Licensed books on medicine
<< Ahead || Next >> |
Bleeding and how to stop it
Surgery is accompanied by a violation of the integrity of the tissues, which leads simultaneously to damage to the blood vessels. As a result, bleeding occurs, i.e., the exit of blood from the blood vessels to the external environment or into the tissues and cavities of the body.
Depending on the type of the main damaged vessel, the bleeding can be arterial, venous, capillary, parenchymal.
Depending on the cause of the bleeding, it can be traumatic and neurotrophic.
Depending on the location of the outpouring of blood, the bleeding can be external and internal.
Given the time of onset, bleeding can be primary or secondary.
Ways to stop bleeding. They can be spontaneous and artificial. The latter, in turn, are divided into temporary and permanent.
Temporary stop bleeding. For a temporary stop of bleeding using the following methods: the imposition of a tourniquet or hemostatic forceps, digital pressure vessels, the imposition of a pressure bandage.
The imposition of a harness to stop bleeding is possible only on certain parts of the body - limbs, tail. Bleeding is stopped by circular squeezing of soft tissues along with blood vessels with a rubber band or improvised means (soft rope, towel, rubber or linen bandage, etc.).
To avoid excessive compression of the tissues and paresis (paralysis) of the nerves, a tourniquet is applied in areas where the vessels and nerves are well protected by muscle tissue (the lower leg and forearm region). If necessary, apply a harness in the lower third of the metacarpus (metatarsus) under a layer of cotton wool or a towel. The skin and hair in the overlap area of the tow are pre-cleaned (with a brush, swab) from visible impurities. Squeeze the limb tissue above the site of bleeding.
A tourniquet is applied as follows. With one hand grab the end of the harness, and the other - its middle part. The tourniquet is stretched, circled around the limb and tightened until the bleeding from the wound stops or the pulse disappears in the peripheral part of the limb. The next two or three circular tours of the tourniquet are made next to the first, without prejudice between the folds of the skin. In conclusion, fix the ends of the harness with a hook, chain or knot and record the time it is applied. In summer or when animals are placed in warm rooms, the tourniquet can be left on the limbs for no more than 1.5-2 hours, and in the cold in winter - 45-60 minutes. The tourniquet is removed slowly, in several stages, gradually weakening the bandage tours. Rapid removal of the harness imposed by extensive crushing of muscle tissue, can lead to shock as a result of the absorption of toxic tissue degradation products.
Applying a pressure bandage. To stop bleeding, a pressure bandage is most often used for injuries and operations in the area of the hoof, corolla, and less frequently in other parts of the body. As a result of dressing, the gaps of the damaged vessels are compressed, interstitial pressure in the bleeding wound increases. A pronounced effect of this bandage gives venous and capillary bleeding. A pressure bandage is applied on top of the usual one and is kept on soft tissues for no more than 2 hours. In winter conditions it is applied for a shorter period of time and does not allow icing. On the hoof, the pressure bandage is removed after one day, in some cases it is allowed to take it off after 5–7 days.
Finger pressing of blood vessels is used when bleeding from large arteries and veins for short-term squeezing of the vessel (up to 15 minutes, since a longer pressure is very tedious). And this time is used to prepare the application of a tourniquet or use other methods to stop the bleeding. The vessel is pressed with the fingers to the bone protrusion. In small animals, they sometimes resort to circular squeezing of the limb with the fingers of their hands (dogs, cats, goats, sheep).
The final stop is bleeding. Methods for the final stop of bleeding can be divided into 4 groups: 1) mechanical; 2) thermal; 3) drug (chemical); 4) biological,
Mechanical methods to stop bleeding. The most common of these are tamponade wounds, twisting the vessel, clamping the vessel with hemostatic clamps, bandaging the vessel in the wound and throughout, piercing the vessel and applying a vascular suture.
Twisting of the vessel (torch) is most often used when stopping bleeding from small vessels.
At the same time, Kocher and Pean’s hemostatic clamps are often used. The stump of the bleeding vessel is gripped with a clamp and twisted around the longitudinal axis until it separates. As a result of these techniques, the vessel is compressed, its inner shell is twisted, wrapped in the lumen of the vessel and facilitates the formation of a blood clot.
Vessel ligation (ligation) is the most common and reliable method to stop bleeding. It consists of dressing a bleeding vessel with a thread. First, the vessel is seized in the wound with tweezers and slightly tightened, and then below the forceps, a ligature is applied, tying it with a surgical knot. The ends of the threads are left (0.5 cm long). If the vessel cannot be isolated from the tissues, then for convenience and reliability of applying the ligature, it is cut off with a needle and thread, capturing a part of the surrounding tissues.
Thermal methods to stop bleeding are based on the use of cold or heat. Low temperatures cause short-term vasoconstriction (1–2 hours), and high temperatures have the property of clotting blood and tissue proteins (coagulation). Cold in the form of douches, lotions and irrigations with cold water, the imposition of a rubber bladder with ice, cold clay, cooling compresses are used for bleeding into the thickness of the tissues, cavity.
To influence the bleeding tissue with warm surface of the wound or the wall of the anatomical cavity irrigate with hot (50–60 ° C) solutions of antiseptic agents (for bleeding from parenchymal organs, uterus, etc.), apply to the bleeding surface of the napkin moistened with hot isotonic sodium chloride solution, or they burn it with a hot metal (heatleath pukelen, Desheri, etc.).
Chemical methods to stop bleeding are based on the property of chemical (drug) drugs to constrict the lumen of blood vessels or increase blood clotting.
From local hemostatic agents, antipyrine (20% solution), hydrogen peroxide (3% solution), turpentine, iodoform are used. They are used for wetting tampons, irrigation or powder.
Of the general hemostatic agents, the following drugs are more commonly used.
Adrenaline (1: 1000) is used for internal and external bleeding, except for pulmonary (dilates the blood vessels of the lungs). It is administered to horses and cattle intravenously at a dose of 1-3 ml, under the skin - 2–5 ml; to small cattle, pigs and dogs intravenously - 0.2–0.5 ml.
Calcium chloride is used in the form of a 10% aqueous solution. It is administered intravenously in 150–200 ml of horse and cattle. Ergotin (10% ergot extract solution) is injected subcutaneously at a dose of 5–10 ml for horses, and 0.5–1 ml for a dog.
Ephedrine is prescribed subcutaneously for horse and cattle at 0.05–0.5 g, for a dog - at 0.01–0.05 g.
Sodium chloride is used in the form of a 10% solution in a dose of 100-150 ml for large animals. A pronounced hemostatic effect occurs 30–45 minutes after infusion of the solution into the vein.
Epsilon-aminocaproic acid hydrochloride is administered intravenously in the form of a 5–10% solution of cattle, horses, dogs at a dose of 0.03–0.05 g / kg animal weight 15 minutes before the operation.
Ichthyol in the form of a 3-5% aqueous solution is injected subcutaneously with 1.5–2.5 ml per 10 kg of animal weight 15 minutes before the operation.
Biological methods to stop bleeding. They have primarily a general effect, increasing blood clotting. For this, transfusion of small amounts of compatible blood is used: 400–500 ml for horses and cattle.
To stop the nasal, uterine bleeding, bleeding parenchymal organs prescribed vikasol (vitamin K). Locally applied horse serum, soaking it with tampons. Hemostatic sponges are also used, pressing them against the bleeding surface.
| << Ahead || Next >> |
| = Go to tutorial content = |
Bleeding and how to stop it
- Ways to stop bleeding
There is a temporary (preliminary) stop of bleeding, which is made immediately at the scene of an incident, and the final stop, carried out by a doctor in the hospital. Ways to temporarily stop bleeding include: pressing the bleeding vessel with a pressure bandage; finger pressing of the artery far from the wound; overlay harness; maximum limb flexion followed by
- BLEEDING AND METHODS OF THEIR STOP
Bleeding is divided into arterial, venous and capillary. Arterial bleeding. Blood flows out of a strong pulsating stream, its color is bright red (scarlet). Venous bleeding. Blood flows in a stream, but does not pulsate, the color is darker. Capillary bleeding. The blood is dark, excreted from the entire surface of the wound with drops or a sluggish trickle. To stop bleeding
- Bleeding Kinds. Temporary ways to stop
Bleeding - the outflow of blood from a blood vessel as a result of injury or high permeability of the blood-wall as a result of the disease (scarlet fever, etc.) • arterial (accompanied by a jet - a fountain, red blood) • venous (blood from veins, dark, flows a uniform stream) • capillary (blood flows in the form of dew). There are primary and secondary Secondary: • early (3-5
- Question 4. Forced limb flexion as a way to temporarily stop bleeding
applicable to the upper and, to a lesser extent, to the lower limbs. When the limb is forced to bend, the bleeding stops due to the bending of the artery. When bleeding from wounds of the forearm and hand, stop the bleeding is achieved by flexing to failure in the elbow joint and fixation of the bent forearm with a bandage that attracts it to the shoulder. When bleeding from wounds of the upper part of the shoulder
- SESSION 15 First aid for bleeding. Rules stop external bleeding. Technique of anterior tamponade nose. Blood transfusion. Patient care (methods for performing intracutaneous and intramuscular injections).
Objective: To teach students to identify the symptoms of internal bleeding, determine the volume of blood loss, determine the blood group and Rh factor, own various methods of stopping external bleeding, perform a / c, subc / c, in / m injection (from patient care skills). Test questions 1. Bleeding. Definition Bleeding classification. 2. Signs of arterial, capillary,
- STOPPED BLEEDING
Objective: to study the methods of detecting acute blood loss, to learn how to temporarily stop external bleeding. Content 1. Mastering ways to stop external bleeding: 1.1 Applying a pressure bandage. 1.2 Finger pressing the artery above the wound. 1.3 Overlay hemostat. 1.4 Overlap of twist. 1.5
- Stop external bleeding
At the prehospital stage, it is most often necessary to temporarily stop external bleeding for injuries with wounding of large vessels, which allows the victim to be delivered to a hospital and saves the child's life. For emergency arterial hemorrhage arrest, the method of pressing the arteries throughout: fingers, limb compression with a tourniquet, flexion of the extremities with
- LAPAROSCOPIC STOP OF BLEEDING
Laparoscopic surgery, especially sterilization, is sometimes complicated by secondary bleeding. Very often, bleeding can be stopped during repeated laparoscopy by electrocoagulation and / or by applying a bandage (ligature). The purpose of the operation is to stop the bleeding. Physiological effects. Bleeding stops. A warning. If the bleeding area is near
- Stopping bleeding
(For more, see the textbook) A. Arterial / venous bleeding: - the arterial blood “gushes forth”; it is bright red; - venous blood flows slowly, evenly; it is of a darker shade; Application. Most wounds are characterized by bleeding of both types. B. Direct compression Stops the flow of blood into damaged vessels, allowing platelets to close the holes in the walls.
- Nosebleeds. Etiology. Stop methods
Features of the structure and blood supply to the nasal mucosa determine the exceptional bleeding of this area and the frequency of nasal bleeding. Etiology: 1. Local causes: • Traumatic injuries (including surgical); • Foreign bodies of the nose; • Malignant tumors; • Atrophic processes in the nasal cavity; • bleeding
- Question 7. Applying a pressure bandage for temporary stop external bleeding
used mainly for small bleeding such as venous, capillary and bleeding from small arteries. A pressure bandage is applied in the following way: a sterile bandage is applied to the wound, on top of it is tightly rolled into a wad of cotton, and then tightly bandaged with circular bandages. Instead of cotton wool, you can use an unwound sterile bandage. Applying a pressure bandage is
- STOPPING BLEEDING DURING GYNECOLOGICAL OPERATIONS
Gynecological operations in the pelvic area and abdominal cavity are performed in close proximity to large, vital blood vessels. Accidental damage to one of the vessels may cause severe bleeding. Damage to the large arteries of the abdominal cavity and pelvis, as well as minor damage to their accompanying veins should be restored. If the vein damage cannot be