Emergency care for arterial bleeding. Providing first aid for all types of bleeding Sequence of actions for radiation arterial bleeding

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

Types of bleeding and their features

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

• arterial;
• Venous;
• Capillary.

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

First aid for arterial and venous bleeding

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

1. Do not wash or in any other way try to decontaminate the wound, do not remove small fragments that have got there;
2. Apply a pressure bandage as follows: directly on the wound, apply a sterile bandage or a clean cloth folded in several layers (it is desirable that the dressing be sterile, if there is none at hand, use any). Put another roller made of fabric on top. Then bandage everything tightly, after which the limb must be placed above the level of the body. If done correctly, the bleeding should stop;
3. If there was nothing at hand that could serve as a dressing, you can try to stop the bleeding by maximum flexion of the joint located above the wound;

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

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

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

First aid for nosebleeds

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

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

First aid for internal bleeding

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

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

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

A situation that entailed a serious injury and caused arterial bleeding requires quick and decisive action, since first aid for bleeding should be provided immediately. Such a case requires special concentration and composure. The life of the victim depends on how clearly first aid is provided for arterial bleeding.

Kinds

• Arterial.
• Venous.
• Capillary.

An artery is a vessel with a dense and strong partition, through which blood flows under great pressure, carrying oxygen from the heart muscle, nourishing the organs and tissues of the body. If this vessel is damaged, the process of rapid blood loss begins. In the process of this kind of blood goes beyond the boundaries of the blood channel. Any injured artery is a deadly threat that occurs in about an hour. If damaged major artery, then the time for assistance is no more than two minutes. This is the most dangerous of all types of bleeding.

A vein is a vessel with a thinner wall. The blood flowing through the veins contains large amounts of carbon dioxide and a small amount of oxygen. The consequence of a deep inflicted cut or wound - which is also fraught with a noticeable loss of blood. The resulting air embolism threatens to block the veins.

Capillaries are small vessels that exchange oxygen and carbon dioxide and are located very close to the surface of the skin. They are very easily injured, leaving abrasions and wounds. their damage does not cause profuse blood loss, but there is a risk of infectious inflammation on damaged surfaces.

Arterial bleeding is easy to distinguish from venous bleeding by several external signs.

The blood flowing through the veins is dark and thick. Arterial blood differs from venous blood in a bright red color and watery composition.

From the damaged aorta, the blood pulsates like a fountain simultaneously with the contraction of the heart muscle, as a result of which blood loss occurs, life-threatening, causing vasoconstriction and loss of consciousness.

If a venous vessel is damaged, then blood flows out of the damaged area arbitrarily and not so quickly. This is what distinguishes arterial bleeding from venous bleeding.

Temporary stop

By the time paramedics arrive, a number of actions must be taken to ensure a temporary stop arterial bleeding.

(arterial) by points:

• When providing first aid for bleeding, you need to remember anatomical features human body. Given that the heart muscle starts the blood flow, the artery must be clamped slightly above the damaged area. The exception is the neck and head area. In this case, the artery is clamped below the damaged area.
• To prevent the artery from slipping, it must be pressed firmly against the bone.
• If the limb is damaged, it is necessary to put the person so that the injury site is located above the level of the heart. This helps reduce the amount of bleeding.
• Small ones are clamped with fingers, and large aortas, passing in the femoral part and abdominal aorta, are clamped with a fist.

Receptions that provide a temporary stop of arterial bleeding:

• Finger clamping of the injured vessel.
• The imposition of a tightening bandage (tourniquet).
• Use of a pressure bandage.

With the help of finger clamping, slight bleeding stops. In this case, the artery is pressed with both hands to the bone for 10-15 minutes. It is applied in the event that it is impossible to use a compressive bandage. This method is effective in preventing blood loss from the injured artery of the head and neck.

A bleeding pressure bandage is used to prevent blood loss from small arteries. To do this, the injured vessel must be pressed with a dense cloth. The wound is tightly bandaged with a dressing.

A tourniquet is the surest method for injuring large arteries passing in the limbs. In the absence of a medical tourniquet, any suitable item is used (belt, bandage, hose, rope).

The tourniquet is applied only to the compress over the wound. We must not forget that in the summer the tourniquet can be applied for no more than 1 hour, and in the winter - no more than half an hour. 10 minutes after the tourniquet is applied, it needs to be slightly loosened. The same should be repeated at intervals of 15 - 20 minutes.

The tourniquet cannot be applied:

• On a third of the thigh (lower region).
• On a third of the shoulder in the middle.
• On a third of the lower leg (upper region).

When providing first aid, it is necessary to remember the rules for stopping blood loss from various arteries.

Injury and bleeding of the brachial artery - the victim's hand must be placed behind the head or raised. Pinch the vessel with the fingers in a circular girth. The armpit should be pressed against the bone with force.

From wounded limbs: lift it up and apply a pressure bandage.

If the iliac or subclavian artery is damaged, then a tight tamponade is made using sterile gauze swabs placed in the wound, and a pack of non-deployed bandages is tightly bandaged over it.

• in the bend of the elbow, you need to put several packs of bandages and squeeze the hand in the joint as tightly as possible. After tightening the tourniquet above the injury at a distance of 5 cm.

First aid for femoral artery:

• using weight force, it is necessary to clamp the aorta, which is located in the inguinal region near the femur. By using thumbs both hands produce force pressure on a point in the groin. With the rest of the fingers, clasp the thigh completely.

• the upper third of the thigh in the inner inguinal zone is very strongly clamped. The top is fixed with a tourniquet.

The carotid artery must be clamped below the scarification site. Pressing is made to the vertebrae on the front surface of the neck on the side of the larynx, then apply a pressure bandage, under which a gauze bandage should be placed. Then a tourniquet is applied, pulled over the hand of the injured person thrown behind the head.

When scarifying the temporal aorta, the vessel is pressed with the thumb against the temporal bone, which is located in front of the auricle.

If the shoulder is damaged, it is necessary to clamp the artery at the bone protrusion with a fist in the armpit and fix the arm tightly pressed to the body.

It is necessary to press the fist to the spine at the level of the navel. Under no circumstances should you let go of your hand.

To stop bleeding from the lower leg, it is necessary to pull the most bent leg to the stomach.

Bleeding is a severe traumatic injury. Among all its types, arterial is considered the most dangerous. After all, untimely or incorrectly provided first aid for arterial bleeding can result in unpleasant consequences for the patient, including death.

There is an opinion that knowledge, as well as practical skills in first aid, should be owned only by medical workers, because this is their direct responsibility. In fact, the duty of every person is to know and be able to apply elementary medical skills in practice. After all, one day it can help save a human life.

With arterial bleeding, first aid should be carried out immediately. After all, blood is lost at a very high speed, and there is practically no time for reflection. In such a situation, a clear algorithm of actions helps, which must be worked out to automatism.

Distinctive signs of arterial bleeding

The classification of bleeding implies its division into three main types:

• arterial,
• venous,
• capillary.

With extensive traumatic injuries, mixed bleeding can be observed, for example, venous and arterial. In addition, any bleeding with respect to where the blood is poured is divided into internal (in the body cavity) and external (into the external environment). First aid for internal bleeding, as well as its diagnosis itself, is carried out exclusively by medical staff. External bleeding is easier to diagnose and can be treated by anyone.

Arterial bleeding occurs due to damage to the arterial trunks - vessels that carry oxygenated blood from the heart cavities to all body tissues. Venous bleeding develops when the integrity of the veins that collect blood saturated with carbon dioxide and carry it to the heart is disrupted. Capillary bleeding occurs due to traumatization of capillaries - small vessels that are directly involved in tissue gas exchange.

With arterial bleeding, the color of the outflowing blood is bright red or scarlet, in contrast to venous bleeding, in which the blood is dark red and it comes out slowly. In the case of arterial injury, blood is released rapidly in a gushing stream. The jet of blood at the same time pulsates, each portion of it comes out synchronously with the pulse and heartbeat. This is explained high pressure in the arteries that come directly from the heart.

With arterial bleeding, if help is not provided in time, the phenomena of hemorrhagic shock quickly increase - a pathological condition due to significant blood loss. It has these symptoms:

• drop in blood pressure;
• increased heart rate;
• pallor and marbling of the skin;
• cyanosis of the extremities;
• respiratory disorders;
• decrease in diuresis;
• severe weakness;
• dizziness;
• cold extremities;
• loss of consciousness.

Attention! The faster a person loses blood, the more pronounced the symptoms of shock, as the body does not have time to compensate for blood loss.

First aid

The most important role in emergency care with bleeding of arterial origin, the time factor plays: for maximum effectiveness, it should be provided no later than 2-3 minutes from the moment the injury was caused. If the matter concerns the main arterial trunks, then it is necessary to stop bleeding from them no later than 1-2 minutes after the injury. Otherwise, the chances of a successful outcome will decrease every second with every milliliter of blood lost.

Important! No matter how critical the conditions are, before helping others, protect yourself first of all - put on rubber gloves from the first-aid kit, and in their absence, minimize contact with blood using improvised items (for example, cellophane).

The algorithm for stopping any arterial bleeding is as follows:

1. Assessment of the type of bleeding.
2. Finger pressure on an artery that is damaged.
3. Applying a tourniquet, applying maximum limb flexion or pressure bandage.
4. The imposition of an aseptic bandage on the wound.

This sequence of actions may vary slightly depending on the characteristics of the damaged anatomical region.

Methods to stop bleeding are temporary and definitive. Temporary arrest of arterial bleeding is used at the stage of the first pre-medical and medical care. The final one is carried out in a hospital and is part of the hospital stage of care. It is worth noting that in some cases, temporary stop measures are enough to completely stop the bleeding.

Finger pressure

This technique should be used as a starting point in helping the wounded. The basic principles of digital compression depend on the anatomical region in which the artery is damaged. General rule says that you need to press the vessel above the site of injury. But if bleeding occurs in the neck or head area, then the vessels are pinched downward from the wound. This is because the arteries in this area go up from the heart.

Attention! Applying any methods to stop bleeding, you need to raise the affected limb up to reduce blood flow to it.

Damaged arterial vessels must be pressed against the bony prominences, as they can slip out, and then the bleeding will resume.

To better remember the method, you can use the 3D mnemonic rule:

• "Push".
• "Ten".
• "Ten".

It means that you need to press the artery by pressing ten fingers of both hands for 10 minutes, after which it is recommended to check if the bleeding has stopped. If it is stopped, and this happens if it is not the main arterial vessel that is damaged, then you can limit yourself to applying a pressure aseptic bandage to the wound.

Because blood pressure in the arteries is very high, it will take a lot of effort to press the vessel and stop the bleeding. Finger pressure is a method of temporarily stopping bleeding, so while one person is pressing the artery, the second should already be looking for a tourniquet and dressing. Time should not be wasted in removing clothing or freeing limbs from it. In parallel, one of the eyewitnesses should immediately call ambulance to provide first aid and transport the victim to the hospital.

The biggest disadvantages of the finger pressure technique are:

• significant pain for the injured;
• physical fatigue of the one who provides emergency assistance.

The speed of execution is considered the most important advantage of temporarily stopping external arterial bleeding using finger pressure.

Maximum fixed limb flexion

In some cases, you can use the maximum flexion of the limbs as a method of temporarily stopping the bleeding from the artery. It should be performed, making sure that the victim does not have a fracture of the injured limb.

A dense roller should be placed in the place of the bend of the limb (popliteal, ulnar and inguinal regions) to compress the damaged artery at maximum flexion

After inserting the roller, the bent arm or leg is fixed to the patient's torso. Such actions are aimed at a temporary cessation of bleeding, and if they are ineffective, one should prepare for the imposition of an arterial tourniquet. The same technique, even when performed correctly, has questionable effectiveness.

Applying a tourniquet for arterial bleeding

Stopping bleeding from an artery by applying a tourniquet refers to a temporary method of stopping bleeding. The task of everyone who helps the victim is to correctly perform the tourniquet technique and ensure the delivery of the wounded to a medical facility.

A tourniquet should be applied only with severe arterial bleeding. In all other cases, you should try to stop the bleeding with digital compression or a pressure bandage. A pressure bandage is made with arterial bleeding from a whole roll of a sterile bandage, which is tightly fixed to the wound surface.

If the rules for applying a tourniquet are violated, sad consequences may occur: necrosis, gangrene, damage to the nerve trunks

This is especially true of the shoulder region, because there is superficially radial nerve. A tourniquet is applied to the middle third of the shoulder only as a last resort. It is better to choose a place higher or lower. One of the available tools can be used as a tourniquet: a wide rope, belt or scarf.

Attention! A homemade tourniquet should not be too thin, because this can cause tissue necrosis.

So how to apply a tourniquet for arterial bleeding, so as not to harm the patient in the future? Remembering a few ground rules you can avoid a lot of mistakes.

The harness overlay algorithm looks like this:

1. Choose a place for applying a tourniquet. It is located above the injury site, but as close as possible to it (the optimal distance is 2-3 cm). We should not forget about injuries to the neck and head - there a tourniquet is used below the wound. In case of damage, the femoral artery is clamped at the level of the middle third of the thigh, and in case of bleeding from the arm, in the upper or lower third of the shoulder.
2. Wrap the selected area with a cloth, gauze or bandage.
3. The limb must be in an elevated position.
4. The tourniquet is stretched and several turns are made around the limb. At the same time, its first turn is done with more, and all subsequent ones - with less effort. In case of damage to large arterial trunks, for example, the femoral artery, it makes sense to apply two tourniquets - one above, the other below.
5. Its ends are tied into a knot or fixed with a special chain or hook.
6. The correct application of the tourniquet is checked: the pulsation of the injured artery below the damage is not palpable, and the bleeding from the wound stops.
7. The exact time the tourniquet was applied is recorded. This can be done on a piece of paper that is inserted under the tourniquet itself, directly on the patient's body near the site of injury or on clothing.
8. An aseptic bandage is applied to the wound.

In case of injuries of the carotid artery, the tourniquet is applied below the injury, while it should not pinch the artery of the same name on the other side. To do this, a tight roller is applied on the side of the injury, while the tourniquet is fixed on the opposite side through the raised arm of the patient and the attached flat board.

Correct application of a tourniquet according to Mikulich in case of injury to the carotid artery

The tourniquet should not be applied too tight, as properly applying a tourniquet means applying minimal pressure to stop bleeding. In this case, the blood supply should be carried out at the expense of the deep arteries and veins, and in no case should it completely stop.

If the tourniquet is applied too tightly, it can lead to necrosis of the limb, followed by amputation.

The time factor is also important here. The maximum tourniquet application time varies depending on the ambient temperature:

• in summer - for 1 hour;
• in winter - for 30 minutes.

If a longer time interval is required to transport the victim to the nearest hospital, the tourniquet is temporarily removed, switching to a 10-minute finger pressure. Then again you need to apply a tourniquet according to the above rules.

In the absence of a special tourniquet, you can use an impromptu twist tourniquet. To form it, you need to take a wide ribbon, scarf or piece of fabric and wrap it around the limb above the wound. The fabric is then tied with a double knot. A small stick is inserted into the gap between the resulting nodes and twisted with rotational movements until the bleeding stops.

Rope and wire cannot be used for twisting.

The stick is fixed with a rope above the place of application of the tourniquet to the limb also with double knots. A note is inserted under the tourniquet indicating the exact time the twist was applied.

Thus, due to the direct threat to life that occurs with arterial bleeding, you need to act very quickly. Briefly described first aid rules will help not to panic, and in an extreme situation, save someone's life.

It is the most dangerous for humans.

Arterial bleeding is the most dangerous for a person. The blood spurts out in a fountain, and in a few minutes the victim loses consciousness. A lethal outcome occurs very quickly if first aid for arterial bleeding was not provided in time. There are several ways to stop blood loss and reduce the risk of developing serious consequences.

This type of lesion can be easily distinguished from venous or capillary by the presence of characteristic signs of arterial hemorrhage:

• blood gushing up, like a fountain;
• its color is not burgundy, but bright scarlet;
• the fountain beats up in accordance with heart rhythms.

In the arteries, the flow is stronger than with the flow of venous blood, so there is a rapid loss of blood. Only emergency care can save a person's life.

artery zones

Arterial vessels run throughout the human body. There are several areas of their location:

• carotid artery;
• temple area;
• area under the upper jaw (neck area);
• a vessel under the clavicle;
• armpit;
• shoulders;
• hips;
• areas under the knees.

Ways to stop arterial bleeding

To stop arterial bleeding and provide first aid, you first need to calm down.

A gushing fountain often causes panic, but you won't be able to take part in stopping the bleeding if you're too nervous.

You can briefly describe the methods and algorithm of actions as follows:

Finger pressure

This method consists in the fact that the person presses the artery in order to slow down the bleeding. This can be done with fingers or a fist (when large arteries are injured). Determine the affected area and slightly lift the part of the body on which the vessel is damaged.

Remember that the pressing time should be 10 minutes. Try pressing with your fingers, but if that doesn't work, use your fist. Arteries are elastic, so they need to be pressed against something solid. Try to rest your finger on the bone to stop the bleeding.

Place your hand just above where the tear occurred. If the cervical artery is torn, then a little lower. The femoral vessels are usually pinched with a fist, as they are larger. If the part under the knees, under the armpits, on the collarbone is damaged, you will need to press harder.

Tourniquet application

The next first aid method for arterial bleeding involves the imposition of a pressure tourniquet that will stop the outflow of blood. In case of hemorrhage, the rules for providing assistance should be as follows:

• use a dense tissue that can compress the artery and twist it;
• apply tissue at a distance of 3 cm from the affected area upwards;
• gradually tighten the tourniquet on the limb on which the hemorrhage occurred. Do this until the bleeding stops completely;
• additionally use a clean cloth treated with a disinfectant solution to prevent infection from entering the wound;
• record the time of dressing. The tourniquet can not be kept for more than half an hour with low temperature air and longer than an hour - in summer;
• if help has not yet arrived, but a lot of time has passed, the tissue is loosened for a while, then tightened again (no longer than 15 minutes). The sequence of actions is repeated until hospitalization. Otherwise, necrosis will begin, and the victim will lose a limb. Additionally, apply a cold compress.

Fixed limb flexion

Another way is a strong flexion of the limb. It is used if for some reason it is impossible to apply a tourniquet or press the edges of the wound. To stop an arterial hemorrhage, a dense roller of tissue is pressed onto the vessel, the limb is bent as much as possible and fixed.

Other emergency methods

Instead of a tourniquet, you can use a pressure bandage made from some clean cloth. Hemostatic drugs are also used, but they are not always at hand.

Arterial bleeding is extremely dangerous guy hemorrhages. In a few minutes, there is a strong loss of blood, a person is at risk of death. If you quickly apply a tourniquet or press down on the vessel, you can save the victim. The medical team does not always have time to quickly get to the scene. Therefore, whether a person survives often depends on whether others have time to react.

Bleeding is commonly understood as a pathological condition when blood leaves the vascular bed into internal organs, natural cavities or out. If a significant amount of blood is lost during this, this can create a serious threat to the life of the victim and even lead to death. This condition requires urgent care.

What is arterial bleeding

Arterial bleeding is a pathological condition caused by a violation of the integrity of the artery wall and the release of blood from the lumen of the vessel to the outside or into one of the cavities of the body. This type of bleeding is the most dangerous for the human body.

Damage can affect any artery in the body. But the most significant violations of the integrity of large arteries are considered:

• aorta (thoracic and abdominal);
• pulmonary trunk;
• external iliac;
• femoral;
• popliteal;
• anterior and posterior tibial;
• dorsal artery of the foot;
• external and internal carotid;
• subclavian;
• axillary;
• brachial;
• ray;
• elbow;
• superficial and deep palmar arches.

There are many large arteries in the human body, damage to any of them is dangerous.

Varieties of hemorrhages

Arterial bleeding is divided into 2 types:

• internal - characterized by the accumulation of flowing biological fluid in organs and cavities, this type is the most dangerous, since it is more difficult to diagnose;
• external bleeding - characterized by the release of blood to the outside.

External bleeding, in turn, is also divided into 2 types:

• explicit - when the blood immediately pours out (for example, with injuries of the limbs);
• hidden - when fluid accumulates in cavities that communicate with the external environment (in the lungs, stomach, intestines, etc.).

According to the duration and intensity of bleeding can be divided into acute and chronic:

• in acute bleeding in a short period (from several minutes to several hours), a large volume of blood is lost, this condition is typical for injuries;
• in chronic bleeding, the biological fluid is poured out little by little over a long time.

Why Arterial Bleeding Occurs

Bleeding can develop as a result of a mechanical violation of the integrity of the wall of a healthy artery or the destruction of a pathologically altered vessel.

The mechanical causes of arterial bleeding include:

• gunshot wounds;
• injuries as a result of exposure to the body of sharp objects;
• open bone fractures;
• thermal or chemical burns;
• bruises.

Photo gallery: traumatic causes of bleeding

Arterial bleeding can result from a gunshot wound
Bleeding occurs when cut with sharp objects
An open bone fracture can cause arterial bleeding
Severe burns can cause bleeding

The factors causing mechanical arterial bleeding can be:

• criminal incidents;
• transport accidents;
• injuries at home or at work;
• falling from a great height.

TO pathological reasons include:

• vascular disease;
• purulent-inflammatory diseases (phlegmon, abscesses, sepsis);
• diseases that are accompanied by a violation of blood clotting;
• liver disease (cirrhosis, hepatitis, tumors);
• heavy infectious lesions(tuberculosis, typhoid fever);
• malignant tumors;
• diseases of internal organs - polyps, hemorrhoids, diabetes, peptic ulcer stomach, etc.

Clinical signs

Arterial bleeding has several characteristic features:

• bright scarlet color of blood;
• high exit speed, blood "spouts";
• more liquid consistency;
• jet pulsation in the same rhythm with heart contractions;
• lack of pulsation in the area below the rupture of the vessel;
• lowering blood pressure and body temperature;
• a sharp deterioration in the general well-being of the victim.

How to distinguish between different types of bleeding

In addition to arterial, bleeding can be venous or capillary. Each type has significant differences from others.

So, when the vein wall is damaged, the blood flows out relatively slowly, it has a dark cherry color. If a large vein is affected, the pulsation does not coincide with the heart rate, but with the respiratory movements chest.

With capillary damage, blood collects on the surface of the body in small drops. The amount of loss in this case is insignificant and, as a rule, does not entail serious consequences.

Arterial, venous and capillary bleeding differ in the color of the blood, its volume and the nature of the flow from the wound.

Symptoms of hidden blood loss

The symptoms of occult bleeding depend on the internal organ damage to the vascular wall occurred. Each of them has its own distinctive features:

Clinical symptoms of internal bleeding

There are common Clinical signs characteristic of all internal hemorrhages:

• increased weakness and drowsiness;
• dry mouth, thirst;
• pallor of the skin and visible mucous membranes;
• a sharp decrease in blood pressure;
• increase in heart rate;
• cold extremities.

With intra-abdominal bleeding, there is pain in the abdomen and tension of the abdominal wall

In addition to general symptoms, local manifestations can also be observed. They depend on which part of the body the hemorrhage occurred.

Table: local signs of internal hemorrhages

Methods for diagnosing internal bleeding

Diagnosis of internal bleeding begins with questioning and examining the patient. In addition to subjective complaints, the following objective data are taken into account:

• when examining the patient, pallor and sharpening of facial features are noted;
• on palpation (palpation) of the abdomen, sharp pain and muscle tension are possible, such signs are inherent in bleeding into the abdominal cavity;
• percussion (tapping) helps to detect dullness of sound in the area of ​​​​blood accumulation;
• during auscultation (listening) of the chest, respiratory noises are not heard in places of accumulation of blood.

In the development of any bleeding, two periods are distinguished: latent, from the moment blood enters the digestive tract, and generalized, manifested by such clear signs blood loss, such as tinnitus, dizziness, weakness, cold sweat, palpitations, drop in blood pressure, fainting. The duration of the first period depends on the rate and volume of bleeding and ranges from several minutes to a day.

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In a general clinical blood test, the following changes can be determined:

• decrease in indicators of erythrocytes and hemoglobin;
• decrease in hematocrit - an indicator of the ratio of the amount of blood plasma and red blood cells.

Instrumental diagnostic methods are assigned taking into account the nature and localization of the pathological process:

• with gastric bleeding, esophagogastroduodenoscopy (examination of the inner wall of the stomach with the help of special optical equipment) can be prescribed;

  Esophagogastroduodenoscopy refers to endoscopic research methods, thanks to special equipment, the doctor can see the lumen of the esophagus and the stomach cavity

• with bleeding from the intestines - colonoscopy, sigmoidoscopy (examination of the intestines using special devices inserted through the rectum);
• bronchoscopy is used to diagnose pulmonary hemorrhage;

  Bronchoscopy helps detect pulmonary hemorrhage

• with bleeding from Bladder diagnostic value has cystoscopy (examination of the bladder cavity);

  Using a cystoscope, the doctor can see bleeding from the bladder

• if blood is poured into closed cavities (thoracic, abdominal, heart sac, pelvic cavities), an x-ray examination is used to determine the horizontal level of fluid in the cavity;
• with the accumulation of blood in the cranial cavity and ventricles of the brain, x-rays are taken and CT scan skulls;
• if bleeding into the abdominal cavity is suspected, exploratory laparoscopy may be indicated.

Measures of first aid

A person who has started arterial bleeding needs help immediately. At the same time, it is necessary to call an emergency team or organize the delivery of the victim to a medical facility.

The author happened to examine a patient who was injured at work - cut wound anterior abdominal wall. The victim was put on a tight pressure bandage of cotton wool and a bandage and taken to a surgical hospital, where the doctor performed suturing of damaged vessels and soft tissues.

First of all, you need to look at the patient and determine the place of bleeding. If possible, free the wound area from clothing. Stopping external bleeding from an artery can be done in several ways:

• finger pressure;
• tourniquet;
• tight tamponade.

Finger pressure

Finger pressure on the damaged artery allows you to stop the blood for a while. Before performing such a manipulation, it is advisable to wash and disinfect your hands in order to prevent infection from entering the wound. But if a large vessel is damaged and there is a real threat to the life of the victim, this rule can be neglected.

You can hold the injured artery with your finger for 10 minutes until the ambulance arrives or a tourniquet is applied. The places of pressure of different arteries are shown in the table and diagram.

Table: where the arteries are pressed during bleeding

Finger pressure on the artery allows you to stop the blood while waiting for the ambulance

Video: rules for finger pressure of arteries

Tourniquet application

To combat external bleeding, special tourniquets are used. But such a device may not be at hand. In this case, you can use any improvised means:

• belt
• tie;
• a folded piece of any fabric;
• scarf;
• scarf.

You can not use a wire, fishing line or thin rope to stop the blood instead of a tourniquet - this can further damage the skin and injure soft tissues.

Photo gallery: types of medical hemostatic tourniquets

Esmarch's tourniquet is a dense rubber strip
Hemostatic tourniquet Venus is produced in the form of a hollow rubber tube
A tourniquet to stop bleeding can be made of dense matter.

General rules for applying a tourniquet:

1. The device should not be applied to bare skin. Be sure to put it under soft tissue. You can fasten the tourniquet over clothing.
2. The tourniquet should be fixed 3–5 cm above the wound.
3. If the tourniquet is fixed correctly, there is no pulse on the damaged vessel below the application site.
4. In the summer, the tourniquet needs to be loosened a little every 45-60 minutes, in winter it needs to be done every 30 minutes.
5. The total duration of the tourniquet application should not exceed 2 hours.
6. In order to prevent the time being exceeded, a note is attached to the clothes of the wounded, in which the exact time the tourniquet was applied is recorded.
7. The wounded limb is tied up with a scarf or fixed with a splint.

After the tourniquet is applied, a note is attached to it indicating the exact time.

Of particular difficulty is bleeding from the common carotid artery. In this case, it is important not to compress the paired vessel on the opposite side. To do this, raise your hand high on the healthy side. You can use an impromptu tire (stick, piece of thick cardboard).

Between the skin and the tire, a roll of gauze or soft fabric must be laid.

To apply a tourniquet on the carotid artery on the healthy side, raise the victim's hand or put a stick

Video: stopping bleeding with a tourniquet

Tamponade of the wound

This method is used when it is not possible to apply a tourniquet. For tamponade you will need:

• bandage;
• cotton wool;
• napkins.

Cotton wool or napkins are folded in several layers and wrapped with a bandage. Press the tampon to the wound and bandage it tightly.

The essence of tamponade is to press the bleeding vessel using sterile materials.

What to do with large blood loss

If a large artery has been injured, blood loss can lead to the death of the victim. To prevent this, along with stopping the bleeding, the following measures are taken:

• Provide fresh air to the wounded.
• It is very important to calm the person so that he does not make unnecessary movements.
• If the temperature allows environment, excess clothing is better to remove.
• The patient is laid on his back, legs are placed on an elevation to ensure blood flow to the center of the body and vital organs.
• The victim can be given water or tea to partially restore fluid loss.

First aid for a patient with internal bleeding

The most important task for internal bleeding is the immediate delivery of the victim to the hospital for medical care. It is imperative to call an ambulance. Before she arrives, there are a few steps you can take:

1. Lay the patient down and keep him calm.
2. Apply ice to the area where bleeding is suspected. It can be the stomach, chest, large joint. Depending on the circumstances, you can use an ice pack, collect snow in a bag, or attach frozen food from the refrigerator.
3. With a sharp decrease in pressure, the patient's legs are raised above chest level by 30–40 cm.
4. Before the arrival of the doctor should control the pulse and respiration.
5. If necessary, you can give the victim to rinse his mouth with clean water or moisten his lips.

In case of internal bleeding, it is necessary to lay the patient down, apply ice to the sore spot and raise the legs 30–40 cm above chest level

• throw the patient's head back;
• independently move the victim and change the position of his body;
• give water to drink or allow food to be taken;
• self-administer any medications, especially painkillers;
• rub or massage the affected area.

Medical care for arterial bleeding

Full assistance and the final stop of blood is produced by doctors in a hospital.

The main goals of medical care are:

• complete cessation of bleeding;
• elimination of rupture of the vascular wall;
• normalization of blood circulation in microcirculation vessels (small arteries, veins and capillaries);
• replacement of the volume of lost blood.

For external bleeding, the following methods of treatment are usually used:

• suturing the wall of the damaged artery;
• tight bandaging of the wound (in case of damage to a small vessel);
• arterial prosthetics (replacement of the damaged area with own tissues or artificial implants).

With internal and hidden bleeding, the patient can be provided with the following medical assistance:

• suturing the damaged vessel, while the injured edges of it are partially excised to speed up healing;
• tamponade of the wound with synthetic or natural materials, often a muscle flap or omentum (folds of the peritoneum) is used for this;
• application of a hemostatic sponge - medication, which is applied to the wound area and very quickly stops the blood;
• electrocoagulation - cauterization of an injured vessel;

Stop bleeding with a hemostatic sponge

Along with surgical methods stop bleeding, the patient is also prescribed medication:

• hemostatic drugs;
• antibiotics to prevent the development of inflammation in the wound;
• saline solutions and blood substitutes to restore the volume of circulating blood.

Forecast and possible consequences

If bleeding began as a result of damage to small vessels, it can be stopped almost immediately. With significant ruptures of the walls of large vessels, bleeding can last several hours. The longer the patient does not receive medical care, the higher the likelihood of complications.

The consequences of arterial bleeding can be:

• hemorrhagic shock is a life-threatening condition that develops due to significant blood loss and is accompanied by impaired consciousness, a sharp decrease in pressure;
• accession of infection and the development of a purulent-inflammatory process in the wound;
• sepsis;
• heart failure;
• ischemic damage to the heart, kidneys, lungs or liver - a pathological condition that occurs when there is insufficient supply of oxygen to the organ;
• hypoxia (oxygen starvation) of the brain;
• the formation of an aneurysm of the vessel - the expansion and thinning of its walls with impaired blood flow in this place;
• compression of accumulated blood (tamponade) of vital organs - the heart, brain, lung;
• formation around the accumulated blood focus of a dense shell with inclusions containing calcium salts (calcification);
• development of adhesions in the abdominal cavity or small pelvis;
• anemia - a disease accompanied by a decrease in hemoglobin levels.

Timely and qualified assistance will help to avoid the development of such complications.

Timely and correctly provided assistance in the event of bleeding from an artery helps to avoid many complications, and in many cases saves a person's life. Since no one is immune from such an injury, it is very important to know the rules of first aid and master the skills of temporarily stopping bleeding. This must be done immediately, even before the arrival of the doctor.