Bleeding issues will never lose their relevance. After all, as if medicine has not learned how to deal with them, there will still be unresolved issues in some cases. This is especially important with regard to massive blood loss, in which it is extremely important to instantly recognize specific types of bleeding, which will help to provide the correct help. And although, at first glance, nothing is complicated in this, but even experienced physicians in some critical situations can make mistakes, losing themselves at the sight of a large amount of blood. Therefore, each person is obliged to know what a particular type of bleeding looks like, and how much activity should be provided.
General classification of
The division of bleeding into different species is highly useful in connection with the ease of determining therapeutic tactics at different stages of medical care. Wherever it is found, all doctors know its clear algorithm. This approach minimizes the time consuming and minimizes the amount of blood loss. People who are not connected with medicine should also know the main features and possible types of hemorrhage in order to help themselves or their loved ones if necessary.
The classification is shown in tabular form.
|External bleeding( blood flow with direct contact with the external environment)||Internal bleeding( the bleeding does not have direct contact with the environment)|
| || |
|By the magnitude of blood loss for any bleeding|
The most common type of external bleeding is capillary. There are any traumatic injuries with a violation of the integrity of the skin. They are manifested by a non-intensive uniform flow of blood from the wound due to damage to the capillaries( the smallest vessels of the body).Rarely lead to severe blood loss, as in most cases they stop on their own. There are no difficulties for either diagnosis or treatment. The exception is extensive surface wounds, in which long neglect with medical care can cause a lot of blood loss.
Venous bleeding occurs with superficial and deep wounds of any size, in which the integrity of the subcutaneous or intermuscular veins is impaired. In this case, there is quite a lot of bleeding. Clinical recognition of venous bleeding can include symptoms such as:
- Dark blood;
- Bleeding is very strong by the type of constant flow of blood from the wound;
- Reduces when pressing down the area below the wound.
Venous bleeding is extremely dangerous if medical care is not provided promptly. In this case, in a short time there is massive blood loss, up to a shock state. They rarely stop on their own, so you should not neglect their stopping. The superficial veins bleed less intensively, the damage to the deep veins causes profuse bleeding.
Differences between arterial( a) and venous( b) bleeding
Given the deep occurrence of arteries in tissues, their damage is the least common. The most frequent reasons are knife, gunshot and mine-explosive wounds. In everyday life it can be punctured wounds by thin and narrow objects. Clinically, it is possible to suspect arterial bleeding by such signs:
- Bright red blood;
- Expires in the form of a pulsating jet;
- Very intense;
- Does not decrease with the usual pressing of the wound or tissues above and below it;
- Wound localization corresponds to the projection of the course of large arteries.
Usually, arterial bleeding is very intense and quickly leads to massive blood loss and shock. If there is a complete rupture of the artery, then in just one minute you can lose virtually the entire volume of circulating blood. Therefore, such bleeding requires immediate assistance.
What are the main signs of internal bleeding?
Unlike external bleeding, in which one can not help noticing their symptoms, the internal ones are more insidious. After all, recognizing them is not so easy. Usually they show themselves at a sufficiently large blood loss. Therefore, it is extremely important to know all the possible signs of this dangerous condition. These include:
- General weakness and drowsiness;
- Discomfort or abdominal pain;
- Unmotivated lowering of arterial pressure;
- Frequent pulse;
- Pale skin;
- Appearance of pain in one of the halves of the neck, appearing in the horizontal position and decreasing in the vertical( Vanka-Vstanka symptom).
Occurrence of internal bleeding is preceded by closed or penetrating wounds of the abdomen, lower back, rib fractures, stabbing knife or gunshot injuries. In this case, damage to internal organs occurs, which causes damage to the integrity of blood vessels and bleeding. As a result - the accumulation of blood in the abdominal cavity, chest, impregnating it with a damaged organ or internal fat( hematoma).
Such bleeding may progress at a lightning speed, but may also build up within a few days after the injury. Everything depends on their intensity and the amount of damage to the injured organ. The spleen usually suffers, more rarely the liver. With one-stage break, bleeding occurs immediately, with a two-stage rupture, intraorganic hematoma first appears, which breaks down after a few days, causing an instantaneous weighting of the patient's condition.
If you understand to the end, this type of bleeding can not be classified unambiguously. After all, the blood expires in the lumen of the gastrointestinal tract, but at the same time it contacts the air. But this is not as important as finding the symptoms of such a condition. After all, the life of a patient depends on timeliness. Signs of gastrointestinal bleeding can be considered:
- General weakness and dizziness;
- Frequent pulse and decreased pressure;
- Pale skin;
- Vomiting of blood or brown mass;
- Liquid bloody or thick black feces.
Gastrointestinal bleeding occurs with peptic ulcer, tumorous diseases, various necrotic processes in the mucosa of the digestive tract and some other diseases. Therefore, people who have a similar pathology, must be aware of the possibility of developing bleeding and in case of their occurrence it is necessary to seek medical help.
Training video on first aid for bleeding:
What to do with bleeding
Treatment tactics should be differentiated and depends on the specific type of bleeding. There is a total volume of activities that must be performed for any of its forms. All the specific manipulations are purposeful, since improper rendering of them can harm the patient. To general measures of help with bleeding can be attributed:
- Put the victim in a horizontal position;
- Follow the consciousness, pulse and blood pressure;
- Rinse the bleeding wound with hydrogen peroxide and apply a pressurized clean bandage;
- If possible, apply cold to the source of bleeding;
- To transport the patient to the nearest institution.
The differentiated tactics are presented in the form of a table.
|Type of bleeding||Scope of necessary measures|
|First aid( temporary bleeding stop)||Specialized medical care( final stop of bleeding)|
|Venous|| || |
|Arterial|| ||Sewing or prosthetics of the damaged artery with further stitching of the wound.|
|Internal and gastrointestinal bleeding||General measures for bleeding, typical for the prehospital stage.|| |
Rules for the application of the
harness. The tourniquet should be applied exclusively for arterial bleeding. Its erroneous use for venous bleeding will lead to their amplification. The characteristic of the correct application of the plait:
- It is superimposed on the affected segment not less than 20 cm from the wound. Can be higher. A lower location is only permissible if it is not possible to perform a classical manual;
- A cloth bandage is laid on the skin under the tow;
- As a tourniquet, a special hemostatic tourniquet or improvised materials can be used to replace it;
- The first circular tours of the tourniquet around the limb are less tight. After them, more tight tours should be imposed;
- After a correctly applied tourniquet, the bleeding is reduced. If this did not happen, this indicates either its incorrect application or the absence of evidence for this;
- The allowable length of harness holding on the limb should not exceed 2 hours in summer and 1-1.5 hours in winter;
- If it is impossible to apply the tourniquet( neck injuries, high shoulder and hip wounds), it is replaced by other methods of stopping bleeding: the external finger pressing of the pulsating vessel above the wound or directly in it.
Correct application of a tourniquet as one of the ways to stop arterial bleeding
Only strict observance of algorithms for determining the type of bleeding and step-by-step implementation of therapeutic measures can really effectively help in combating this problem. Remember the general rules and then you can protect yourself and your loved ones from dangerous complications of any bleeding.