every hour, in winter - twice as often.
With the correct application of the tourniquet skin turn pale. The tourniquet stops the pulsation of the arteries in the area below.
Use clamp to stop bleeding requiring mandatory transport immobilization followed by a final stop of blood in a hospital.

Can a twist be used instead of a tourniquet? It should be answered in the affirmative. In most cases, only a high-quality bandage is required, while a tourniquet should only be used for arterial bleeding.

Ways to finally stop bleeding

Ways to finally stop bleeding include:

Mechanical.
Thermal.
Chemical.
Biological.

The characteristics of each of them are presented below. Types of bleeding and ways to finally stop them

View	Actions	Indications for use
Mechanical	Ligation of blood vessels, application of vascular sutures, pressure bandages, plugging, use of vascular prostheses (shunts)	Vessel ligation is used for wounds of small and medium-sized vessels, excluding the main ones.
Chemical	The use of drugs that narrow blood vessels and increase blood clotting (adrenaline, ergot preparations, calcium chloride, etc.)	The method is used for internal bleeding, excluding other measures of influence. Used as a necessary aid for uterine bleeding, as well as loss of blood from the lung, stomach
Biological	1. Tampons from animal tissues rich in thrombokinase (omentum, adipose tissue etc.).	The method is used in various situations varying degrees bleeding severity
	2. Local use of blood products (thrombin, hemostatic sponge, etc.).
	3. Blood transfusion with the use of drugs that increase blood clotting (plasma, fibrinogen, platelet mass, etc.) depending on the degree of blood loss.
	4. Entering vitamins (C, K in the form of vikasol), which increase blood clotting.
	5. Intramuscular injection of human or animal blood serum for a hemostatic effect.

Stop bleeding from a small wound in the face or head

When a wound is formed on the skin of the face or head, blood appears on the forehead or from the nose, it can cause quite severe bleeding due to the fact that it is here that many blood vessels close to the surface.

In most cases, such bleeding can be easily eliminated at home, even if it seems very dangerous.

To do this, you need to be well aware of the difference between wounds that are subject to self-treatment, know how to stop them, and those whose treatment requires emergency medical care. Cases requiring emergency assistance include:

Deformities of the skull, the appearance of sunken areas on them, visible fragments of bones or exposure of the brain;
eye injury;
Appearance clear liquid flowing from the nose or ears.

If you need to stop bleeding from a small wound the following rules must be observed:

Wash hands thoroughly with soap and water before handling;
With the help of another person, put on latex gloves. In their absence, you can use a plastic bag or a clean cloth folded in several layers;
Put the victim on his back;
Remove any wound visible objects, but do not try to clean it;
Press firmly on the wound with gauze, a clean cloth, or other clean material. If there is an object left in the wound that cannot be removed, try not to touch it;
For a quarter of an hour, press down on the wound, checking the time by the clock, without lifting the tissue during this period. If the blood has soaked the matter, put on a new one;
If, after 15 minutes of continuous pressure, blood continues to flow, you need to press down the wound for another 15 minutes. This method can be repeated up to 3 times;
In cases of continued bleeding, continue to press down and call an ambulance;
The appearance of anxiety, confusion, signs of fear, shallow and frequent breathing in the victim should be remembered that all of them may indicate the onset state of shock, also life-threatening and requiring emergency medical attention.

Video

Briefly about other types of bleeding and ways to stop it

Pleural bleeding

Occurs with fractures of the ribs, injuries of the chest. The presence of bleeding can be assumed by the following signs:

Increasing pallor;
Acute pain in the chest;
Difficulty breathing.

Ways to stop bleeding are possible only with treatment in a hospital.

Pulmonary bleeding

Blood coming from the pulmonary vessels begins to accumulate in the bronchi, causing a reflex cough. It can be distinguished by its frothy character in the expectorated sputum. Elimination of such bleeding at home is impossible. The main method is hospitalization. Before the doctor arrives,:

Leave the patient in a sitting position;
Give a tablet of Codterpine to relieve cough;
Put cold compress on the chest;
If the patient is ill with tuberculosis, provide rich drinking saline solution(a spoonful of salt in a glass of water);
Mandatory transportation to a medical facility.

Bleeding from the stomach or intestines

Acute bleeding of the internal organs can be caused by an ulcer of the stomach or intestines, in which the decay of the tumor damages the blood vessels.

The outpouring can occur in the form of a dark-colored vomit or appear as liquid stool. The patient should not be given food or drink. On the upper part cold compress should be applied to the abdomen.

Ways to stop bleeding are available only to specialists, so you need to ensure transportation to the hospital.

For injuries and other damage to blood vessels, a temporary method of stopping bleeding is used. The goal is to stabilize the condition of the victim, stop and make it possible to transport the patient to a hospital for medical care.

Types of bleeding and ways to stop

The way to stop bleeding is chosen depending on which vessels are damaged, their location on the body, how quickly blood loss occurs. According to the nature of the damage, there are:

Venous.
Arterial.
Capillary.
Mixed.

Focusing on clinical data, a temporary method of stopping bleeding is used:

Consider the two most common types of life-threatening vascular damage - arterial and venous bleeding.

Signs of arterial bleeding

A tourniquet is the most effective temporary way to stop bleeding from the extremities. But this method is quite traumatic, since it completely stops the blood circulation in the tissues located below the site of application and, if used incorrectly, can lead to serious complications. Therefore, it is necessary to clearly distinguish between arterial and venous bleeding.

When an artery is damaged, the following symptoms are observed.

The color of blood is bright red, scarlet, saturated.
Blood flows out in shocks, which corresponds to heart contractions. When the main artery is damaged, the trickle literally beats with a fountain.
The bleeding is very fast. Without emergency assistance, the victim can get in a few minutes. If the bleeding is not stopped, then death occurs in 5-10 minutes.

How to stop arterial bleeding

There are several techniques, most often they are combined. The fastest temporary way to stop bleeding from an artery is to press the vessel with your finger against the protrusion of the underlying bone above the wound. After that, all the necessary materials are prepared and a tourniquet or twist is applied. These are the most effective ways temporary stop of arterial bleeding on the vessels of the extremities.

If the lateral branch of the main artery is damaged, a pressure bandage may be used.

Pressing the vessel with the fingers

These methods of stopping arterial bleeding are used when the following vessels are damaged:

carotid artery.
Axillary artery.
Brachial artery.

Or, with four fingers of the hand, the vessel is pressed against the protrusion of the bone above the area of damage. There should be no pulse below the pressure point. You need to know the points in advance, having trained on yourself or a partner.

It is important to remember that finger pressure is difficult to maintain for long periods of time. Therefore, after stopping the bleeding, a tourniquet is applied or, in its absence, a twist using improvised means.

Circular compression methods

With this method, all vessels are squeezed soft tissues limbs. The blood supply below the site of application is completely stopped. When applying methods for temporarily stopping external bleeding by circular compression of the limb, it is important to follow the basic rules.

A tourniquet is applied in a strictly defined place, otherwise the nerves of the limb can be damaged. They try to do this as close as possible to the wound, but without touching the damaged tissues.
Do not apply a tourniquet in case of inflammation at the site of application.
Control the duration of the application of the tourniquet. It is no more than 1.5 hours in winter and 2 hours in summer. Attach a note indicating the exact time of application, fixing it on the victim's clothing or directly under the tourniquet.
It is forbidden to cover the tourniquet with clothing or a bandage. It must be visible.
To prevent injury to soft tissues, a bandage, piece of cloth or other soft material is placed under the tourniquet.

Place to apply:

Mid-calf.
Lower third of the forearm.
upper third of the shoulder.
Just below mid-thigh.
Limb root with fixation to the body.

Tourniquet technique

Ways to temporarily stop external bleeding from the arteries of the extremities with the help of a tourniquet are carried out in the following order.

If more than 2 hours have passed since the application, then the tourniquet must be loosened for 15 minutes without removing it from the limb. At this time, the artery is clamped with a finger. The tourniquet is re-applied to a place slightly higher than the previous one and for a shorter period. When the tourniquet is reapplied, the Gersh-Zhorov method can be applied. With this method, a counter stop is placed on the opposite side of the limb - a wooden tire. The circulation is thus partially preserved. The same method is used to apply a tourniquet to the carotid artery. As a counter-stop in the absence of a splint, the victim's hand is used on the opposite side, lifting it up.

In the absence of a standard harness, a rubber tube is used. It is also possible to compress the limb by applying a twist. A strip of durable material, a scarf, a scarf, a trouser belt is applied to the appropriate place, tied and pulled together with a stick until the artery is squeezed and the bleeding stops.

The stick is fixed on the limb with a bandage.

Signs of bleeding from a vein

Methods for temporarily stopping bleeding from a vein are different from those for damage to an artery. Bleeding from a vein is characterized by the following symptoms.

Blood flows out in a steady stream.
The color of blood is dark, cherry.
The intensity of bleeding is less than with damage to the artery, but without assistance in violation of the integrity of large veins, significant blood loss, a drop in blood pressure and death from hypovolemic shock are also possible.

Ways to stop venous bleeding

With extensive damage to the venous vessels of the limb, it is possible to apply a tourniquet according to the same principles as with venous bleeding. In other cases, a pressure bandage is applied or the limb is flexed.

Ways to stop venous bleeding through the use of a pressure bandage:

You can clamp the vein and stop bleeding by applying the limb flexion method. A dense roller of fabric or a bandage is laid in the place of the fold, the limb is bent as much as possible and fixed in this position with a strip of fabric, a belt, a bandage.

Ways to temporarily stop bleeding are used for traumatic damage to arteries and veins. The victim is given first aid, stabilized and transported to a hospital, where surgical methods are used to restore the integrity of blood vessels.