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FUNDAMENTALS OF FIRST AID
Stop bleeding. Health care
Directory / Fundamentals of First Aid First aid for bleeding at the scene aims to temporarily stop the bleeding, in order to then deliver the victim to a medical facility, where the bleeding will be stopped completely. First aid for bleeding is carried out by applying a bandage or tourniquet, maximum flexion of the injured limb in the joints. Capillary bleeding easily stopped by applying a conventional bandage to the wound. To reduce bleeding during the preparation of the dressing, it is enough to raise the injured limb above the level of the body. After applying a bandage to the area of the injured surface, it is useful to put an ice pack (Fig. 50).
Fig. 50. Applying a pressure bandage Stop venous bleeding performed by applying a pressure bandage. To do this, several layers of gauze are applied over the wound, a tight ball of cotton wool and tightly bandaged. The blood vessels squeezed by the bandage quickly close with clotted blood, so this method of stopping bleeding can be final. With severe venous bleeding during the preparation of a pressure bandage, bleeding can be temporarily stopped by pressing the bleeding vessel with your fingers above the wound. To stop arterial bleeding vigorous and swift action is needed. If blood flows from a small artery, a pressure bandage works well. To stop bleeding from a large arterial vessel, the technique of pressing the artery above the injury site is used. This method is simple and based on the fact that a number of arteries can be completely blocked by pressing them against the underlying bone formations in typical places (Fig. 51).
Rice. 51. Clamping of the arteries: a - places of clamping of the arteries: 1 - femoral; 2 - axillary; 3 - subclavian; 4 - sleepy; 5 - shoulder; 6 - finger clamping Prolonged stopping of bleeding with the help of finger pressing of the artery is impossible, since this requires great physical strength, is tiring and practically excludes the possibility of transportation. A reliable way to stop severe bleeding from the artery of the limb is the imposition of a hemostatic tourniquet, standard or improvised (Fig. 52).
Rice. 52. Places for applying a tourniquet in case of bleeding from the arteries: 1 - shins; 2 - lower leg and knee joint; 3 - brushes; 4 - forearm and elbow joint; 5 - shoulder; 6 - hips The tourniquet is applied over the sleeve or trousers, but not on the naked body: the skin can be damaged. Hold the tourniquet for no more than 2 hours (in winter - no more than 1,5 hours), because a longer squeezing of the vessels can lead to necrosis of the limb. A note must be placed under the tourniquet with an exact indication of the time it was applied (up to a minute) (Fig. 53).
Rice. 53. Correct tourniquet application If the tourniquet is applied correctly, the bleeding stops immediately, the limb turns pale, and the pulsation of the vessels below the tourniquet disappears. Excessive tightening of the tourniquet can cause crushing of muscles, nerves, blood vessels and cause limb paralysis. A weakly applied tourniquet does not reach the target and creates conditions for venous congestion and increased bleeding. If there is no special tourniquet, you can use improvised means: a belt, a scarf, a piece of cloth, a scarf, etc. A tourniquet made from auxiliary materials is called a twist. To apply a twist, it is necessary to freely tie the object used for this at the required level. A stick should be held under the knot and, rotating it, twist until the bleeding stops completely, then fix the stick to the limb. The application of the twist is painful, so it is necessary to put cotton wool, a towel or a piece of cloth folded 2-3 times under it. All errors, dangers and complications noted during the application of the tourniquet fully apply to twisting (Fig. 54).
Fig. 54. Twist overlay To stop bleeding during transportation, pressure on the arteries is used by fixing the limbs in a certain position. When the subclavian artery is injured, bleeding can be stopped by maximally retracting the arms back with their fixation at the level of the elbow joints. Pressing the popliteal, femoral, brachial and ulnar arteries is shown in the figure (Fig. 55).
Rice. 55. Fixation of limbs Stopping bleeding from wounds on the forearm (shoulder, thigh or lower leg), in the elbow (armpit, inguinal fold or popliteal fossa) put a roller of cotton wool or tightly folded tissue, bend the arm to failure in the elbow joint (or, respectively, in the shoulder, pressing it to the body, and the leg - in the hip or knee joint) and fix it in this position with a bandage, scarf, belt, towel. You can leave the limb in this position, like a tourniquet, for no more than 2 hours (Fig. 56).
Fig. 56. Stopping bleeding in the forearm This method is not suitable for broken bones or severe bruises. Authors: Aizman R.I., Krivoshchekov S.G.
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