Classification according to the nature of injured blood vessels;
1, arterial bleeding: the blood is bright red, and it is very dangerous to spray blood from the wound.
2, venous bleeding: blood is dark red, blood continues to flow out.
3, capillary bleeding: the blood is bright red, and the blood oozes from the whole wound, which is less dangerous.
(2) Type of bleeding
According to the different classification of bleeding sites:
1, external bleeding: blood flows out of the body from skin injury, and bleeding can be seen.
2. Internal bleeding: deep tissues and internal organs are damaged, blood flows into tissues or internal organs and body cavities from ruptured blood vessels, and no blood can be seen on the body surface.
(3) manifestations of blood loss
When the blood loss reaches more than 20% of the whole body blood volume, there will be shock symptoms: pale face, blue lips, cold sweat, cold limbs, irritability or indifference, slow response, shortness of breath, palpitation and shortness of breath, weak or invisible pulse, no drop in blood pressure or no measurement.
(4) Hemostasis method
1, shiatsu hemostasis (compression hemostasis):
Put your finger on the compression point of the artery above the wound (near the heart) and press the arterial blood vessel on the bone hard to stop the blood circulation and stop the bleeding. Finger pressure hemostasis is a quick and effective temporary hemostasis method. After hemostasis, other hemostasis methods should be used immediately. ① Hemostasis of temporal artery:
Gently press the mandibular joint with your thumb or forefinger above the tragus. It is used for bleeding in the scalp and temporal region (figure 1- 1).
② Hemostasis of external maxillary artery:
Press the external maxillary artery on the mandible about half an inch before the mandibular angle with your thumb or forefinger. Used for bleeding on cheeks and face.
③ Hemostasis of common carotid artery:
Place your thumb or other four fingers in the groove between the lateral trachea (flat thyroid muscle) and the anterior edge of sternocleidomastoid muscle, touch the common carotid artery, and press the injured common carotid artery to the back of the neck to stop bleeding. For head and neck bleeding. This method cannot be used unless it is urgent. It is forbidden to compress bilateral common carotid arteries at the same time to prevent cerebral ischemia coma. .
④ subclavian artery hemostasis:
The thumb touches the pulse of the artery in the supraclavicular depression, and the other four fingers are placed behind the neck of the injured person. Press the thumb down to the depression, and press the arterial blood vessel to the first rib in the depth to stop bleeding. Used for underarm, shoulder and upper limb bleeding.
⑤ Hemostasis of ulnar and radial arteries:
Lift the injured person's arm, and press the thumb of both hands on the internal and external pulsation points (ulnar and radial arteries) above the wrist striation to stop bleeding. Hand bleeding.
⑥ Hemostasis of brachial artery:
Turn the upper limb abduction outward, bend the elbow to raise the upper limb, use your thumb or four fingers at the medial groove of the biceps brachii of the upper arm, and press the brachial artery on the humerus to stop bleeding. For hand, forearm and lower arm bleeding.
All landowners femoral artery hemostasis:
A strong beating point (femoral artery) can be felt at the thigh root slightly below the groin midpoint, and the thumb of both hands overlap to apply gravity compression to stop bleeding. Used for arterial bleeding of thighs, calves and feet.
(8) Dorsal foot artery and posterior tibial artery to stop bleeding:
Press the middle of the instep near the ankle (instep artery) and between the medial heel and the medial ankle (posterior tibial artery) to stop bleeding. Used for foot bleeding.
Pet-name ruby digital artery hemostasis:
Lift the injured finger and press both sides of the root of the injured finger with the healthy thumb and forefinger. Suitable for self-rescue of finger bleeding.
2, pressure bandage to stop bleeding:
First, cover the wound with sterile gauze pad, then fold it into a pad with cotton ball, gauze roll or towel and hat, put it on the wound dressing, and then wrap it tightly with triangle towel or bandage to achieve the purpose of stopping bleeding. This method is forbidden when the wound has broken bones. For arterioles, veins and capillaries to the blood. 3, padded limb flexion hemostasis:
(1) If the forearm or calf bleeds, gauze pads, cotton balls, towels or clothes can be placed in the cubital fossa or popliteal fossa. , flexion of the joint, with a triangle towel or bandage to tightly wrap up the flexion of the liver.
② If the upper arm bleeds, pad the underarm to bend the forearm to the chest, and fix the upper arm tightly to the chest with a triangle towel or bandage (Figure 1- 12).
③ When the thigh bleeds, pad the root of the thigh, bend the hip joint and knee joint, and fix the leg tightly on the body with a triangle towel or a long belt.
Precautions:
Fracture and limb suspected of fracture or joint injury should not be stopped with padded limb, so as to avoid dislocation of fracture end and severe pain. When using, always pay attention to the blood circulation at the distal end of the limb. If the blood circulation is completely blocked, slowly loosen it every hour or so, and observe it for 3-5 minutes to prevent limb ring death.
4, tourniquet to stop bleeding:
It is used for bleeding of the great arteries of limbs. Tourniquet can only be used when other methods can't stop bleeding or the injured limb can't recover. Because tourniquet is easy to cause limb disability, you should be especially careful when using it. There are two kinds of tourniquets: rubber tourniquets and cloth tourniquets. If you don't have a tourniquet, you can use a wide bandage, triangle towel or other cloth instead for emergency use.
(1) Rubber tourniquet for hemostasis:
First, use gauze, towel or clothes of the injured person to pad the part where the tourniquet is wrapped (the upper part of the wound), then hold the end of the tourniquet with the thumb, food and middle finger of the left hand, tighten the tourniquet with the other hand, circle the limb twice, put the end of the tourniquet between the index finger and middle finger of the left hand, and pull it back and fix it.
(2) The stool material is twisted to stop bleeding:
In the absence of a tourniquet, you can use ready-made materials at hand, such as triangular towels, bandages, handkerchiefs, cloth, etc. Fold it into a strip and wrap it around the upper part of the wound (near the heart end). Cushion the wound, and then stick it hard.
Wear a short stick in or under the knot, rotate the short stick to tighten the band until there is no bleeding, and fix the short stick on the limb (Figure 1- 15).
③ Matters needing attention in tourniquet hemostasis:
Hemostasis with tourniquet is an important means to save lives when great blood vessels are injured. However, if used improperly, serious complications may occur, such as limb ischemia and acute renal failure. Therefore, we must pay attention to the following points:
The tourniquet cannot be directly wrapped around the skin, and it must be made into a flat pad with a triangular towel, towel, clothes, etc.
Avoid binding the upper arm in the middle 1/3, which will easily damage the nerves and cause limb paralysis. The upper limb should be tied at 1/3, and the lower limb should be tied at the middle thigh.
In order to prevent ischemic necrosis of the distal limb, under normal circumstances, the tourniquet should not be placed for more than 2-3 hours, and the tourniquet should be loosened every 40 to 50 minutes to temporarily restore blood circulation. Before loosening the tourniquet, press your fingers to stop bleeding. After loosening the tourniquet 1-3 minutes, tie it to another slightly higher plane. If there is still a lot of bleeding during the release process, do not release the tourniquet during transportation to avoid aggravating the shock.
If the limb injury can no longer be retained, a tourniquet should be tied above the wound (near the heart) until the amputation.
After tying the tourniquet, mark the obvious part of the injured person, indicate the time of tying the tourniquet, and send it to the hospital as soon as possible.
It is forbidden to use metal wire, thread or rope instead of tourniquet.
5, tamponade hemostasis:
Fill the wound with first aid kit, cotton pad or sterile gauze, and then apply pressure to bandage it. Used for bleeding of thigh root, armpit, shoulder, mouth, nose and uterine cavity.
Bandage hemostasis
Bandage hemostasis refers to the treatment of applying bandages, triangular towels, tourniquets and other items directly to the wound or ligating a certain part.
Key points of operation
1. pressure bandage hemostasis: suitable for bleeding of arterioles, veins and capillaries. After applying a sterile gauze pad to the wound, fold it into a pad with cotton balls, gauze rolls, towels, etc.
Put it outside the dressing at the bleeding site, and then wrap it tightly with a triangle towel or bandage to stop bleeding.
2. Buffering upper limb bleeding: When there is bleeding in the upper limb and calf, the upper limb can be buffered to stop bleeding without fracture or joint injury. If the upper arm bleeds, a cushion with a certain hardness and appropriate size can be placed under the armpit, and the upper arm is close to the chest side, and the chest can be fixed with a triangle towel, bandage or belt; If the forearm or calf bleeds, it can be fixed with a pad at the elbow socket or the national socket.
3. tourniquet hemostasis method: elastic rubber tube and rubber band are used as materials. Ligate the upper limb at the upper third of the upper arm. The lower limb is ligated in the middle of thigh. When ligating, you should first raise the injured limb, pad the notebook with soft fabric such as dressing or towel, properly stretch the tourniquet, wrap the limb for two weeks, and tie the knot on the outside to fix it. To show the time of tourniquet, relax every 40 minutes.
Matters needing attention
1. If the wound is fractured, splint should be added for fixation. When there are broken bones or foreign bodies in the wound, the pressure bandage hemostasis method shall not be applied.
2. To stop bleeding with tourniquet, it must be tied tightly. If it is not tied tightly, there will still be blood flowing out of the deep artery.