In case of damage to blood vessels of a different nature, it is necessary to stop the blood in time. This is especially true for heavy bleeding, which can be fatal. To avoid large blood loss, it is important to be able to determine the nature of the wound.and right first aid.
Photo 1. Even a small wound needs to be treated. Source: Flickr (Kenga86).
Types of bleeding
Vascular damage that caused bleeding can be associated with injuries as a result of external exposure (traumatic bleeding), or with the destruction of blood vessels from the inside (for example, the growth of a tumor into the wall of a vessel).
In the direction of the outpouring of blood, there are bleeding external and domestic.
According to the type of damaged vessel, they are divided into three groups:
A clear separation of species is of great practical importance, since each of them requires different approaches to providing assistance.
How to stop bleeding
At home, it is very easy to damage the skin, given the arsenal of cutting and piercing objects in the kitchen (knives, graters, nozzles for the combine, hatchets for cutting meat). If such a nuisance happened, then the first thing to do is to assess the depth of tissue damage.
Even when examining a wound, it becomes clear: this is a superficial or deep wound. Each of them requires different measures to stop bleeding.
This means damage in which the integrity of only the skin and the underlying fatty tissue is broken. Large vessels are not injured, blood flows evenly, in small volumes.
Often, such bleeding can be stopped independently without going to the hospital.
- First of all, the wound needs to be carefully rinse with running cold water. This is done to remove both possible tissue contamination and reflex narrowing of small vessels. Already even these manipulations help reduce blood loss. The next step is the treatment of wounds with antiseptics - special solutions that prevent infection of tissues.
- Edges of the wound appropriate processiodine.
- Further superimposed wound dressing. To do this, it is better to use a gauze bandage or special sterile bags (usually found in first-aid kits). If none of this is at hand, any clean cloth (handkerchief, towel) will do.
Note! If after all the actions the blood does not stop within 15 minutes, then the person should be taken to a specialized hospital to provide assistance.
With such damage is high the probability of destruction of large vessels, nerves, tendonssince the wound is much deeper. If assistance is not provided on time, a fatal outcome is possible.
The algorithm of actions is as follows:
- Determine the type of bleeding. Venous - blood flows smoothly; it is dark burgundy in color. When bleeding from arteries, the color of blood is saturated red, it flows out under high pressure (gushes).
- To reduce blood loss, you should pinch vessels in the right place. This should be done immediately, especially with extensive cuts. With venous bleeding, a tourniquet is attached from improvised means below the wound (further from the heart), with arterial bleeding above the site of damage (closer to the heart). A belt, a towel, and a piece of a sheet are suitable for these purposes. Tighten the tourniquet until the blood stops completely.
- Cover the wound with a bandagepossibly sterile.
- In parallel should call an ambulance.
It is important! Remember the time of applying the tourniquet and tell your healthcare provider later. Even better, write down the time on a piece of paper and attach it in a prominent place on the patient's body.
With cuts in children First of all, do not panic. Since the volume of circulating blood in a child is less than in an adult, then with a serious wound, you should act as soon as possible.
Children respond much more to acute blood loss. It should be remembered that the child may be frightened by the sight of his own blood, up to the loss of consciousness. therefore distract the baby anything interesting, try to prevent the wound from falling into his field of vision. If the victim fainted, then do the following:
- lay down horizontally.
- Take the child out if possible to fresh air or open a window.
- Helps energetic trituration ears, cheeks.
Well brings to consciousness swab withammoniacarried to the nose.
What should not be done
- In no case worth it fill the wound with iodine tincture. This will lead to a chemical burn in the wound, and it will be difficult to heal. This rule also applies to a solution of brilliant green, hydrogen peroxide, when it comes to deep damage.
- It is impossible touch wound edges dirty hands.
- If left in a wound cutting objects (a glass fragment stuck, for example), then in no case do not take out them yourself. This leads to repeated trauma to the tissues and increased blood loss.
- Do not remove the bandage soaked in blood, but lay a new layer of dressing on top.
- You can not delay the delivery of the victim to the hospital.
It is important! No need to drink and feed the victim, even with a minimal chance of internal bleeding!
Most of the hemostatic agents have a narrow scope and are not prescribed for small cuts.
An example is the drugs:
- tranexamic acid (appointed only in the postoperative period),
- aminocaproic acid (with a lack of coagulation factors in the body),
- vagotil (mainly used in gynecology).
At home, it is not advisable to use these medicines, they have a lot of contraindications.
Note! The most affordable and safe means is a solution of hydrogen peroxide. When applied to the edges of the wound, it, in addition to the antiseptic effect, also stops the blood. It is especially effective for superficial damage to the skin.
For the treatment of cuts, such preparations are well suited:
- furatsilin (both ready-made solution, and tablets for its preparation),
- diamond greens (brilliant green),
- potassium permanganate solution.
Among the plants there are those that perfectly stop the bleeding:
- Plantain leaf. Indispensable for minor abrasions, scratches. Contains a lot of antibacterial substances, tannins (have an astringent effect).
- Yarrow. For external bleeding, freshly squeezed juice from the leaves of this plant is used. Frozen leaves help to stop blood faster with a small cut, you just need to attach them to the wound.
- Nettle. Fresh gruel will help stop the blood faster and reduce tissue inflammation.
What threatens blood loss
During the Great Patriotic War, a third (and according to some sources, half) of those killed on the battlefield died of blood loss. And in our time, untimely stopping of bleeding is one of the main causes of death in traffic accidents. And there is not so much time left to help. If large arteries are injured - carotid or femoral - a person can die from blood loss within 10-15 minutes.
Blood loss in a volume of up to 500 ml usually does not cause significant disruptions in life, at this stage the compensatory capabilities of the body are enough. But the loss of 1 liter of blood already leads to severe circulatory disorders, and blood loss of 2 liters or more poses a real threat to life. However, these figures are conditional. The severity of the lesion depends on the initial condition of the victim - cold, hunger and fatigue worsen the prognosis. Children and the elderly suffer more loss of blood than young people, men - harder than women. The combination of pain shock and blood loss significantly aggravates the condition of the victim. The speed of blood loss also matters. In case of damage to large vessels, when blood is lost very quickly, death sometimes occurs with the loss of 1 liter of blood or even less, since in such cases the compensatory mechanisms do not have time to turn on.
Methods for stopping bleeding, in turn, are divided into mechanical, chemical and thermal. In addition, there are permanent and temporary stop bleeding. At the prehospital stage, essentially only a temporary stop of bleeding is possible, which involves the provision of further qualified medical care.
Chemical methods at the prehospital stage, only capillary bleeding can be stopped. The meaning of the method is to use substances that enhance blood coagulability - for example, silver, lead. Dangerous razors are a thing of the past, and less often a shaving pencil is used in pharmacies - it contains silver salts, and it stops bleeding from small cuts well. With bleeding abrasions and superficial wounds, a lead lotion is used.
Has a hemostatic property and hydrogen peroxide. Tampons are moistened with it to stop nosebleeds or wound tampons, and capillary bleeding is stopped with its help.
From pharmaceuticals, a collagen hemostatic sponge is also used, it quickly and effectively stops small bleeding.
From my own experience, I’ll also attribute such chemicals as newsprint to chemical means of stopping bleeding. Repeatedly tested - it stops bleeding much better than any other. Previously, I attributed this to the lead of printing ink, but as far as I know, lead has not been used for a long time, and newsprint still helps.
Thermal method used mainly during surgery - this is electrothermocoagulation, cauterization of small vessels during surgery. In community-acquired conditions, in everyday life, we resort to this method when we apply snow to minor injuries or lower our wounded arm into very cold water. You should not abuse it and apply cold for more than 10 minutes, so as not to get, in addition to the wound, blood flow disturbances in small vessels.
The main method for stopping bleeding from large vessels - both temporarily and permanently - is mechanical.
The very first thing that can be done with bleeding is a very simple technique called "elevated position of the limb." If you raise your arm or leg above the level of the heart, then the pressure in the veins will noticeably decrease, and the venous, and even more capillary bleeding will weaken. Unfortunately, with arterial bleeding, this practically does not help. Usually this method is used as a temporary one, especially with self-help - to give yourself time to collect your thoughts and remember what to do next.
A simple and fairly effective way to stop bleeding is a pressure dressing. Outwardly, it looks like an ordinary bandage dressing. The difference is that when it is performed, each turn of the bandage is superimposed with considerable effort, “pulling”. For all its simplicity, this method is quite effective, especially with venous bleeding. But we must remember that applying too tight a pressure bandage can be dangerous. If the limb turns red below the bandage, increases in volume, there is a feeling of fullness and throbbing pain - you need to ease it somewhat.
The most effective and at the same time safe way to stop arterial bleeding is finger pressing. With this method, it is necessary to press an artery with a finger at a pulse point above the site of injury. The temporal artery is pressed over the ear, the carotid - on the neck, the femoral - in the inguinal fold. Sometimes it is possible to squeeze the artery directly in the wound. The main disadvantages of this method are the complexity (it is necessary to press tightly) and the difficulty in transportation. So this method is really used for several minutes - before applying a pressure bandage or tourniquet, for example.
A technique similar to maximum limb flexion is close in mechanism to finger pressing. It is used for injuring the arm below the elbow or leg below the knee. In this case, the limb is strongly bent in the joint and fixed in this position with a bandage. The effectiveness of this technique is increased if a tissue swab is placed in the elbow or popliteal fossa, respectively. Before conducting maximum bending, make sure that there are no fractures.
With deep puncture wounds, you can try to stop the bleeding by tight tamponade. To do this, you must literally fill the bandage into the wound to the entire depth, to the very bottom, and push it into the wound with an effort to create pressure that can stop the blood flow. Dressings over wounds are completely useless in such cases. I once saw a young man bleeding with a stab wound to the subclavian artery. An ambulance paramedic stuck a tampon in the wound, like a cork in a bottle, and blood oozed from under it, completely soaking in a warm jacket.
And finally, the imposition of a tourniquet. For some reason, this is exactly what people remember best after school lessons in anatomy or car courses. Meanwhile, the tourniquet as the least physiological of all methods should be an extreme measure, should be used only if all other methods are ineffective. Of course, if blood spurts from the wound, like water from a faucet, it makes no sense to try to apply a pressure bandage, but in general at the prehospital stage, the tourniquet is imposed unjustifiably often - often incorrectly. Meanwhile, an improperly applied tourniquet is fraught with serious complications, up to paralysis or gangrene of the limb.
There is no need to describe the technique of applying the tourniquet in detail. The tourniquet is a rubber band, which is stretched strongly, the pull is applied 2-3 turns on the limbs above the wound and fixed. In community-acquired conditions, for example, a rubber catheter or a tube from a tonometer can be used as a tourniquet, and in the absence of suitable material, a twist from a bandage, rope or strip of fabric can be made. A tourniquet injures the skin and soft tissues, squeezes nerves and disrupts blood circulation in the affected limb, so the following rules must be well remembered:
- The tourniquet should not be applied to bare skin. If for some reason you can’t put it on clothes, you should put at least a bandage or scarf under it.
- The tourniquet must not be covered with clothing; it must be visible. The fact is that at different stages different people can provide assistance to the victim, and they may simply not know or forget about the tourniquet hidden under a sleeve or leg.
- The tourniquet must not be applied for a long time. Previously, it was believed that the tourniquet can be left for 2 hours (and in winter, in frost, for 1 hour). Now these terms are no longer considered safe. It is strongly discouraged to leave the tourniquet longer than 1 hour. Moreover, every 20-30 minutes it is necessary to weaken it for 5-10 minutes. If bleeding resumes at the time of removing the tourniquet, then for these few minutes you need to use another method (as a rule, finger pressure). If, after removing the tourniquet, bleeding is not noted, then it is not necessary to reapply it. In this case, a pressure dressing should be applied to the wound. Each time the tourniquet is applied, a note should be put under it indicating the exact time so as not to forget when it was applied.
- The harness should not be tightened too much. If the bleeding has stopped, everything should be tightened (or twisted) more strongly. However, an insufficiently tightened tourniquet is dangerous - it can increase bleeding due to the fact that the blood flow through the artery continues, and the venous outflow stops, and the pressure in the vessels becomes higher.
- The tourniquet is not applied to the forearm, hand and lower leg. In these places, blood vessels are located between the bone formations, and it is impossible to compress them with a tourniquet. When injured in these places and the need to use a tourniquet is placed on his shoulder or thigh.
Once, I was faced with a situation when, on a trip, tourists imposed a tourniquet on a wounded man in violation of almost all of these rules. Including the very first - that the tourniquet should be applied in a pinch. From serious complications the guy was saved only by the fact that his friends had not yet dragged him in plainly.
It must be remembered that no matter what method of stopping the bleeding was used, thrombus formation occurs in the body, which should themselves lead to blockage of damaged vessels. In order not to damage the resulting thrombus and not displace it, it is recommended that the wounded limb be immobilized. The most effective in this sense is tire overlay. Ideally, if it is possible to use an inflatable tire, it at the same time will reduce bleeding due to vascular compression. But usually you have to do with an improvised tire from improvised materials. And, of course, the victim should be taken to the doctor. Even if the bleeding has already stopped, monitoring by the surgeon is still necessary. The fact is that once stopped bleeding can resume - these are the so-called secondary bleeding. This occurs due to the destruction or displacement of the thrombus or due to its melting during suppuration of the wound.
And in the end a couple of words about internal bleeding. They are manifested by hemoptysis, bloody vomiting, blood in the stool, bloody discharge from the vagina.It should be remembered that blood under the influence of hydrochloric acid of the stomach turns black, and signs of bleeding can also be black vomiting (the so-called "coffee grounds"), loose black stools. Generally speaking, it is impossible to stop internal bleeding at the prehospital stage. In such cases, you should immediately call an ambulance. And before the doctors arrive, it is necessary to provide the patient with peace, if possible, lay him down. With hemoptysis or bloody vomiting, it is necessary to give the patient to drink very cold water in small sips, to swallow small pieces of ice. You can put ice on the sternum with hemoptysis, in the left hypochondrium with bloody vomiting, in the anus with heavy hemorrhoidal bleeding, on the lower abdomen with vaginal discharge. A belt that is too tight should be loosened.
Many people tend to get scared of the sight of blood. In addition, spilled blood has such a feature - it always seems to be more than it is, 200-300 ml of blood on clothes and on the floor visually give the impression of “bloody puddles”. But if you do not panic, but act clearly and quickly, then in most cases it is not so difficult to help.