FIRST AID FOR BLEEDING.
As you know, the blood in the human body circulates through the blood vessels: arteries, capillaries and veins, which are found in all organs and tissues. When harmed Denia any organ or human tissue is always to some extent damaged blood vessels.
Going out (expiration) of blood from the blood -bearing vessel called bleeding. The causes of bleeding are extremely diverse. Naibov Lee often a direct injury (prick incision punch, stretching, crushing, etc.). The intensity of the blood flow depends on the amount of damaged blood vessels, their caliber damage character (full break vessel parietal damage, crush injury, etc.) And the type of the damaged vessel (artery, Vienna, capillary). Na Ying intensity of bleeding is also influenced by the level of arte ble pressure, the state of the blood coagulation system. Moreover, matters which pours blood to the outside, a large or small volume closed fifth cavity (pleural, abdominal cavity, the cavity to lennogo joint etc.), Soft tissue (subcutaneous millstands Chatka, muscle and intermuscular spaces).
Receptacles affected atherosclerotic process, may deteriorate with increasing blood PRESSURE Nia, hypertension. Especially dangerous are ruptures of the aortic aneurysm, when all the circulating blood can flow out within a few minutes. Heavy krovotech Nia arise from varicose veins. Most formidable is bleeding from varicose veins food water in portal hypertension ( cirrhosis ). Once Rushen blood vessel wall can be obuslov Leno inflammatory and ulcerative process or zloka qualitatively tumor.
The cause of bleeding is sometimes a change in the chemical composition of blood, so that it can go through the wall of the vessel, even intact, such a state is observed in a number of diseases:. Des tuhe, sepsis, blood diseases, and others.
TYPES OF BLEEDING.
There are different intensities of bleeding and hang on the type of the damaged blood vessel. Once guish arterial, venous, capillary and parenchymal bleeding.
- Arterial bleeding e – the blood flow chenie from damaged arteries. Pour out the blood is bright red, thrown strong pulsating boiling stream. Arterial bleeding is the most dangerous, usually very intense, and blood loss with it can be large. In case of damage to large arteries, the aorta, blood loss incompatible with life can occur within a few minutes, and the patient dies.
- Venous bleeding occurs when veins are damaged. The pressure in the veins is much lower than in the arteries, therefore, the blood flows slowly equal volumetric and uneven spray. The blood in this blood flow a dark cherry color. Venous bleeding is less intense than arterial bleeding, and therefore is rarely threatening. However, when wounded veins of the neck and chest, there is another deadly Nost. These veins at the time of inhalation occurs negative -negative pressure, so when wound in their lumen at a deep inspiratory air can enter the wound. Air bubbles penetrate from the current of blood in the heart can cause heart and blood vessel blockage – air embolism and cause a lightning -bearing death.
- Capillary bleeding occurs when damage to the smallest blood vessels – ka Pillyar. Such bleeding is observed, for example, with shallow cuts in the skin, abrasions. In normal blood clotting capillary bleeding Terminated schaetsya own.
- Parenchymal bleeding. Ne ry, spleen, kidney and other parenchymal organs have a very developed network of arterial, venous suck rows and capillaries. If the damage these organs Naru creases the integrity of all types of vessels, and there is excessive bleeding, called parenchymal. Since the vessels are encased in body tissue and do not collapse, self -sustaining stop bleeding almost never occurs.
Depending on where the blood poured out of CEMs rezhdennogo vessel bleeding distinguish external and internal.
External bleeding characterized will do blood Niemi directly to a body surface through pa well skin. Bleeding in the lumen of the hollow organ (stomach, intestines, urinary bladder, trachea), communicating with the external environment, called outer Concealed tymi, since the selection of blood out occurs after a certain period of time, sometimes through MULTI to hours.
Internal bleeding observed at penetrate boiling wounds, closed injuries (at rupture of internal organs without damage to the skin resulting from bounce, falls from height, compression), as well as diseases of the internal organs (ulcer, cancer, tuberculosis, aneurysmal blood vessels). When vnut nal bleeding blood enters into any cavity.
Internal bleeding into closed cavity (ple vralnuyu, abdominal, cardiac shirt cavity Th turnip) is especially dangerous. These hidden bleeding occur, their diagnosis is extremely difficult, and they can not be recognized if not careful observation Denia for the sick.
In the pleural or abdominal cavity, all the blood circulating in the body can easily fit, so such bleeding is often the cause of death.
In some cases, bleeding may become a danger nym not because of the amount of extravasated blood, and as a result of the fact that blood is shed causing compression of vital organs. Thus, accumulation of blood in serdech Noah chemise can lead to compression of the heart (Tampa nada) and its stop, and in the cavity of the skull – compression of the brain and death.
Significant loss of blood available at a hemorrhage in the interstitial space of tissue (mouse gical, adipose tissue). In this form the so- Vai hematoma, bruising.
Bleeding dangerous because with decreasing Included Quantity ARISING circulating blood deteriorates activity of the heart is disturbed oxygen supply to vital organs – the brain, kidneys, and liver. This causes a sharp change in all metabolic processes in the body, which accelerates the development of terminal conditions.
FIRST AID FOR EXTERNAL BLEEDING.
In conditions of first aid, only a temporary or preliminary stop of bleeding is possible for the period necessary for the delivery of the victim to a medical institution.
To stop bleeding time methods otno syatsya:
- imparting the damaged portion of the body is elevated Nogo position relative to the torso;
- pressing a bleeding vessel at the site of injury with a pressure bandage;
- compression of the artery throughout;
- stopping bleeding by fixing the limb in the position of maximum flexion or extension in the joint;
- circular compression of the limb with a tourniquet;
- wasps SETTING bleeding overlay clip on the blood flow chaschy vessel in the wound.
By apillary bleeding, it is easy to stop by applying a conventional dressing to the wound.
To reduce bleeding during cookin Nia dressing sufficiently raise harmed -degenerate limb above the level of the trunk. The inflow of blood to the limb decreases sharply decreases division in vessels that provides rapid education of a blood clot in a wound, closing the vessel and cessation of bleeding.
When venous bleeding reliable BPE meline stop bleeding carried etsya imposition of a pressure bandage.
Over the wound lay several layers of gauze, a dense ball of cotton wool bandage tightly. Blood vessels squeezed by the bandage quickly clot, so this method of temporarily stopping bleeding can become final. With severe venous bleeding during the preparation of the pressure dressing, vein bleeding can be temporarily stopped by pressing the bleeding wound with your fingers. If a limb is injured, bleeding can be significantly reduced by lifting it up.
Arterial bleeding from small arteries can be successfully stop when on a pressure bandage power. When bleeding from a large artery, to stop bleeding immediately, use the method of pressing the artery in the wound with your fingers for the period of preparation of the funds necessary for a more reliable way to stop bleeding. Varieties of stopping bleeding in a wound are the application of a hemostatic clamp on a gaping blood vessel and a tight wound tamponade with a sterile cloth, bandage, etc. The applied clamp must be firmly fixed and ensure its immobility during the period of transportation of the victim.
For emergency stop arterial bleeding, widely used method of pressing arteries Length Research Institute. This method is based on the fact that some of the artery is easily accessible to palpation and can be completely blocked by pressure them to the underlying bone Obra mations.
A prolonged stop of bleeding by finger pressing of an artery is impossible, since it requires great physical strength; it is tedious to turn out to vayuschego assistance and virtually eliminates the possibility of transporting the victim to the hospital. A method for providing hemostasis, do not infect conductive wound and allowing more time to prigotov Lenia everything you need for a more convenient way to stop bleeding: the imposition of a pressure bandage, twist, plait. Press the artery may be pain PWM finger, palm, fist. The femoral and brachial arteries can be pressed especially easily, and it is more difficult to press the carotid and especially subclavian arteries.
Pressing the arteries by fixing the limbs in a certain position is used during transportation of the patient to the hospital. If the subclavian artery is injured, bleeding can be stopped if the arms bent at the elbows are pulled back as much as possible and firmly fixed at the level of the elbow joints. Under the knee artery can pinch the fixing foot with maximum flexion of the knee. Hips naya artery can be clamped to instill maximum deniem thigh to the abdomen. Brachial artery in the Lok tevogo joint fails to block the maximum bending Niemi arm at the elbow. This technique is more effective if a gauze or cotton swab is placed in the limb flexion zone.
Reliably stops krovotech of a circular from the arteries stiff shove drawing in the limbs , providing survive the term of all vessels above the wound site. This is most easily done with a special rubber band.
Technique for applying a tourniquet.
A tow is an elastic rubber tube or strip, the ends koto swarm chain attached hook and used for fastening the harness. As you can harness uses Vat any solid rubber tube.
For a tourniquet on the upper limb Naib a more convenient place is the upper third of the shoulder to the bottom – the middle third of the thigh.
The application of a tourniquet is indicated only with severe bleeding from the arteries of the limbs , in all other cases it is not recommended to be used.
In order to prevent infringements of the skin under the tourniquet enclose a towel, clothing, wounded, and so on.. Of course a few raised toil up the harness is supplied under the limb, stretch and wrap several times around the limb to Terminated bleeding scheniya. Tours harness should lie down next to each other, not to infringe Laa skin. Most tight should be the first round, the second is applied to the Men PWM tension, and the remaining nye – minimum. Con tzu harness fixed at for power chains and hooks on top of all the tours. Tissues should be compressed only until the bleeding stops.
When properly tourniquet arterial bleeding stops immediately limb Bled neet, pulsation vessels below the tourniquet Terminated schaetsya.
Excessive tightening of the harness can cause just soft tissue mozzhenie Loose harness bleeding does not stop, and conversely the mouth, creates a venous stasis (no limb pale, and acquires a bluish color) and enhances venous bleeding. After applying the tourniquet, immobilization of the limb should be carried out.
Errors when applying the tourniquet are:
- lack of evidence, i.e. its imposition with venous and capillary bleeding,
- laying on a naked body and far from the wound,
- weak or excessive tightening
- poor fastening of the ends of the harness.
Counter indication for the use of a tourniquet is an inflammatory process in place a tourniquet.
The tow can be applied to limbs not more than 1 1 / 2-2 hours. Continued squeezing of vessels at leads to necrosis of the entire limb. In this regard, it is strictly forbidden over the harness impose povyaz ki, scarves. The tourniquet should lie so that it is striking. Within 2 hours of the tourniquet should take all measures to ensure that the victim to deliver in a hospital for the final stop KRO votecheniya. If the final stop bleeding for some reason is delayed, you need 10-15 minutes to remove the wiring (arterial bleeding at this time warning finger pressing of arte Rhee) and apply again slightly higher or lower. Sometimes it is necessary to do this several times (in winter every half hour, in the summer in an hour). To monitor the duration of tourniquet in a timely manner to remove it or make a weakening, a tourniquet or clothing Build gave attach a note indicating the date and time (hour and minutes) of a tourniquet. Typical places nalo zheniya harness for bleeding from various arteries need to know everyone who has first aid.
In the absence of a special harness circular peret drawing in extremities can be accomplished by a rubber tube, belt, scarf, piece of cloth. It must be remembered that the rough hard objects, you can easily call the nerve damage.
Circular tug of limb by twisting auxiliary tools.
The item used to spin is loosely tied at the desired level. A stick or board is drawn into the formed loop and, rotating it, twist the loop until the bleeding stops completely, after which the stick is fixed to the limb.
Applying a twist is a rather painful procedure, so you need to put something under the twist, especially under the knot. All errors, dangers and complications observed when applying the tourniquet fully apply to the twist.
FIRST AID FOR SOME EXTERNAL AND INTERNAL BLEEDING
Bleeding can occur not only when the wound research institutes, but also as a result of diseases and blunt trauma.
Nose bleed. Bleeding from the nose can sometimes be significant and require emergency care. The causes of nosebleeds are varied. Bleeding arise as a result of local changes Nij (trauma, scratching, ulceration of the nasal septum, with strong prefecture blowing nose, skull fracture), and for different diseases: blood diseases, heart diseases, infectious tional diseases (scarlet fever, influenza, etc…) , hyper tonic disease. With nosebleeds, blood enters not only through the nasal openings, but also into the pharynx and oral cavity. This causes a cough, often vomiting. The patient becomes restless, which increases bleeding.
The carer should first of all eliminate all causes that increase bleeding. It is necessary to reassure the patient, to convince him that sudden movements, coughing, talking, blowing his nose, tension increase the bleeding.
The patient must sit give it position in which the less opportunity for blood flow into the nasopharynx, put on the nose and nose ice pack wrapped in a napkin snow ball, smo chenny cold water handkerchief, bandage, a ball of cotton wool. In addition to local effects It is necessary to ensure a sufficient flow of fresh air; if bleeding has arisen from overheating, transfer the patient to a shadow, apply cold compresses to the head, chest.
If the bleeding does not stop, you can try camping stop him strong pressing of both halves of the nose to the nasal septum. In this case, the patient’s head is tilted somewhat forward and possibly higher, the nose is compressed with force. The patient should breathe through the mouth. Contractive mother nose needed for 3-5 minutes or more. The blood of the fallen in the mouth, the patient should be spit out.
Instead of pressing, you can swab the nasal passages with a dry cotton ball or cotton ball moistened with a solution of hydrogen peroxide. Cotton balls are inserted into the nasal passages, the patient’s head is tilted forward. On cotton, blood coagulates quite quickly and bleeding stops. Usually, these measures can stop bleeding; otherwise, the patient must be taken to the hospital immediately.
Bleeding after tooth extraction.
Significant bleeding may occur after tooth extraction. They stop it by filling the defect in the gum with a ball of cotton and tightly pressing it with teeth.
Bleeding with damage to the ear canal and internal structures of the ear (shock, scratches, fracture of the skull bones). It is stopped by introducing gauze folded in the form of a funnel into the external auditory canal, which is held with a gauze bandage on the ear.
Pulmonary hemorrhage. When lung injury (severe blow to the chest, broken ribs), a number of diseases of the heart and lungs (tuberculosis, cancer, lung abscess, mit -sectoral heart disease, and others.) May develop pulmonary hemorrhage. In a patient with sputum and coughing begins to stand scarlet foamy blood – the blood of Harkany. Sometimes pulmonary hemorrhages are very strong.
When blood appears in the sputum of the patient, it is necessary to free from clothing that makes breathing difficult, immediately give a semi-sitting position. If possible, the patient should be reassured, convinced that he needs complete rest for treatment. In the room where the patient is, there should be a lot of fresh air. Lock the patient schayut move, talk, it is recommended to breathe deeply and hold back a cough. It is advisable to put an ice bubble on the chest. Of the medicines, cough tablets are prescribed.
Any pulmonary hemorrhage – thunderstorms ny symptom of any of the heavy bolevaniya , so the first task is to help Xia speedy delivery of the patient to a medical establi denie. Patients with pulmonary bleeding excessively Chuv and void to the carriage. Delivery of such patients from home to hospital should be a special nym medical transport in a semi-sitting position, it is necessary to be very careful to avoid shaking and sudden movements that can enhance coughing and bleeding.
Bleeding into the chest cavity. Upon impact in the chest, rib fractures and certain lung diseases cart are possible damage to vessels and the filling of one or both pleural cavities blood. Accumulating blood compresses the lungs, which causes a disturbance of respiratory Niya. Due to blood loss and turning off the lung from the act of breathing, the patient’s condition worsens rapidly: breathing becomes quicker and more difficult, the skin becomes pale, with a bluish tinge.
The patient to be transported to the emergency le chebnoe institution. Help is to give pain Nome semi-sitting position. By thorax applied my dyval ice pack.
Bleeding into the cavity of the stomach and intestines is a complication of a number of diseases ( peptic ulcer, stomach cancer, varicose veins of the esophagus, etc.) and injuries (foreign body, burn, etc.). It may be significant and lead to death. Gastric bleeding symptoms along with symptoms common acute anemia (Bled NOSTA, weakness, sweats) are hematemesis or vomiting color content of coffee grounds, loose stools, and stool staining black (tarry feces).
To improve the condition of the patient and reduce KRO votecheniya need to create a patient rest, give it a horizontal position on the stomach to put the ice pack, completely ban eating and liquid.
The main objective of first aid – organization Nemedia lennoy delivery of the patient to hospital. Pain GOVERNMENTAL with gastrointestinal bleeding need trans port in the supine position with a raised foot end of the stretcher – it warns of brain bleeding.
Bleeding in the abdominal cavity.
It occurs when the sing abdominal trauma, most often due to rupture ne Cheney spleen. The cause of intra-abdominal bleeding may be some diseases of the liver and spleen; in women, bleeding is possible as a result of rupture of the fallopian tube during ectopic pregnancy.
Bleeding into the abdominal cavity appears strong GOVERNMENTAL stomach pains. The skin is pale, the pulse is frequent. With significant bleeding, loss of consciousness is possible. The patient should be laid down, an ice bladder placed on his stomach, the ingestion of food and water is prohibited. Such patients should be transported immediately in the patient’s zu in the supine position.
Developed with significant by Tere blood. Patients endure blood loss in different ways. The most sensitive to blood loss are children and the elderly. Can not tolerate blood loss long bolevshie, of lodnye, tired, people are in a state of fear.
An adult can almost not feel the loss of 300-400 ml of blood, and for a child this blood loss will be fatal. Simultaneous blood loss (2-2.5 L) is fatal.
Loss of 1 to 1.5 liters of blood is very dangerous and manifests the development of severe penalties slime acute anemia, expresses strong blood circulation and the development of sour native starvation. A similar condition can develop with relatively little blood loss, but it happened very quickly. The severity of the patient’s condition is judged not only by the amount of spilled blood, but also by the level of blood pressure.
Symptoms of acute anemia are very characteristic and do not depend on whether the patient has external or internal bleeding. The patient complains of the growing conductive weakness, dizziness, ringing in the ears, darkening and flickering flies in his eyes, thirst, nausea, vomiting. Leather nye integument and visible mucous membranes become pale, his features sharpened. The patient lethargic, sometimes, on the contrary, nervous, rapid breathing, weak pulse of filling or not is determined, arterial pressure was low. In the future, as a result of blood loss, a loss of consciousness due to bleeding of the brain can be observed, the pulse disappears, the pressure is not determined, convulsions, involuntary separation of feces and urine appear. If emergency measures are not taken, death occurs.
When a large blood loss and low pressure of the blood flow chenie may cease; nevertheless, when providing first aid, it is necessary to apply a pressure dressing on the wound, and then start conducting anti-shock measures. The victim should be placed on a flat surface to prevent brain anemia. With significant blood loss that caused a faint, the shock of the patient (wounded) is placed in a position in which the head is below the body.
In some cases it is useful to make “samoperelivanie blood”: recumbent wounded up all course STI, thus achieving a temporary increase in the number of circulating blood in the lungs, brain, kidneys and other vital organs. When stored consciousness and absence of the abdominal cavity of the patient can be damaged by hot drink tea mine tral or, if it does not, plain water.
When the terminal states of cardiac arrest and carry out recovery. The main method of treatment of acute anemia is an urgent transfusion of donor blood , so suffered Sheha is necessary as it is possible to deliver in the hospital faster. When transporting a special ambulance blood transfusion can be produced but also in the car, since such machines have a stock of blood.