Bleedings

Description:

Bleeding — a loss of blood from circulatory system. Blood can expire from blood vessels in an organism or outside, or from natural foramens, such as a vagina, a mouth, a nose, an anus, or through injury of skin. Usually, the healthy person can endure blood loss in 10 — 15% of volume of blood without any medical complications. Donors hand over 8 — 10% of volume of blood.

Symptoms of Bleedings:

Bleeding call outside if blood comes to external environment, and internal if it comes to internal cavities of an organism or hollow bodies.

Internal.
Internal bleeding — bleeding in the organism cavities which are reported with external environment — gastric bleeding, bleeding from an intestines wall, pulmonary bleeding, bleeding in a bladder cavity etc.

Outside.
Outside bleeding is called when blood streams from the damaged vessels mucous, skin, hypodermic cellulose, muscles. Blood directly gets to external environment

Hidden.
Bleeding is called hidden in case of hemorrhage in perigastriums which are not reported with external environment. These are pleural, pericardiac, belly cavities, cavities of joints, cerebral cavities, interfascial spaces etc. The most dangerous type of bleedings.

On the damaged vessel.
Depending on what vessel bleeds, bleeding can be capillary, venous, arterial and parenchymatous. At outside capillary blood is emitted evenly from all wound (as from a sponge); at venous it follows a uniform stream, has dark cherry coloring (in case of injury of a large vein pulsing of a stream of blood in beat of breath can be noted). At arterial the streaming blood has bright red color, it beats with a strong discontinuous stream (fountain), emissions of blood correspond to a rhythm of cordial reductions. The mixed bleeding has signs both arterial, and venous.

Capillary.
Bleeding is superficial, blood on color is close to arterial, looks as saturated red liquid. Blood follows in small volume, slowly. The so-called symptom of "bloody dew", blood appears on the struck surface slowly in the form of the small, slowly growing drops reminding drops of dew or condensate. The stop of bleeding is carried out by means of hard bandaging. At adequate coagulant ability of blood passes independently without medical care.

Venous.
Venous bleeding is characterized by the fact that from a wound a venous blood, dark on color, streams. The clots arising at damage can be washed away by a blood flow therefore blood loss is possible. At assistance it is necessary to apply a gauze bandage a wound. If there is a plait, then it needs to be imposed below a wound (under a plait it is necessary to put a soft lining not to injure skin) and a note with the exact time when the plait was put.

Arterial.
Arterial bleeding is easily distinguished on the pulsing stream of bright red blood which follows very quickly. First-aid treatment needs to be begun with crossclamping of a vessel above the place of damage. Further impose a plait which is left on an extremity at most for 1 hour (in the winter — 30 minutes) at adults and for 20-40 minutes — at children. If to hold longer, there can come the necrosis of fabrics.

Parenchymatous.
It is observed at wounds of parenchymatous bodies (a liver, a pancreas, lungs, kidneys), spongy substance of bones and cavernous fabric. At the same time all wound surface bleeds. In parenchymatous bodies and cavernous fabric the cut vessels are not reduced, do not go to depth of fabric and are not squeezed by the fabric. Bleeding happens very plentiful and quite often life-threatening. It is very difficult to stop such bleeding.

The mixed bleeding.
Arises at simultaneous wound of arteries and veins, most often at damage of the parenchymatous bodies (a liver, a spleen, kidneys, lungs) having the developed network of arterial and venous vessels. And also at the deep getting wounds of a chest and/or abdominal cavity.

Reasons of Bleedings:

By origin bleedings happen traumatic, caused by damage of vessels, and atraumatic, connected with their destruction by any pathological process or with a hyperpermeability of a vascular wall.

Traumatic.
Traumatic bleeding results from the injuring impact on bodies and fabrics exceeding their strength characteristics. At traumatic bleeding under the influence of external factors the acute disorder of structure of vascular network in the place of defeat develops.

Pathological.
Pathological bleeding is a consequence of the pathophysiological processes proceeding in the patient's organism. It disturbance of work of any of components of warmly vascular and coagulant system of blood can be the reason. This type of bleedings develops at the minimum provocative influence or at all without it.

Treatment of Bleedings:

Ways of a stop of bleeding are divided into two types — temporary and final. The temporary stop is applied at the emergency on-site assistance before delivery of the patient in a hospital, final — only in the operating room.

Temporary ways of a stop:
plait (in the winter — the child of 10-12 minutes, adult 20-25 minutes; in the summer — the child and pensioners of 25-30 minutes, adult 45-55 minutes). At arterial bleeding it is imposed above the place of damage, at venous — below. It is necessary to put when overlaying a plait a note with imposing time, and it is obligatory to impose a plait on fabric in order to avoid crossclamping of an extremity. For this purpose it is possible to use the victim's clothes;
manual pressing — external;
the maximum bending of an extremity — external;
ice applying — external;
to put a tampon — internal;

Final ways of a stop:
- Sewing up of vessels
- A wound tamponade — in case of impossibility of sewing up of vessels
- Embolization of vessels. At this method the vial of air which is fixed on a vascular wall precisely in the place of damage is entered into a vessel. It is most often applied in operations on brain vessels.
- Hemocoagulation — by means of introduction of the natural and synthesized artificially haemo coagulants locally and in the general uric descent