7. FIRST AID FOR BLEEDING
Today we will talk about bleeding, their types and how to act in first aid. Bleeding is a penetration of blood
outside the vascular channel into the environment, either in the body cavity or the lumen of the organ. (Lumen: The cavity or channel within a tube or tubular organ such as a blood vessel or the intestine.) The volume of circulating blood in adults, depending on the body weight, is about five liters on average, in newborns, 200,350 milliliters. Blood is the body's life-supporting fluid that participates in all metabolism types,
oxygen and carbon dioxide transportation, water distribution, and products of vital function removal. The main reason leading to death from bleeding is a rapid decrease in circulating blood volume. In adults, it is 30 percent of the total blood volume, approximately 1.5, 2 liters, which can be compared with the volume of a Coca Cola bottle. Therefore, in life-threatening situations, it is necessary not to be confused, assess the patient's condition,
and provide immediate first aid.
There are two main types of bleeding, external and internal. External bleeding occurs when the blood comes
from the vascular channel into the external environment. Internal bleeding develops when the blood is poured into the body cavity, internal organs, for example, in the intestines, or stomach cavity. This bleeding is dangerous because you cannot see it immediately. It accumulates inside the body. Therefore, after falling, or bruising, it is essential to pay attention to the following signs; marked weakness, giddiness, thirsty feeling, pale skin and lips, rapid heartbeat, frequent breathing, blood pressure drop, hemorrhage and soreness in the trauma area, victim’s concern, nausea and vomiting, blackout, loss of consciousness. These signs are common for both internal and external bleeding.
The cardiovascular system consists of heart and vessels. Vessels are arteries, veins, and capillaries. Through the arteries, blood saturated with oxygen enters the tissues. There, in the capillaries, the gas exchange occurs. Oxygen remains in the tissues, blood collects carbon dioxide, and through the veins, takes it back to the heart. Depending on the damage to the vessels, bleeding may be arterial, venous or capillary. Arterial bleeding occurs when the arteries are damaged. The blood colors bright red, scarlet beads like a pulsating fountain because there is a high blood pressure in the arteries. The intensity of blood loss is directly related to the damaged vessel size and the nature of the damage.
Arterial bleeding is the most life-threatening as the victim can lose large amounts of blood in a short time. Getting immediate help will save a person's life. Venous bleeding occurs when the veins are damaged, characterized by slow, not pulsating blood flow, dark cherry color. This bleeding is also quite dangerous and can be relatively abundant. If there is a large amount of veins damage, the victim's condition can be complicated by an air embolism. Air will get into the vein lumen and cause sub-sequence circulation disorder, which often leads to the victim's death.
Capillary bleeding occurs when there is damage to small vessels of the skin. It is characterized by a small amount of blood in the form of tiny droplets bleeding. Depending on the size of the damaged vessel the bleeding can be weak and massive. A weak bleeding usually occurs with minor cuts, abrasions, and usually stops by itself. It does not always require medical assistance. Massive bleeding occurs when large vessels, such as arteries and veins are damaged and the victim quickly loses blood.
During first aid for bleeding, make sure that you are not in any danger. Assess the victim's condition, determine consciousness and breathing. If the victim is unconscious, not breathing and has massive bleeding, call an ambulance immediately or ask others. Wear gloves if possible. If there are no gloves, you can use plastic bags or similar waterproof elastic materials. Remember that you may have contact with biological fluid, blood, that may be infected. If you see small bleeding such as a small venous or capillary, apply clean bandage to the wound. Put a tissue folded several times on the wound and then fix it with a bandage or adhesive tape. If the victim condition allows, asked him to press the bandage with his hand or press it to yourself to stop the bleeding. Remember not to pull the limb too hard until the skin is blue below the bandage.
If you observe massive bleeding, apply clean tissue or several layers of gauze to the wound and then put a roller on top. Applying the roller is necessary to squeeze the walls of the damaged vessels and block the bleeding. Then you should tighten bandage on the wound. You can put your palm on the bandage to check it. If the wound keeps bleeding. Place at the second bandage above the first one without its removal. Make sure that the application fits the wound tightly enough. If the limb turns blue or dull, loosen their bandage slightly.
You may also face the bleeding from the head area. There are many vessels on the scalp and they are connected to the head venous sinuses rich with blood. Therefore the a head wound bleeding is very abundant and usually cannot stop on their own. First, to help the victim sit or lay him down as the bleeding can cause the loss of consciousness. Next, perform direct pressure on the wound and bandage it with a clean tissue. Sometimes damage of the scalp's vein can develop an air embolism as a result of air bubbles entering the bloodstream, since the sinuses of the dura mater (dura mater is the tough outer layer of tissue that covers and protects the brain and spinal cord and is closest to the skull.) are weakly reduced. It also happens due to low comparing to the atmospheric blood pressure in head vessels. Therefore, to prevent such serious complications leading to death, you cannot change the original tissue. When the bandage is heavily soaked in blood, you should put a clean application above the first one, which can be replaced with a new one if needed. Don't forget to fix to the second bandage.
In everyday life, there may be accidents in which internal bleeding can develop. The first aid in case of internal bleeding is the following. If there is no danger to you, determine the victim's condition, consciousness and breathing. If the victim is conscious, try to provide him with complete rest and put him on his back with a pillow under the half-bent legs and feet. If the victim is unconscious but breathing, move him to a stable lateral position. Ask others to call an ambulance if there is nobody nearby, do it yourself. If you know the source of bleeding, you can put a cold compress on the probable area before an ambulance arrives. If you are using ice or snow as cold wrap, wrap it in a towel to prevent frostbite.
Nasal bleeding: In most cases, the reason for that is the feature of anatomic structure of the nose. The nose has a vast network of very thin capillaries, which can be damaged even with minor changes in atmospheric pressure or under physical stress. During first aid, calm the victim. When a person is nervous, his heart beats more rapidly, which increases the bleeding. If the victim can sit, sit him down and ask him to tilt his head forward rather than throwing it back. In this case, you will be able to control the intensity of blood loss. Besides, blood can get into the esophagus, which will provoke vomiting or into the airway, leading to suffocation. Press the nose wings with your fingers to the nasal septum, squeezing the vessels and stopping the blood. Squeeze it for 5-10 minutes. If the bleeding is not stopped, then squeeze for another 10 minutes. If possible, apply ice the nose bridge. The cold will constrict the blood vessels, reducing the hemorrhage. If you cannot stop the bleeding for more than 20-30 minutes or the blood flows more intensively from both nostrils at once, you should call an ambulance. If you are able to stop the bleeding, you can additionally offer the victim to drink something cold. Abstain from coffee and tea as they contribute to vasodilatation and can provoke the bleeding to restart.
Let's sum it up. You have learned what function the blood performs, what types of bleeding there are and how to help a victim who is bleeding.