Types of bleeding and first aid

What is bleeding?

Bleeding is the loss of blood that occurs due to damage to blood vessels. The integrity of blood vessels can be compromised by injury, purulent melting, increased blood pressure, and the action of toxins. Changes in blood chemistry can also cause bleeding. It is provoked by a wide range of diseases: sepsis, scarlet fever, hemophilia, jaundice, scurvy, etc.

When bleeding occurs in a body cavity (abdominal, pleural), it is called internal. Bleeding into tissue is called a hematoma. If any tissue is diffusely saturated with blood, we speak of hemorrhage (in the subcutaneous tissue, brain tissue, etc.)

There are several general classifications of bleeding.

According to the time of bleeding, there can be:

primary (occur immediately after injury or tissue damage);
early secondary (occurs a few hours or after injury, before infection enters the wound);
late secondary (begin after the development of infection in the wound).

Depending on the severity and loss of blood, bleeding occurs:

first degree (loss of circulating blood no more than 5%);
second degree (loss of circulating blood about 15%);
third degree (loss of circulating blood about 30%);
fourth degree (loss of circulating blood more than 30%).

How do blood vessels bleed?

Bleeding can be mild, moderate or severe. His character may be:

arterial - strong, jet;
venous - blood loss occurs gradually;
capillary - minor discharge due to damage to small vessels.

The problem itself can be stable/unstable, recurrent. Vessels of the mucosa, submucosal and intermuscular plexus, as well as those located outside the gastrointestinal tract, can bleed.

The expiration can last for several hours or days. In medicine there are:

profuse blood loss - the patient loses more than 1 liter of blood in 1-3 hours and needs urgent medical attention;
acute - less than 1 liter expires in 1-2 days, the patient’s vital signs are relatively stable;
chronic - develops slowly, often over several weeks or even months, the intensity of symptoms gradually increases.

Symptoms of bleeding

Symptoms of bleeding depend on its type and the type of damaged vessels.

Arterial bleeding occurs when the arteries (carotid, femoral, axillary, etc.) are damaged. It is the most dangerous, since the blood is released very quickly, in a pulsating stream. Acute anemia quickly sets in; the color of blood is bright scarlet. The victim becomes pale, his pulse increases, blood pressure quickly decreases, dizziness, nausea and vomiting, and fainting appear. Death can occur due to oxygen deprivation or cardiac arrest.

Venous bleeding occurs when the integrity of the veins is damaged. The blood flows in a uniform, continuous stream and is dark cherry in color. If the intravenous pressure is not too high, the blood may stop spontaneously: a fixed clot will form. But bleeding leads to shock phenomena in the body, which often leads to death.

Capillary bleeding is the least dangerous and stops on its own. Blood oozes from the wound, no damaged vessels are visible. Capillary bleeding is dangerous only in diseases that affect blood clotting (hemophilia, sepsis, hepatitis).

Parenchymal bleeding occurs when all blood vessels in the wound area are damaged. It is dangerous, usually very strong and long-lasting.

Also, symptoms of bleeding may depend on the location of the wound. If bleeding occurs inside the skull, the brain is compressed, and a pressing sensation appears in the head, especially in the temporal part. Pleural bleeding (hemothorax) leads to compression of the lung and shortness of breath. Ruptures of the abdominal organs cause the accumulation of blood in it (hemoperitoneum): a person experiences abdominal pain, nausea and vomiting. Bleeding into the cavity of the cardiac membrane causes a decrease in cardiac activity and cyanosis; venous pressure is increased.

When bleeding occurs inside a joint, its volume increases. When palpating the joint or moving, a person feels severe pain. Interstitial hematoma is characterized by swelling, pain on palpation, and severe pallor of the skin. If treatment is not carried out in time, the hematoma will compress the veins, which can lead to the development of gangrene of the limb.

Forecast

Controversial. Depends on the situation. There are two main factors. This is the degree of the disorder (its severity), as well as the moment of initiation of therapy. With timely treatment, if the disorder is relatively harmless, there is every chance of full recovery.

Internal bleeding is a life-threatening process that is not always obvious at first glance. Without proper correction, it is often fatal.

Specialists eliminate the causes of the anomaly using surgical methods. Medication methods are also used. The forecasts remain vague. When assessing prospects, you need to proceed from the situation.

Arterial bleeding and first aid

Arterial bleeding is one of the most dangerous bleedings, posing a direct threat to human life. This is primarily due to the fact that blood loss is high and intense. Therefore, it is important to know its main signs and first aid rules.

Arteries are blood vessels; blood circulates through them and is delivered to all vital organs. If an artery is damaged as a result of any traumatic factor, then blood begins to flow out of it. It is not difficult to understand that arterial bleeding; it is characterized by such signs as: the blood is bright scarlet, its consistency is liquid, it does not flow out of the wound, but flows out in a powerful stream, similar to a stream in a fountain. There is always a pulsation that occurs in time with the contraction of the heart muscle. Since blood comes out very quickly, a person may experience vasospasm and loss of consciousness.

First aid algorithm for arterial bleeding

First aid rules will vary depending on where the injury is located and which artery was damaged:

First of all, it is necessary to apply a tourniquet that will prevent blood loss. Before fixing it, it is important to press the injured artery to the bone, above the place where the blood is leaking. If the shoulder is wounded, the fist is placed in the armpit, and the arm is pressed against the body; if the forearm is wounded, place any suitable-sized object in the elbow crease and bend the arm as strongly as possible in this joint. If the thigh is wounded, the artery is pinched with a fist in the groin area; if the lower leg is wounded, a corresponding object is placed in the popliteal area and the leg is bent at the joint.
The limb should be raised and a cloth should be placed under the tourniquet. When there is no rubber band at hand, it can be replaced with an ordinary bandage or strip of fabric. For a tighter fixation, you can use a regular stick.
It is important not to leave the tourniquet on the limb too long; it must be removed after 1 – 1.5 hours, depending on the time of year. It is best to record the time of its application on paper and place it under the bandage. This must be done to prevent tissue death and amputation of the limb.
When the time for wearing the tourniquet has expired and the victim is not hospitalized, it is necessary to loosen it for a few minutes. In this case, the wound should be closed with your hands using a clean cloth.
Deliver the victim to a medical facility as quickly as possible, where he will receive qualified assistance.

The rules for assistance in the event of arterial bleeding from the feet and hands differ. In this case, there is no need to apply a tourniquet. It is enough to bandage the injured area and raise it higher.

When arteries such as the subclavian, iliac, carotid or temporal are injured, the blood is stopped using tight wound tamponade. To do this, either sterile cotton wool or sterile napkins are placed in the damaged area, then a layer of bandage is placed on top and wrapped tightly.

Read more: First aid for arterial bleeding

Venous bleeding and first aid

Venous bleeding is characterized by the effusion of blood from the veins as a result of their damage. Veins carry blood to the heart from capillaries that supply organs and tissues.

To understand that a person has venous bleeding, you need to focus on the following signs: the blood is dark red or cherry in color. It does not pour out like a fountain, but flows out of the wound slowly and fairly evenly. Even if large veins have been injured and the bleeding is profuse, there is still no pulsation observed. If it does exist, it will be slightly perceptible, which is explained by the irradiation of impulses from a nearby artery.

Venous bleeding is no less dangerous than arterial bleeding. In this case, a person may die not only due to excessive blood loss, but also due to the absorption of air through the veins and its delivery to the heart muscle. Air entrapment occurs when inhaling during injury to a large vein, especially in the neck, and is called an air embolism.

First aid algorithm for venous bleeding

In this case, there is no need to apply a tourniquet and first aid rules boil down to the following:

If a vein of a limb is injured, it must be raised up. This is done to reduce blood flow to the damaged area.
Then you should begin applying a pressure bandage. For this purpose, there is an individual dressing package. If this is not at hand, then a clean napkin or cloth folded several times is applied to the wound, after which it is wrapped on top with a bandage. You need to put a scarf on top of the bandage.
The place where such a bandage is applied is below the site of injury. It is important to apply the bandage tightly and in a circle, otherwise it will only provoke increased blood flow.
The criterion for assessing the correctness of the actions performed is the absence of bleeding and the presence of pulsation below the wound site.
When there is no clean tissue at hand, you should squeeze the injured limb in the joint as tightly as possible, or squeeze the area just below the blood outlet with your fingers.
In any case, the victim should be hospitalized.

Sometimes, if the bleeding is severe, it cannot be stopped with a bandage alone. In this case, it is advisable to use a tourniquet. It is applied below the wound, due to the way blood is delivered to the heart muscle through the veins.

Read more: First aid for venous bleeding

Capillary bleeding and first aid

Capillary bleeding is the most common bleeding. It does not pose a threat to human life, since capillaries are the smallest vessels that penetrate all tissues and organs. It has its own distinctive features. The blood flowing from the capillaries has a bright scarlet color, the discharge is not intense, since the pressure in this case will be minimal, and there is no pulsation at all.

First aid algorithm for capillary bleeding

The rules for providing first aid for capillary bleeding are simple.

In this case, there is no need to apply a tourniquet; it is enough to do the following:

Rinse and disinfect the wound.
The injured area should be tightened tightly, but in such a way as not to disrupt the flow of arterial and venous blood, that is, not too much.
Apply cold to the wound site, which will constrict the blood vessels.

If a person has a superficial wound and no other injuries, then he does not require hospitalization.

Read more: First aid for capillary bleeding

Prohibited actions

What you should absolutely not do:

Give enemas.
Give any medications. It is not safe. The use of medications is impossible; a sharp deterioration in the condition is likely.
Under no circumstances should you heat the affected area. This will lead to the dilation of blood vessels and will cause a sharp increase in the intensity of the outpouring of liquid connective tissue.
Also, you should not move the patient again, so as not to provoke increased bleeding.

Attention:
Self-action in such a serious situation is the best way to ensure death for the patient. Everything must be within the minimums described above.

Parenchymal bleeding and first aid

Parenchymal bleeding is bleeding that occurs in internal organs, which is characterized by heavy blood loss. It can only be stopped through surgery. The organs of the parenchyma include the lungs, liver, kidneys, and spleen. Since their tissue is extremely delicate, even minor traumatization leads to heavy bleeding.

To determine parenchymal bleeding, you need to focus on the following signs: general weakness, dizziness, fainting, pale skin, low pulsation with rapid heartbeat, drop in blood pressure. Depending on which organ was injured or diseased, parenchymal bleeding of the lungs, liver, kidneys, etc. may be suspected.

First aid algorithm for parenchymal bleeding

Since this type of blood loss is life-threatening, you must act quickly:

The victim must be sent to a medical facility as soon as possible. If it is not possible to call an ambulance, then you need to go on your own.
Neither pressure bandages nor the application of tourniquets in this case will have an effect on the amount of blood lost.
Until the medical team arrives, the person needs rest. To do this, you need to lay it in a horizontal position and slightly raise your legs.
Cold should be applied to the area where bleeding is suspected to have occurred. If transportation of the patient to a medical facility is delayed, then you can use such agents as: Vikasol, Etamsylate, Aminocaproic acid.

Only a surgeon can stop parenchymal bleeding. Depending on the nature of the damage, complex sutures will be applied, emobilization and electrocoagulation of blood vessels, suturing of the omentum and other surgical methods will be performed. In some cases, parallel blood transfusions and the use of saline solutions are required.

Further treatment

Combined methods are mainly used.

First of all, it is necessary to eradicate the source of the disorder. This problem is solved by surgical intervention methods.

The vessel and tissues are sutured, and the damaged area is eliminated (if necessary, doctors perform a resection and remove part of the altered structures). Mandatory measures are also taken regarding the consequences of the pathological process.

In parallel, transfusion is necessary to restore lost blood volume and the introduction of saline solutions to correct the balance of electrolytes. The patient's condition is constantly monitored in a hospital setting.

Gastrointestinal bleeding and first aid

Gastrointestinal bleeding deserves special attention, as it is a life-threatening condition. It is important not to miss the first signs of such blood loss and seek help from a specialist in time. Among them are the following: bloody vomiting with brown impurities, the presence of loose bloody stools, pale skin, increased heart rate with low blood pressure, general weakness accompanied by dizziness, and sometimes loss of consciousness.

First aid algorithm for gastrointestinal bleeding

In order to stop gastrointestinal bleeding, the person must be taken to the hospital.

However, first aid will include the following:

A person needs complete peace. To do this, it is best to put him in bed.
A cold heating pad or ice pack should be placed on the abdominal area.
You can chop up some ice and give it to the person in small portions to swallow.
Take the victim to the hospital.

Read more: Causes, symptoms, first aid and diagnosis of gastrointestinal bleeding

Who is at risk?

Basically, diseases that lead to bleeding are observed in adults. Moreover, according to statistics, men are 2 times more likely than women to be diagnosed with problems with the gastrointestinal tract - the stomach, duodenum. As we noted above, ulcerative pathologies hold first place in terms of the number of diseases. The peak age for diseases is 40-45 years.

However, the problem is not limited to adults. The diagnosis associated with ulcerative lesions of the gastrointestinal tract is often made to adolescents who uncontrollably consume junk food and drinks. Cases of the formation of intestinal polyps are also common.

Gastric and intestinal bleeding is increasingly being detected even in newborns. Basically, they are caused by intestinal volvulus. In 3-year-old children, leakage can be caused by the formation of a diaphragmatic hernia, as well as abnormalities in the development of the organs of the lower gastrointestinal tract.