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May 7, 2013
Bleeding is the process of a loss of blood of circulatory system of the person arising as an effect of a number of factors.
Reasons and types
Bleeding — result of disturbances of integrity of vessels because of injuries, purulent fusion of sharp increase of a blood pressure, and also because of atmosphere pressure. Permeability of vessels can increase also owing to impact on an organism of toxins, a sharp vitamin imbalance.
Bleeding at some diseases occurs owing to change of chemical composition of blood. Similar is observed at jaundice, hemophilia, scarlet fever, a scurvy, sepsis, etc.
Types of bleeding are defined depending on where blood gets. At internal bleedings it appears in perigastriums (uterine bleeding, gastric bleeding, etc.), in fabrics (hematomas are formed), and also to be hidden (such bleeding decides only on the help of some methods of research). At outside bleeding blood, respectively, comes to light. If certain reasons of bleeding lead to diffusion impregnation of fabric blood, then the speech already goes about hemorrhage.
Treatment of bleedings depends also on other classifications used in medicine. Considering a time factor, the following types of bleedings are defined. Primary — occurs right after emergence of injuries or damages. Early secondary bleeding is shown before in a wound the infection, that is at first after wound developed. As a rule, such bleeding arises owing to pushing out by a blood clot blood-groove when in vessels pressure increases. Late secondary bleeding begins at any time, but how in a wound the infection develops. Such bleeding can become an effect of purulent fusion of blood clot in a vessel which was damaged, or vascular walls. They are dangerous to the patient therefore they demand an immediate stop.
Defining weight of blood loss and the arisen anemia, physicians diagnose four extents of blood loss. If at the first degree the satisfactory condition of the person and deficit of blood no more than 5% is noted, then at the fourth extent of blood loss the condition of the person already becomes close to agonal, and deficit of the circulating blood makes 30% and more.
At the person various symptoms of bleeding depending on its type are shown. Symptoms of arterial bleeding are observed at injury of an artery. Blood is thrown out a stream with a pulsation of it, at the same time blood has bright red color. It is necessary to know that arterial outside bleeding is the strongest, and the acute anemia at it comes very quickly. The victim at the same time very pale, at him the frequent and hard listened pulse, is marked out sharp lowering of blood pressure. Can darken in eyes, there comes the syncope, vomiting and nausea is noted. Owing to air hunger and disturbance of work of the main systems of an organism there can occur the death.
At venous bleeding blood dark, it flows constantly and exactly. If outside bleeding is noted, blood follows from a vein slowly. If large veins are injured, then in view of the complicated blood outflow it follows a stream, however does not pulse. Very little signs of a pulsation connected with the pulse wave transferred from an artery are noted very seldom. The main danger at injury of large veins is a manifestation of an air vascular embolism of heart or brain vessels.
At capillary bleeding it is impossible to observe separate vessels which bleed, and blood at the same time exudes. Its coloring — average between venous and arterial. The person can independently stop capillary bleeding, and it constitutes danger only to people at whom the lowered coagulability of blood to a type of a number of diseases is noted.
At parenchymatous bleeding bleeding of all surface of a wound therefore it is especially difficult to stop it is noted. If the displaced injury of small veins and arteries, and also capillaries of internals is noted (spleens, a liver, kidneys, lungs), then bleeding happens especially long and strong.
The main symptom at all described types of bleedings — acute anemia at strong losses of blood.
And here local symptoms of internal bleeding differ. If the reasons of blood loss lead to accumulation of blood in a head cavity, then at the patient brain prelum symptoms are noted. Symptoms of internal bleeding in a pleural cavity are expressed by an asthma and respiratory noise as there is a squeezing of a lung.
If at the patient hypodermic ruptures of parenchymatous bodies, and also ruptures of uterine tubes, wounds of internals of an abdominal cavity are observed, then blood collects in a peritoneum that causes a number of the symptoms connected with irritation of an abdominal cavity. These are stomach pains, vomiting, nausea, etc.
What symptoms of intra joint bleeding, the patient can even learn partially visually. The volume of the affected joint increases, noted pain its mobility is limited.
Symptoms of an interstitial hematoma depend on that, where exactly it was formed what its size, etc. as a rule, there is a swelling, cyanosis is noted or skin turns pale, grows cold. Severe pain develops. Often hematomas in fabrics develop if there is a damage of the main vessels of hands and legs. Sometimes hematomas squeeze veins and arterial trunks. If treatment was not carried out timely, then in that case there is ischemic gangrene of an extremity.
Besides, internal bleedings can provoke also other states, for example, internal hemorrhoids, stomach ulcer, etc. Timely recognition of such states is necessary, first of all, in order that in time first aid was given at internal bleeding. The most important point in this case is the stop bleeding. What for this purpose needs to be done and what ways of a stop of bleeding to use, depends on its type. If at capillary bleeding it is enough to use liquid for a blood stop, then at arterial the algorithm of behavior differs categorically.
If it is easy to distinguish external bleeding visually, then at hidden or internal a number of methods is applied to confirm or exclude bleeding. If bleeding small, is applied a puncture. Besides, endoscopy and radiological inspection practices. Other methods of research are applied depending on that on bleeding in what body there is a suspicion. Internal bleedings sometimes decide on the help of a tracer technique. If there is a suspicion on intestinal bleedings, the benzidine test which allows to define both gastric, and gastrointestinal bleeding can be applied.
Severe bleeding which leads to sharp lowering of arterial pressure or lowering of hemoglobin on a third of norm can lead to brain desalination. But if blood of people loses slowly, that is for several weeks, his organism manages to adapt to it and at a low indicator of hemoglobin can long function.
If blood streams in a perigastrium, it can squeeze bodies, and also to become the environment for development in it pathogenic microorganisms. Therefore, at internal hemorrhages the probability of an infection considerably increases.
Therefore if adequate first aid at bleedings was not provided, in serious cases everything can come to the end with death owing to anemia of a brain and disturbance of functions of cardiovascular system. First-aid treatment at bleedings is especially important at wounds, sometimes the pre-medical help is capable to save life to the person.
First aid at bleedings
Before to give help, it is important to define what vessels were damaged, being guided by the symptoms described above. If at the victim symptoms of arterial bleeding are observed, then assistance in that case provides crossclamping of a vessel which was damaged, above the damaged place. How to stop a wound, depends on the place of wound. The stop of a loss of blood will occur only when pressing an artery to a bone. If bleeding from a wound on a brush, a forearm, the middle or the lower third of a shoulder is observed, then first aid at arterial bleeding is given by crossclamping of a humeral artery. The pre-medical help at bleeding from wounds in a shoulder joint, in a zone of armpits or under a clavicle appears by pressing of a subclavial or carotid artery. At damages on the lower extremities it is necessary to press a femoral artery.
It is possible to apply different ways of a stop of blood depending on a situation. If necessary to stop a wound it is immediately possible to press fingers an artery to a bone. It is better to press a femoral artery a fist. But this method it is possible to use short time. Further the applying a tourniquet is made. Under a plait cotton wool and napkins from a gauze is enclosed. It needs to be drawn in several rounds. It is necessary to consider that the weak plait can strengthen a loss of blood only. When crossclamping by a plait of a carotid artery under it it is necessary to enclose a bandage hank to interfere with suffocation. It is necessary to consider that it is possible to hold a plait two hours during the summer period and one — in winter. By rules, under a plait it is necessary to put a note where time of its imposing is designated. Further the patient is urgently carried to a hospital, at the same time area where the plait is imposed, has to be open. It is necessary to consider that the applying a tourniquet can have also unpleasant effects. If not to remove it in time, paresis and even anaerobic gangrene can develop.
If at the injured person symptoms of venous bleeding are noted, then first aid in this case consists in applying of cold to the place of defeat, a rearrangement of affected area of a body in sublime situation, and also in overlaying of a compressing bandage. The stop of venous bleeding is very important as the long loss of blood conducts to an air embolism.
Assistance provides the correct way of a stop of blood. For this purpose it is necessary to apply a compressing bandage below a wound. The plait is imposed below as the venous blood goes to heart from peripheral vessels.
The bandage is done of sterile bandage on which the applying a tourniquet is made. If a wound was stopped, but the vein pulsation remains below, so the bandage is made correctly. Ways of a stop of venous bleeding provide also influence by cold. The bubble with ice can be put on a bandage. Later about half an hour the cold for ten minutes cleans up to recover a blood stream in the field of defeat. How to stop a wound at damage of veins it is necessary to solve quickly not to allow considerable blood loss.
If the victim has symptoms of capillary bleeding, then it is not necessary to trifle of a question how to stop a wound. At some people bad coagulability of blood is noted, than hemophilia, sepsis and other diseases is characterized. In that case the stop of blood can be a big problem.
The help at capillary bleeding provides imposing of a compressing bandage. It is possible to impose at first on a wound an absorbable gelatin sponge, and from above already to make a compressing bandage. In the absence of such sponge several sterile napkins from a gauze will approach.
If the extremity is wounded, it needs to be moved to sublime situation. It is possible to put cold. Liquid is whenever possible applied to a bleeding stop which aluminum chloride solution with lidocaine is.
Ways of a stop of bleeding can be combined what symptoms like bleeding would not be observed at the person.
As ways of a final stop of blood four groups of such methods are used: mechanical, chemical, thermal, biological. If bleeding very strong, the combination of several methods is possible. Elimination of acute anemia by hemotransfusion or the special solutions substituting blood is in parallel provided. Also solution of glucose and other solutions is entered. To stop internal bleeding, the decision on carrying out urgent operation is sometimes made.
Nasal bleedings at children
So widespread problem as nasal bleedings at children, also demands the correct actions to avoid big blood loss.
Sometimes bleeding from a nose at children arises spontaneously, and in certain cases it is provoked by injuries. The reasons of this phenomenon — either damage of walls of blood vessels, or the broken coagulability of blood. Most often vessels are damaged if their textures are located very close. Sometimes both night, and day bleedings are provoked by existence in a nose of a foreign body. Adults have to watch whether the kid pushed a small subject in a nose carefully. Frequent bleedings can be result of existence of a tumor in a nose. In most cases such tumors happen high-quality, both their removal and the subsequent treatment allows to get rid of bleedings from a nose. Sometimes to bleedings gives a partition curvature in a nose or pathology of vessels mucous a nose. Blood from a nose can go also at different diseases.
Doctors define treatment taking into account the reasons of nasal bleeding. But parents have to know accurately how to stop a wound and to give first aid at nasal bleeding. The child needs initially to provide inflow of fresh air: to open a window, to undo clothes. The stop of blood will occur quicker if the child breathes through the mouth, but not a nose. From above on a nose it is necessary to put cold, at the same time legs of the kid should be kept in the warm. If bleeding from a nose at the child happens often, then to it appoint vasodilating drops.
At suspicion on existence in a nose of a foreign body independently it is impossible to take it not to put damage. It is necessary to show the child to the specialist urgently.
At plentiful bleeding it is necessary to call "ambulance" urgently. It is important to monitor pulse and breath of the child and it is obligatory to control a situation that the child did not choke with blood.
After bleeding managed to be stopped, it is necessary to grease in a nasal cavity with vaseline that the mucous membrane did not dry up. At least for days it is necessary to protect the kid from exercise stresses.
At regular bleedings it is important to watch that the child had no organism exhaustion, and anemia did not develop. Comprehensive inspection at the doctor in that case is necessary.