Self-help fractures and cuts burns. Summary: Providing first aid for fractures, dislocations, burns, frostbite
First health care with bleeding. Bleeding is the release of blood from a damaged blood vessel. Depending on the type of damaged vessel, bleeding is distinguished arterial, venous and capillary, and from the direction of blood flow, bleeding is divided into external and internal.
With external bleeding, blood is poured into the external environment. Most often, external bleeding occurs with injuries of the upper and lower extremities, neck, head and is not difficult to diagnose.
With internal bleeding, blood accumulates in a cavity, such as the abdominal, thoracic, or cranial cavity. This type of bleeding is dangerous to the life of the victim, as it is difficult to immediately detect. With significant internal bleeding, the victim is pale, he has a sharp weakness, dizziness, drowsiness, darkens in the eyes, cold sweat appears, falls arterial pressure, the pulse becomes frequent, weak filling.
Types of bleeding:
Arterial bleeding is characterized by the outflow of blood of a bright red color, a pulsating jet ("beats with a fountain");
With venous bleeding, blood flows out in an even, more or less strong stream, of a dark red color;
With capillary bleeding - the entire wound surface bleeds. Capillary bleeding from internal organs with abundant blood supply (liver, kidneys, lungs, spleen) is called parenchymal bleeding.
The severity and danger of each type of bleeding, as well as its outcome depends on:
a) the amount of blood shed;
b) from the caliber of the damaged vessel;
c) the duration of bleeding.
The degree of blood loss is divided into light, medium, heavy.
With a mild degree of blood loss, the body loses about 10-15% of the volume of blood circulating in the vascular bed (the amount of blood in an adult is about 4-5 liters, in a teenager - 3 liters). Moreover, the amount of blood circulating in the blood vessels is approximately 50%, the second half of the blood is in the so-called blood "depots" - the liver, spleen. Such a small blood loss is compensated by the body due to the redistribution of blood from the "depot" and increased production of formed elements in the bone marrow, spleen and liver.
Average degree blood loss is a decrease in the volume of circulating blood by 15-20% and requires the introduction of blood-substituting solutions.
With a severe degree of blood loss, the body loses up to 30% of the volume of circulating blood. In this case, it is necessary to transfuse blood, blood substitutes, saline solutions, etc.
Loss of 50% of blood volume quickly leads to death.
When providing first aid, it is necessary to quickly assess the degree of blood loss, the type and duration of bleeding and choose the most effective way temporary stop of bleeding.
Ways to temporarily stop bleeding include:
1. Elevated position of the limb.
2. Tight pressure bandage.
3. The method of maximum flexion of the limb in the joint.
4. Finger pressure of vessels (arteries) along their length.
5. Applying a tourniquet or twist.
An elevated position of a limb or part of the body is used for minor bleeding from the veins of the limbs.
A tight pressure bandage is used to stop venous bleeding. Finger pressing of blood vessels is a method based on pressing the artery at certain anatomical points to the underlying bone formations.
With arterial bleeding, finger pressing of the vessels is performed above the wound (on the neck and head - below the wound). It should be remembered that it is impossible to hold the vessel with your fingers for a long time, especially when the skin and clothes are moistened with blood.
With severe arterial bleeding, a tourniquet is applied. This is the most reliable and long-term method of temporarily stopping bleeding, in which three types of hemostatic tourniquets are used: rubber band, rubber tubular and cloth with a twist. The rubber band has a hook at one end and a chain at the other. The cloth plait consists of a cloth tape and a clip. Often they use improvised means (shawl, belt, etc.).
Tourniquet application method:
A pad of clothing, bandage, gauze is applied to the exposed part of the limb above the wound;
Raise the limb by 20-30 cm to ensure outflow venous blood;
The tourniquet is grasped with the right hand at the edge with the chain, and with the left - 30-40 cm closer to the middle;
The tourniquet is stretched and the first turn is made around the limb, each subsequent turn is applied with great tension (until the bleeding stops);
The end of the harness is fixed with a hook and chain;
An aseptic dressing is applied to the wound, the patient is given an anesthetic (analgin, amidopyrine, etc.) and the limb is immobilized;
A note is placed under the tourniquet, which indicates the exact time the tourniquet was applied. It should be remembered that the tourniquet is applied for a strictly limited time: in summer - for 1.5-2 hours, in winter - for 1 hour. In case of long-term transportation, the bleeding vessel is pinched with fingers, the tourniquet is removed and applied to a new place.
When applying a cloth tourniquet, the same rules are followed as when using a rubber tourniquet.
With the correct application of the tourniquet, the skin is pale marble in color, the bleeding from the wound stops, and the pulse on the peripheral arteries is not palpable.
The victim with a tourniquet applied must be immediately taken to a medical facility for the final stop of bleeding.
If internal bleeding is suspected, it is necessary to provide the victim with absolute rest, put cold on the area of \u200b\u200bthe alleged source of bleeding and quickly deliver to a medical facility.
First aid for injuries. A wound is any damage associated with a violation of the integrity of the skin or mucous membranes. Regardless of the origin, the wound is characterized the following signs: pain, gaping (divergence) of the edges of the wound, bleeding and impaired function and limb or other parts of the body.
First aid for any injury consists, first of all, in finding a wound, removing clothes and shoes from the victim. Pants, shirt, tunic are cut along the seam on the side of the wound, shoes - at the back. Removal of clothes is made first of all from a healthy limb and only then from the patient.
In no case should you touch the wound with your hands, remove deeply embedded foreign bodies from it, remove the remnants of clothing adhering to it. The wound is washed with a solution of hydrogen peroxide, then the skin around the wound should be treated with alcohol, gasoline, brilliant green or iodine, then apply a bandage with a sterile bandage, an individual dressing bag or any clean cloth. If necessary (bleeding), a tourniquet or twist from improvised material is applied. With extensive injuries, immobilization (creation of immobility) is performed using tires or improvised means.
First aid for burns. A burn is tissue damage caused by high temperature, caustic chemicals, electric current and radiation. According to the damaging factor, burns are divided into thermal, chemical, electrical and radiation. Thermal burns are the most common. Depending on the temperature and the duration of its exposure, burns of varying degrees are formed.
First degree burns are characterized by redness and swelling of the affected area of the skin and burning pain.
With a second-degree burn, against the background of reddened skin, small blisters appear, filled with transparent contents, and a sharp pain is felt.
III degree burns are characterized by extensive blisters, some of which open. In place of the opened blisters, a wet pink surface with areas of a pale whitish color or a dense dry dark gray scab (crust) is visible.
Burns I, II degree are called superficial, because. only the superficial layer of the skin (up to the growth layer) is affected. The healing of such burns occurs spontaneously.
With burns of the III degree, all layers of the skin are affected, and with burns of the IV degree (charring), the skin, subcutaneous tissue and underlying tissues are affected up to the bones. Healing of III and IV degree burns is impossible without skin grafting.
The severity of the burn is characterized not only by the depth, but also by the area of the lesion. The affected area is determined in two ways:
Providing first aid to the victim includes:
1. Removal from the fire zone.
2. Extinguishing burning clothes (cover with a blanket, bag, coat, i.e. stop air access to the fire).
3. Clothes stuck to the wound should not be torn off, but cut off with scissors.
4. Applying a sterile dry bandage to the burn area (if there is no sterile dressing, then you can use any clean, freshly ironed cotton fabric, sheet). Dressings with ointments, fats, dyes contaminate the burn surface, complicate subsequent diagnosis and treatment of burns, and therefore are not recommended for use.
5. Conduct immobilization for extensive burns.
6. Create complete rest for the victim.
7. In order to relieve pain and prevent shock, warm the victim (give 100-150 ml of wine or vodka), give 2 g of analgin or other non-narcotic analgesic inside.
8. Call a health worker, ambulance.
Bleeding is the outpouring of blood from a damaged blood vessel. It is one of the frequent and dangerous consequences of injuries, injuries and burns. Depending on the type of damaged vessel, there are: arterial, venous and capillary bleeding, and on the direction of blood flow they are divided into internal and external.
arterial bleeding occurs when the arteries are damaged and is the most dangerous. A sign is the outflow from the wound of a pulsating jet of scarlet blood.
First aid designed to stop bleeding. The most reliable way to temporarily stop arterial bleeding in the upper and lower extremities is to apply a hemostatic tourniquet or twist. In the absence of a tourniquet, any improvised material can be used. Stopping is carried out by finger pressing the bleeding vessel above the wound, where the vessel passes superficially and can be pressed against the bone, as well as by applying a hemostatic tourniquet or twist.
The procedure for applying a hemostatic tourniquet. In case of damage to large arteries, the tourniquet is applied above the wound so that the tourniquet completely compresses the artery. With a raised limb, several turns are made until the bleeding stops completely. The ends of the harness are securely fixed. A properly tightened tourniquet should stop the bleeding and cause the peripheral pulse to disappear. A note must be attached to the tourniquet indicating the time the tourniquet was applied. In the warm season, the tourniquet is applied for no more than 1.5-2 hours, in the cold season - about 1 hour. If necessary, a longer stay of the tourniquet on the limb is loosened for 5-10 minutes (until the blood supply to the limb is restored), while finger pressing the damaged vessel during this time. These actions can be repeated several times, but at the same time, each time it is necessary to reduce the length of time between them by 1.5-2 times compared to the previous ones. The victim with a tourniquet applied is immediately sent to a medical facility for the final stop of bleeding.
Venous bleeding occurs when the walls of the veins are damaged. An even, more or less strong stream of dark red color flows out of the wound.
First aid - lift the limb, bending it as much as possible in the joint and apply a pressure bandage. The imposition of a hemostatic tourniquet in venous bleeding is contraindicated.
capillary bleeding - a consequence of damage to the smallest blood vessels (capillaries), in this case, the entire wound surface bleeds. Capillary bleeding from internal organs with abundant blood supply (liver, kidneys) is called parenchymal bleeding.
First aid is to apply a pressure bandage. A bandage (gauze) is applied to the bleeding area, you can use a clean handkerchief or a bleached, ironed fabric.
The severity and danger of each type of bleeding, as well as the outcome depends on: the amount of blood lost; damage diameter; duration of bleeding. The degree of blood loss is divided into mild, moderate, severe. With a mild degree of blood loss, the body loses from 10 to 15% of the volume of circulating blood. A small blood loss is compensated by the redistribution of blood from the organs (liver, spleen), as well as by increased production of blood cells in the bone marrow, spleen, and liver. With an average degree, there is a loss of 15-20% and there is a need to introduce blood-substituting solutions. With severe blood loss, the body loses up to 30% of blood. In this case, blood transfusion, saline solutions, etc. are used. Loss of 50% or more of circulating blood is fatal.
There are permanent and temporary ways to stop bleeding. The first are used in medical institutions. Second at the scene. These include: elevated position of the limb; tight pressure bandage; method of maximum flexion of the limb in the joint; finger pressure of blood vessels to the bone above the wound; the imposition of a tourniquet or twist. The finger pressure method is applied for a short time, necessary for the preparation of a tourniquet or pressure bandage. This is most easily done where the artery passes near or over the bone.
Bleeding from wounds of the neck and head can be stopped or reduced by pressing on the side of the wound the temporal artery, which runs 1-1.5 cm in front auricle. When bleeding from a wound located on the neck, the carotid artery is pressed on the side of the wound below the wound: the pulsation of this artery can be detected to the side of the trachea (windpipe). It can also be stopped by pressing the jaw artery against the mandible 1 cm in front of the angle of the mandible with the fingers. When the wound is located high on the shoulder, near the shoulder joint or in the axillary region, bleeding can be stopped by pressing the subclavian artery in the fossa above the clavicle. In case of bleeding from the middle part of the shoulder, the brachial artery is compressed, for which the fist of the assisting person is placed in the armpit and there it is tightly fixed by pressing the affected shoulder to the body. When bleeding from a wound in the forearm, the brachial artery is pressed against humerus at the inner surface of the biceps muscle with four fingers. The effectiveness of pressing is checked by the pulsation of the radial artery. Bleeding from the hand should be stopped by pressing the radial or ulnar artery. You can stop bleeding from a hip injury by pressing on the femoral artery located in the upper part of the thigh. When bleeding from the lower leg, press the popliteal artery with both hands. The thumbs are placed on the front surface of the knee joint, and with the rest of the fingers they feel for the artery in the popliteal fossa and press it against the bone. It should be borne in mind that pressing the artery against the bone requires considerable effort, and the fingers get tired quickly. If internal bleeding is suspected, it is necessary to provide the victim with absolute rest, put cold on the area of \u200b\u200bthe alleged source of bleeding and deliver to a medical facility.
Wound - any damage associated with a violation of the integrity of the skin or mucous membranes. The wound is characterized by the following signs: pain, divergence of the edges of the wound, bleeding, impaired body functions. Classification of wounds depending on the type of injuring object: cut; chipped; chopped. Incised wounds are characterized by a relatively shallow depth, smooth edges, heavy bleeding. Stab wounds are characterized by deep wounds, a small wound, no or mild external bleeding, with dangerous damage to internal organs and large vessels. Chopped wounds are characterized by damage to soft tissues, bones and internal organs. Depending on the penetration into the body cavity, wounds are divided into: penetrating and non-penetrating. In addition, wounds are divided into clean (surgical intervention) and infected (accidental).
First aid when injured, it consists in finding a wound, washing with a solution of hydrogen peroxide, then the skin around the wound is treated with alcohol, iodine solution, brilliant green, alcohol, vodka, or, in extreme cases, cologne. With a cotton or gauze swab moistened with one of these liquids, the skin is lubricated from the edge of the wound. They should not be poured into the wound, as this, firstly, will increase the pain, and secondly, it will damage the tissues inside the wound and slow down the healing process. If there is a foreign body in the wound, in no case should it be removed. After completion of all manipulations, the wound is closed with a sterile bandage. A sterile dressing (an individual dressing bag, a sterile bandage, a clean cloth) is applied without touching the hands directly to the wound and the area adjacent to it. Minor skin lesions can be sealed with a piece of bactericidal adhesive plaster, and on top of it put another piece of adhesive plaster, 0.5 cm wider than before on each side. After applying a bandage and temporarily stopping the bleeding, the victim must be sent to the hospital for primary surgical treatment of the wound and the final stop of bleeding.
Burn is tissue damage caused by heat, caustic chemicals, x-rays, or radiation from nuclear bomb explosions (radiation burn). Depending on the damaging factor, burns are divided into thermal, chemical, electrical and radiation.
Depending on the temperature and duration of exposure, burns of varying degrees are formed. At burn I degrees the skin turns red, swells, becomes painful. The burn passes within 3-5 days. For small burns, the burned area is immersed for 5-10 minutes in clean cold water, then a bandage is applied from a sterile bandage moistened with a solution of potassium permanganate, drinking soda or alcohol. Burn II degrees characterized by the appearance of blisters filled with fluid, there is a sharp pain. The longer the blisters remain intact, the more likely they are to remain free of infection. The first aid for such burns is the imposition of a sterile bandage. In no case should you apply any ointments yourself. With extensive burns, the victim should be covered with a clean sheet, a warm blanket, warm sweet tea, coffee should be given, with severe pain - cognac or vodka. ABOUT burn III degrees characterized by damage to the skin and other tissues, extensive blisters. Burn IV degrees - there is damage to the skin, subcutaneous tissue and various tissues up to the bone - charring. Healing of III and IV degree burns is impossible without skin grafting. In both cases, the victim must be taken to the hospital.
First aid in case of burns, it is aimed at stopping the effects of high temperature on the victim. A person in burning clothes should not be allowed to run, as this fans the flames. Clothing stuck to the wound should be cut off with scissors. If the burn is chemical, then the burnt areas should be washed with water for 15-20 minutes. For acid burns, apply a bandage soaked in a solution of baking soda (1 teaspoon per 1 glass of water) to the wound, and for alkaline burns, a weak solution of table vinegar or boric acid (1 teaspoon per 1 glass of water). Burnt places should not be lubricated with fat, various oils, petroleum jelly, since fat facilitates the penetration of infection and complicates the primary surgical treatment of the burn. Therefore, it is necessary to apply a sterile dry dressing to the burn area. Then it is necessary to carry out immobilization, ensure peace and warm the victim. If the area of the burnt surface is more than 10%, the victim may develop a burn disease, starting with burn shock. The most accessible means of combating burn shock is to drink plenty of fluids, along with drinking it is necessary to give the patient 2 tablets of analgin or aspirin, 20 drops of carvalol, valocordin or valerian tincture, a tablet of validol under the tongue. These remedies will relieve pain and support the activity of the heart.
A wound is a damage to the tissues of the body, in which the integrity of the skin or mucous membranes is necessarily violated. In the centers of mass destruction and in natural disasters, injuries are most often caused by fragments of glass and fragments of various objects as a result of a shock wave and the destruction of structures or buildings.
A wound can lead to life-threatening bleeding, and the entry of microbes into the wound, causing it to fester, is also life-threatening for the victim. Severe bleeding wounds, bone fractures and burns can lead to the development of shock and endanger the life of the victim.
Bleeding can be arterial (with damage to the arteries), venous (with damage to the veins) and capillary (with damage to the capillaries). The most dangerous is arterial bleeding, in which a stream of bright red (scarlet) blood flows out of the wound under pressure, as if in jolts.
In addition, they distinguish between internal bleeding, when blood is poured into the internal cavities of the body (the cavity of the chest, abdomen, skull), and external bleeding when blood flows out through the wound.
Rice. 1. Places of possible pressing of the arteries to the underlying bones.
Rice. 2. Ways of digital pressing of the arteries to the underlying bones.
What to do with external bleeding. Capillary bleeding is easy to stop, just apply a pressure bandage to the wound. Before this, the skin around the wound is smeared with iodine, which destroys the microbes on the skin, then a napkin (preferably sterile, that is, disinfected) is applied from several layers of gauze or from some other clean cotton fabric and bandaged tightly. If the bandage gets wet, then put another napkin on top and bandage it. Usually such a pressure bandage is sufficient for venous bleeding; in this case, the limb should be given an elevated position.
With arterial bleeding, with damage to large arteries, it is necessary to act quickly. Knowing the places of possible pressing of the arteries to the underlying bones (Fig. 1), you should first stop the bleeding in this way. The vessel is pressed, strongly squeezing with fingers, as shown in Fig. 2. In case of bleeding on the limbs, it is best to apply a standard cloth or rubber tourniquet or twist from improvised means - a belt, a piece of cloth, etc. (Fig. 3).
Rice. 4. The sequence of applying the rubber band.
Rice. 3. Rubber band.
Rice. 5. Stop arterial bleeding by twist:
a - tying a knot; b - twisting with a stick; c - fixing the stick.
A tourniquet or twist, applied with force, pulls the limb and compresses the walls of the bleeding artery. Methods and techniques for applying a tourniquet or twist are shown in fig. 4 and 5.
When applying a tourniquet or twist, the following rules should be followed:
- under the tourniquet (twisting) a fabric folded in several layers is placed on the skin so as not to infringe on the skin folds;
- it is necessary to tighten the tourniquet until the pulse disappears and the bleeding stops, it is impossible to apply the tourniquet too tight, as tissue necrosis is possible;
- a note must be placed under the tourniquet (twist) indicating the exact time of its application in 24-hour terms (for example, 02 h 25 min). This is done so that at the medical center where the victim goes, it is known when the tourniquet is applied in order to avoid tissue necrosis.
The tourniquet or twist can be kept for no more than 1-2 hours. If bleeding continues when it is removed, then the tourniquet is loosened for several minutes and tightened again, while pressing the bleeding vessel with a finger.
Rice. 6. Stop bleeding by maximum flexion of the limb.
In addition to the tourniquet, you can stop bleeding on the limb by bending it as follows (Fig. 6). To do this, a roller is made of gauze or other soft material and placed under the bend (in the popliteal fossa, armpit, elbow bend), at the same time the limb is bent with force and fixed in this position with a bandage.
internal bleeding It is practically impossible to stop in the order of self-help and mutual assistance. In case of obvious internal bleeding or suspicion of it, the victim should be provided with complete rest and a rubber bladder or a plastic bag with snow or ice (a flask or a bottle with cold water). Such a victim is carefully, on a stretcher, urgently transported to a medical center.
External and internal bleeding
Blood is one of the liquid internal environments organism. Blood moves through a closed system of blood vessels and performs a transport function. It brings nutrients and oxygen to the cells of all organs and transports waste products to the excretory organs. Blood provides the body's defenses against infections.
An adult human body contains 5-6 liters of blood. Blood consists of a liquid part - plasma and shaped elements suspended in it - erythrocytes, leukocytes and platelets.
Plasma makes up 55% of the blood, erythrocytes, leukocytes and platelets 45%.
Erythrocytes (red blood cells) carry the oxygen we breathe from the lungs to the cells in the body.
Leukocytes (white blood cells) protect the body from invading bacteria by absorbing and destroying them.
Platelets (platelets) help stop the flow of blood, helping it to clot.
When a vessel is damaged, part of the platelets disintegrates and, upon contact with air, the thromboplastin protein is formed, which interacts with prothrombin, turning it into the thrombin enzyme. The conversion of prothrombin to thrombin occurs only in the presence of calcium ions. In turn, thrombin interacts with the fibrinogen protein dissolved in plasma and turns into insoluble fibrin. Fibrin forms a network of insoluble threads in which blood cells get stuck, and a clot is obtained - a thrombus. It clogs the hole and the bleeding stops. Next, a connective tissue is formed - a scar.
Bleeding is the leakage of blood from a blood vessel into tissues or body cavities or into environment.
If blood leaks into the environment, such bleeding is called external. When blood flows into a tissue or body cavity, they speak of internal bleeding.
In addition, depending on the damaged vessel, there are arterial, venous, capillary and mixed bleeding.
Knowledge of the types of bleeding is necessary in order to anticipate possible consequences.
The blood from the artery is bright red. Since the arterial blood is coming straight from the heart, it may pulsate or spurt from the wound. Arterial bleeding is difficult to stop, urgent help is needed.
The blood from the vein is dark red and flows more slowly. Blood loss from a vein can be either minor or very serious. Because the veins are closer to the skin, venous bleeding occurs more frequently.
Most of the capillaries are close to the skin, so a small injury usually causes the capillaries to bleed. The blood from the capillaries is bright red, it oozes from the wound.
Mixed bleeding occurs when both veins and arteries bleed in the wound. Most often, such bleeding occurs with deep wounds.
Types of bleeding: a - arterial; b - venous
external bleeding
External bleeding is bleeding from a wound or ulcer directly onto the surface of the body.
A wound is a violation of the integrity of the skin or mucous membranes (often also of deeper tissues and organs) caused by mechanical action.
The amount of external bleeding depends on the type of wound, as well as the place on the human body where there was a violation of the integrity or mucous membranes.
The most likely types of wounds are:
A cut wound is a wound caused by the sliding movement of a thin, sharp object. (Razor, knife for example)
Characterized by the predominance of length over depth, smooth parallel edges.
There may be severe bleeding.
A lacerated wound is a wound that has arisen under the influence of tissue overstretching.
It is characterized by an irregular shape of the edges, detachment or separation of tissues, a significant area of their damage. Great risk of infection. (Car accident, for example)
Stab wound - a wound caused by a sharp object with small transverse dimensions.
It is characterized by a narrow and long wound channel. Increased risk of infection. Hidden damage to organs and deep blood vessels is possible. (Nail, sharpening, stiletto, Russian square bayonet)
Chopped wound - a wound from a blow with a heavy sharp object.
Characterized by a large depth of damage. There may be severe bleeding. Breaks are possible. risk of infection. (Axe, of course)
A gunshot wound is a wound inflicted by small arms or explosive ammunition (shells, mines, bombs, grenades, etc.)
It is characterized by serious internal damage. It is possible for foreign particles to enter the body through a wound. At the entry point, the wound will be small, and at the exit point, if the bullet has gone right through, the wound will be large and lacerated. (It is especially lousy that around the actual wound channel there is an extensive zone of tissue contusion, and the channel is full of all sorts of rubbish - pieces of clothing, earth, etc.)
Contusion wound - a wound from a blow with a blunt object with simultaneous bruising of the surrounding tissues.
characterized by tissue damage. There may be fractures or internal injuries. The skin may burst, but this usually does not happen. A bruise and swelling form at the site of impact.
(Anecdotally textbook examples - with a hammer on the finger, with a brick on the head)
A bite wound is a wound caused by the teeth of an animal or a person.
It is characterized by infection, uneven, crushed edges. The bites of animals with rabies can infect humans.
For example, in our zoo, a zebra bit off the fingers of a stupid girl.
Crushed wound - a wound, during the application of which crushing and rupture of tissues occurred.
It is characterized by an extensive area of tissue damage.
(Favorite - traffic injury and fall from a height)
When caring for a victim with external bleeding, the following priorities should be considered:
if the bleeding is severe, then the priority is to stop the bleeding;
if the bleeding is minor, then the priority is to prevent infection.
internal bleeding
Causes of internal bleeding can be:
a blow to the stomach, chest, or head;
bone fracture;
stab or gunshot wounds;
chronic diseases.
Internal bleeding can be covert or overt.
Latent internal bleeding - blood is poured into a closed space (abdominal cavity, pleural cavity, brain).
Symptoms and signs of occult internal bleeding:
The reaction is in most cases the victim is conscious, but the condition can worsen very quickly, up to loss of consciousness.
The airways are clear, but with loss of consciousness, there may be a retraction of the tongue and closure of the airways. (Did you forget about the pose on the side?)
Breathing is shallow and may stop completely.
Blood circulation - the pulse is rapid, weak, may stop.
Other signs are restlessness, anxiety, weakness, pale and wet cold skin, thirst, dizziness.
Explicit internal bleeding - blood is poured into organs that have communication with the external environment.
A pronounced sign for recognizing obvious internal bleeding can be bleeding from the natural openings of the human body - ears, nose, mouth, vagina, anus, urethra. Types of bleeding from natural orifices of the body.
Place on the body. Kind of blood. What does this mean?
Ear: fresh, bright red damaged ear vessels.
Watery, brain injury (traumatic brain injury).
Nose: fresh, bright red damaged nasal vessels.
Watery, fracture of the bones of the skull (fluid leaks from the cranium).
Mouth: fresh, bright red damaged vessels of the oral cavity (tongue, lips, oral cavity).
Foamy, bright red damaged lungs.
Vomiting blood, dark red-brown damaged stomach.
Vagina: Fresh, dark period, miscarriage, damage to the uterus, the result of rape.
Anal opening: fresh, bright red hemorrhoids.
Dark, foul-smelling damaged lower intestines.
Urethra: red, cloudy urine, damaged kidneys, bladder, member.
First aid for internal bleeding
As can be seen from the symptoms and signs of internal bleeding, they are very similar to the symptoms and signs of shock. Therefore, first aid is in many ways similar to helping with shock.
Give a comfortable posture:
wound chest, damage to the lungs, stomach, miscarriage. Semi-sitting position. Reduces bleeding.
abdominal cavity, pelvic organs - legs are raised. Allows the use of additional blood deposited in the limbs.
traumatic brain injury - with a raised head end - reduces bleeding.
Call an ambulance.
Cover the victim with a blanket, coat, or something else to protect them from the cold.
Do not allow the victim to move.
Do not give the victim to drink, eat, smoke.
(Do you want him to vomit after being anesthetized to treat his wound? Surgeons and rescuers don't.)
To control Airways, breathing, blood circulation, be ready, if necessary, to proceed with cardiopulmonary resuscitation.
Ways to stop external bleeding
When providing first aid to stop external bleeding, depending on the degree of damage, several methods can be used: direct pressure on the wound, applying a bandage, pressing the artery, applying a tourniquet. It is often necessary to use a combination of these methods.
A) direct pressure on the wound
Direct pressure on the wound allows you to buy time, to allow the blood to clot. To exercise direct pressure, it is necessary, if possible, to lift the injured part of the body up and strongly press on the wound with your fingers or palm, and it is better to do this through sterile gauze or a piece of clean tissue. If after some time the bleeding decreases but does not stop, a pressure bandage should be applied.
B) applying a bandage
Bandages are usually used to apply bandages. Bandage (German Binde - bandage, bandage) - the general name of medical products of tape or tubular shape, intended for applying and fixing dressings.
In order for the bandage to give the desired effect, certain rules must be observed:
If possible, disposable rubber gloves should be worn. They protect against diseases transmitted through the blood: hepatitis, HIV infection, etc. If this is not the case, use ordinary plastic bags. Worse than gloves, but you can work.)
Use sterile dressings whenever possible.
Select the required sizes of dressings, the bandage should be selected so that it is equal to or greater than the diameter of the part of the body being bandaged. Using a narrow bandage not only increases the dressing time, but can also cause the bandage to cut into the body.
The use of a bandage wider than the wound makes the bandaging process difficult.
Hold dressings by the edges so as not to disturb their sterility.
Bandaging the victim, you should explain to him the purpose of the bandage, which will allow him to control his condition and to some extent distract him from pain.
Proper application of a bandage when applying a bandage
Using a triangular scarf to apply bandages on the foot (a) and hip joint (b)
Rice. 1. Different types of bandage dressings: a - circular; b - turtle; in - creeping; g - cruciform; d - spike-shaped; f, g, h - sling-shaped.
Rice. 2. Bandage bandages on the top and lower limbs: a - on the hand and wrist joint; b - on the second finger of the hand; c - on the first toe; g - on the whole foot; e - mesh bandage on the fingers.
Rice. 3. Cruciform bandages on the ankle (a) and knee (b) joints. The numbers indicate the sequence of applying bandage tours.
Rice. 4. A variant of using a triangular scarf (bandage with a tie): a, b - folding a scarf into a tie; c - bandage on the area of the elbow joint; g - on the brush; d - on knee-joint; e - on the foot.
Bandage should be tight, but not tight. The bandage should not be too loose and shift over the surface of the body, but it should not be too tight so as not to disrupt blood circulation.
Dressing should be started from the narrowest place, gradually moving to a wider one. In this case, the bandage holds better. To avoid bandage displacement, the first rounds should be applied tighter than subsequent ones. Tie the ends of the bandage with a straight knot. The straight knot does not stretch, so the bandage does not loosen. In addition, the straight knot is flat and therefore more comfortable on the body. Finally, it is easy to untie when needed.
After applying the bandage, it is necessary to check the blood circulation. If necessary, restore circulation by loosening the applied bandage. Signs of too tight bandaging are: pale or blue-gray skin color, numbness of the bandaged part of the body, lack of movement in the bandaged part of the body.
If, after applying the bandage, the blood continues to ooze, you need to apply another bandage (up to 3), without removing the previous one. If the previous bandage is removed, the bleeding will increase.
Applying a bandage to a wound with a foreign object
When assisting a victim with a foreign object (a piece of glass, a sliver, for example) in a wound, this object must not be pulled out of the wound so as not to increase bleeding. It is also impossible to press on this object, so as not to increase the wound.
Necessary:
Press the edges of the wound to a foreign object without removing it,
If the wound is on a limb, raise the limb up as far as possible.
Press down the edges of the wound with tampons or non-deployed bandages, so that these tampons or bandages are higher foreign body, which is preliminarily closed with a napkin or gauze pad, without pressing on it.
Bandage the part of the body around the foreign object in such a way as to press the tampons or non-deployed bandages to the edges of the wound and not press on the foreign object.
Give the victim the best position.
If the dimensions of a foreign object do not allow closing it with a gauze pad, press tampons or non-deployed bandages to the edges of the wound around this object and fix them with a bandage.
Take anti-shock measures and call an ambulance.
In some cases, with deep wounds of the limbs and head, as well as during immobilization, triangular kerchief bandages are used. Most often they are used to perform lifting or supporting dressings.
B) Compression of the artery
Pressing the artery is used when the application of a bandage does not work. In the case of pressing the artery, the access of blood to the part of the body located below the point of pressing is completely blocked. As soon as the bleeding stops, pressure on the artery should be stopped.
If within 10 minutes after pressing the artery, the bleeding has not stopped, you should stop pressing the artery for a few seconds, and then resume it again, since in case of pressing for more than 10 minutes there is a risk of developing thrombosis at the place of pressing.
There are at least 22 pressure points known (11 each on the left and right sides of the body). However, in practice it is advisable to use two of them, points on the femoral and brachial arteries.
To carry out pressing of the brachial artery, it is necessary:
Find an artery on the inside of the shoulder;
Press on the artery above the bone between the muscles of the shoulder.
To apply pressure to the femoral artery, you must:
Put the victim on his back with legs bent at the knees, placing folded clothes under his knees, and find the femoral artery in the groin area;
Press firmly on the artery with your thumbs.
Method of temporary stop (finger pressure) of arterial bleeding. a - the layout of the main arteries and their pressure points (indicated by arrows).
Use of a waist belt as a hemostatic tourniquet: a, b, c, d - stages of tourniquet application; e, f - preparation of a double loop.
Methods for stopping bleeding from the vessels of the extremities by their forced flexion
d) Applying a tourniquet
Tourniquet is effective way stop bleeding, but should be used only in the most extreme cases. The fact is that the application of a tourniquet stops the flow of blood to the part of the limb located below the tourniquet, and can lead to damage to the nerves, blood vessels and, ultimately, loss of the limb.
A tourniquet is applied when the bleeding is very intense, and there is no opportunity to call an ambulance.
Harness rules:
The tourniquet is applied above the damage by about 5 cm;
before applying a tourniquet, wrap the place of its application with a bandage or a clean cloth;
as a tourniquet, either special rubber hemostatic tourniquets or improvised materials are used, such as a belt, belt, scarf, etc. You can not use anything that can cut into the wound, for example, laces, ropes, twine, etc., so how they can damage underlying tissues;
having made the first turn, the tourniquet is tightened so that the bleeding stops, but no more, so as not to cause damage to the underlying tissues, and then, reducing the pressure, fix the entire tourniquet on the limb;
if improvised means are used, it is necessary, after making one turn and tying on one knot, to place an object on top (stick, pen, scissors, etc.), fasten it with another knot and twist until the bleeding stops, then fix it with a double node;
the tourniquet can remain on the limb for no more than 1 hour from the moment it is applied; if during this time the victim could not be delivered to a medical institution, then after an hour the tourniquet must be loosened for 1-2 minutes (until the skin turns red), then applied again, but higher former place;
at the place where the tourniquet was applied, a note should be placed indicating the time of its application.
Bruises, sprains, dislocations
A bruise (contusio) is a closed mechanical damage to soft tissues or organs without a visible violation of their anatomical integrity.
A bruise most often occurs as a result of a blow with a blunt object. As a rule, a swelling appears at the site of the bruise, often a bruise (bruise). If there is a rupture of large vessels, a hematoma may form - an accumulation of blood under the skin.
Soft tissue bruises usually cause pain, while bruising of internal organs can lead to serious consequences, up to death of the victim.
First aid for bruises
If there is a suspicion that as a result of a bruise, damaged internal organs, you need to take care of the priorities of first aid: DP-D-CC.
Apply cold to the bruised area for 15–20 minutes, and then apply a bandage to the bruised area, and bandage should be quite tight. The purpose of such a bandage is to compress the tissues and limit the spread of hemorrhage. Apply cold again over the bandage and hold it for another 1.5–2 hours.
2-3 days after the bruise, heat should be applied to accelerate the resorption of the spilled blood (warming compresses, local warm baths).
Stretching (distorsio) - damage to ligaments, muscles, tendons and other tissues under the influence of a force acting longitudinally, without violating their anatomical integrity.
Muscle strain most often occurs as a result of a blow or an unsuccessful step if a person stumbles. A sign of muscle strain is a sudden sharp pain, hemorrhage, a felt hollow.
Ligament sprain can lead to tearing of individual fibers of the ligament with hemorrhage into its thickness. There is pain in the joint during movement, swelling.
Stretching or tearing of the tendon is possible with excessive load or in the event of a fall, provided that the tissue is poorly supplied with blood. Only previously damaged tendons are torn.
First aid for sprains
Apply ice to the injured area, then apply a tight bandage. You can use an elastic band.
Provide complete rest and cold for 2 days, after which apply heat (warm compresses, local warm baths).
Prevention of re-stretching - massage, therapeutic exercises.
If you suspect a rupture, and also if the pain and swelling do not go away, consult a doctor.
Dislocation (luxatio) - a persistent displacement of the articular ends of the articulating bones beyond their physiological mobility, causing dysfunction of the joint.
Signs of dislocation - pain in the joint, deformation of its contours, dysfunction of the joint, when probing, the definition of an empty articular fossa. The victim may show signs of shock.
First aid for dislocation
Fix the dislocated limb in the position that it took after the injury.
Take anti-shock measures.
Apply ice to the injured area.
If it is possible to lift an injured part of the body, for example, if a dislocated finger or toe has occurred.
Call an ambulance.
Do not allow the victim to drink or eat.
In no case do not try to straighten the dislocation on your own.
Wounds of the head, in the chest and abdomen wounds of the head
First aid for head wounds should be aimed at stopping bleeding, which can be very strong due to the fact that the vessels are close to the surface of the skin.
(Old surgical adage: "Blood gushing like a ram, heals like a dog." I mean, bleeding usually looks scary, but wounds heal very quickly.)
Due to the fact that under the soft tissues are the bones of the skull, in the best possible way stopping bleeding is the imposition of a pressure bandage.
For this you need:
Close the wound with a sterile gauze pad, pressing it against the skull bone.
Fix the napkin with dressings.
If the pressure of the bandage is not enough, and bleeding starts again, squeeze the edges of the wound with your hands.
Lay the victim on their back in a position with raised shoulders and head.
Call an ambulance.
To fix the dressing on the head wound, you can also use a scarf bandage.
Close the wound with a dressing, ask the victim, if he is able, to hold the dressing, then cover his head with a kerchief bandage at a right angle back.
Bring the sharp corners of the kerchief bandage one on top of the other behind the head.
Move them forward towards the forehead.
Tie the sharp corners of the scarf on the forehead.
Bend the corner at the back and tuck it behind the crosshairs of the ends with sharp corners. Hide the ends of the knot located on the forehead.
Penetrating chest wound
Penetrating wounds of the chest are dangerous because the most important internal organs can be damaged - the heart, lungs and others, which can lead to death or create very serious problems for the victim.
When the chest is injured, the integrity of the pleura can be broken, and then pneumothorax develops. Pneumothorax is the presence of air in the pleural cavity. With a penetrating wound to the chest pleural cavity Atmospheric air can enter through the hole, which can lead to compression of the lung and loss of its function.
Symptoms and signs of a penetrating chest injury:
The reaction is the victim is conscious, but the condition may worsen to the point of loss of consciousness.
The airways are open, but can be blocked by coughing up blood when the reaction level drops.
Breathing is difficult, painful, frequent, shallow, in some cases you can hear the sound of air sucked through the wound into the chest.
Blood circulation - the pulse is weak, frequent.
Other signs are expectorated bright red, frothy blood, pale and cold skin, blue lips, blue bases of the nails, perspiration, skin around the wound to the touch, seething, due to the penetration of air into the subcutaneous tissues. Possible shock. With pneumothorax - whistling and hissing of air seeping through the wound, bubbling blood in the wound, a sharp deterioration in the condition of the wounded, squelching, smacking sounds can be heard that occur both during inhalation and exhalation. On exhalation, bleeding from the wound increases, in which foamy blood is released.
First aid for a penetrating wound of the chest
Conscious victim
1. Close the wound with the palm of your hand.
2. Seat the victim, tilting him towards the wound.
(Important! If you tilt the patient, on the contrary, to the healthy side, the blood flowing in the affected part will put pressure on the heart and the intact lung with its weight, squeezing them with its weight. Hence the worsening of the heart and a sharp restriction on the work of the whole lung. And it is one working.
It was from this that the famous Admiral Nelson died - he was carefully laid with the wound up. Blood accumulated, pressing on the underlying heart and lung, the admiral barely survived until the end of the battle. Lying on the other side, he lived, much more. In addition, when the wound is up, it is more difficult to stop air being sucked into the cavity.)
Ask him to cover the wound with his hand. Apply a dressing to the wound, cover it with polyethylene or any other air-tight material and bandage it or seal it with a plaster.
Call an ambulance.
Monitor the condition of the victim, be ready to start cardiopulmonary resuscitation.
The victim is unconscious
Close the wound with the palm of your hand, apply a dressing, cover it with polyethylene or other airtight material, bandage it, or stick it with a plaster.
Put the victim in a safe position, wound down.
Call an ambulance.
Monitor the condition, be ready to start cardiopulmonary resuscitation.
Wounds to the abdomen
Wounds in the abdomen are dangerous because damage to the abdominal organs is possible. This, in turn, can lead to serious complications such as internal bleeding and inflammation of the peritoneum - peritonitis. (What is especially lousy is that it is difficult to immediately assess how dangerous the wound is. A deep wound can be minor, and a relatively harmless-looking one can be extremely serious)
The risk of infection is high.
The goal of first aid for abdominal wounds is to stop bleeding, minimizing the risk of infection and shock.
Abdominal wounds can be longitudinal and transverse. Accordingly, the assistance in these cases has some differences.
First aid for abdominal wounds
If the victim has a longitudinal wound of the abdomen, put him on his back.
If the wound is transverse, put the victim on his back, bending his knees to reduce stress on the wound.
Put a bandage on the wound. If a part of the intestine is visible, then first close it with polyethylene, without adjusting or touching it with your hands, and then apply a dressing and apply a wide bandage loosely.
Call an ambulance.
Monitor the condition of the victim, if he starts to cough or vomit, hold the bandage so that the intestines do not fall out.
If the victim has lost consciousness, it is necessary, despite the wound, to transfer him to a safe position and be ready to perform cardiopulmonary resuscitation.
Bleeding from the nose
Bleeding from the nose can be caused by trauma to the mucous membrane in the area of the nasal septum in its anterior lower part, some common diseases such as high blood pressure, blood diseases, etc. Bleeding from the nose may be postoperative. In these cases, the blood flowing from the nose will be bright red in color.
If the bleeding from the nose is caused by a fracture of the bones of the skull, bloody fluid will flow from the nose. (mixture of brain fluid with blood)
The danger of bleeding from the nose lies in the fact that due to the abundance of blood vessels in this area, it can be quite strong.
With heavy bleeding, the blood not only flows out, but flows through the nasopharynx into the oral cavity, is partially spit out and expectorated by the victim, and partially swallowed. Entry of blood into oral cavity under certain circumstances, it can create a threat to the respiratory tract with all the ensuing consequences.
Abundant nosebleeds lead to the appearance of symptoms of acute blood loss (pallor, dizziness, thirst, rapid pulse, low blood pressure).
First aid for nosebleeds
Have the victim lean forward. In this case, the blood will not flow into the oral cavity, and pose a threat to the respiratory tract.
Ask the victim to breathe through the mouth and pinch the nose in the cartilage area.
Ask the victim not to speak, swallow, cough, spit, or sniffle.
Give the victim a clean handkerchief or piece of clean cloth.
After 10 minutes, open the nose, if the bleeding continues, pinch again.
If the bleeding continues for more than 30 minutes, take the victim to the hospital in the above position.
If the bleeding has stopped, leave the victim in a forward-leaning position and clear the face of blood.
Advise the victim to rest for a while, not to blow their nose and not to exert themselves physically so that the bleeding does not resume again.
bone fractures
Fracture (fractura) - damage to the bone with a violation of its integrity. There are several dozen types of bone fractures. Most often, fractures of the bones of the extremities occur.
Fractures can be closed, when the skin over the fracture site is not damaged, and open - the skin over the fracture site is damaged, soft tissues and bone fragments can be seen in the wound.
The cause of the fracture, as a rule, is a mechanical effect, and the main signs are deformation in the fracture area, shortening of the limb, a change in its axis (in other words, the limb does not look like it should and is different from the other, asymmetrical), sharp pain at the fracture site, loss of ability to control this part of the limb, a specific crunchy sound of bones.
When breaking it is necessary to remember. That usually vessels and nerves pass under the protection of bones. In the event of a fracture, protection becomes a threat - since pointed fragments may appear at the fracture site, which will tear blood vessels and nerves with excessive effort in immobilizing the fracture. If you undertake to apply a splint for a fracture or lay the affected limb "properly", remember that you can pick at the fracture zone like a Cro-Magnon with your bone weapon. Work carefully.
By the way - in case of a fracture, for example, the femur in the fracture zone accumulates at least half a liter of blood due to damage to the vessels passing there. Try not to aggravate the situation with your bearish actions.
MINISTRY OF LABOR AND SOCIAL DEVELOPMENTRUSSIAN FEDERATION
APPROVED
Deputy Minister of Laborand social development
Russian Federation
Providing first aid to victims of burns, bleeding, fractures, bruises, electric shock. (recommended)