Haemorrhage or bleeding , type of haemorrhage or control of bleeding

  Haemorrhage or bleeding

Bleeding is the expulsion of blood due to injury or rupture of blood vessels . haemorrhage may vary  in intensity from severe to slight. Severe haemorrhages can be due to a torn artery or vein.blood from an artery in the systemic circulation is bright red in colour and tends to spurt out in jets corresponding with pulsations of the heart.blood from a vein is dark red in colour and flows in a brisk continuous stream.bleeding from injured capillaries is slight and flows in a continuous stream or ooze from all parts of wound.

Note: it is important to remember that infection may occur due to invasion of disease producing bacteria into the body through the broken skin.the bacteria multiply in a wound and make it septic.cleanliness is essential to prevent infection and everything which comes in contact with a wound such as hands and dressing must be thoroghly cleaned.

Types of heamorrhage

1. According to the surface of the body,it could be 

A) internal

B) external

         

                       Internal bleeding:

When the bleeding is from within the body cavities,such as chest,skull or abdomen etc.it is called internal bleeding.

                                       This cannot be seen immediately but leter the blood may ooze out through the nose, coughed out from the lungs ( haemoptysis), vomited out from the stomach (haematemesis) or may be present in the urine (haematuria) .

                         

External bleeding: 

When bleeding is from surface of the body which can be seen immediately after the occurance of the injury or trauma.

                            

2. According to the involvement of blood vessels.

A) arterial

B) venous

C) capillary bleeding and

D) the combination of all three.

Arterial bleeding: 

The blood comes out in jets because it corresponds to the beats of the heart in action.the  blood is bright red in colour.this kind of bleeding is not controlled immediately and may cause death.

Venous bleeding: 

The blood flows out in a continuous stream and is dark in colour.

Capillary bleeding: 

The blood oozes out slowly.

Signs and symptoms of bleeding: 

1 the casualty feels faint and  may even collapse.

2 skin becomes pale ,cold and clammy.

3 pulse becomes rapid but Very weak.

4 breathing becomes shallow,casualty grasps for breath and sighs deeply.

5 profuse sweating.

6 excessive thirst.

First aid treatment.

The aims of the first aid are: 

1 to stop the bleeding quickly,and

2 to set immediate medical aid,and/or ,if necessary, to take the casualty to a hospital for blood transfusion.

** In  case of severe external bleeding: 

1 bring the sides of the wound together and press firmly.

2 place the casualty in in a comfortable position and raise the injured part (if no bone fracture is suspected), and reassure him.

3.  Press on the pressure point firmly for 10 to 15minutes.

4 apply a clean pad larger than the wound and press it firmly with the palm until bleeding become less the less finally stops.

5  if bleeding continues ,do not take off the original dressing but add more pads.

6 finally bandage firmly but not too tightly.

7 treat for shock .

8 get the casualty to the hospital as soon as possible.

**In case of internal bleeding.

The aim of first aid is to prevent worsening of the condition.

1 lay the casualty down with head low .raise his legs by use of pillows etc.

2 keep him calm and relaxed.reassure him.do not allow him to move.

3 keep up the body heat with thin blankets ,rugs or coats.

4 do not give anything to eat or drink because he may have to given an anaesthesia later.

5 do not apply hot water bottles or ice bags to chest or abdomen. This might only make things worse.

6 take him to a hospital as quickly as possible.transport gently.

*Control of bleeding 

Bleeding may be controlled by applying

1 direct pressure

2 indirect pressure.

Direct pressure: 

Apply direct pressure with the thumb or fingers after covering the wound with a pad.

Note: 

If a foregien body or projecting broken bone is present in the wound press alongside the wound but never over it.

In case the bleeding point is not readily visible grasp the whole wound and squeeze it tightly.

Indirect pressure

When bleeding is not controlled by the application of direct pressure or when it is impossible to apply direct pressure,then apply indirect pressure over the appropriate pressure point.a pressure point is one where an artery can be pressed against the underlying bone to stop the blood flow beyond that point.

The various pressure point to control bleeding are: 

a) carotid pressure point

Carotid arteries are the branches of the arota and pass up on either side of the trachea to supply to the head.

To control bleeding..

1 place the thumb in the hollow between the lower part of the larynx and the sternomastoid muscle.

2 compress the artery below the level of the wound .

3 reassure the casualty.

B) subclavian pressure point

The subclavian arteries are branches of the aorta and pass behind the inner ends of the collar bones across the first ribs to the axilla.

**To the control bleeding: 

1 bare the casualty's neck and upper part of his chest;

2 depress his shoulder and incline his head to the injured side; 

3 press one thumb on top of the other in the hellow above and behind the collar bone and compress the artery against the first rib.

4 reassure the casualty.

C) brachial pressure point: 

The branchial arteries run along the inner sides of the biceps muscles.

** To control bleeding

1. Pass your fingers under the patient's arm and compress the artery against the humerus.

2 reassure the casualty.

D) radial or ulnar pressure point: 

Lower part of the radial or ulnar arteries pass over the wrist into the palm to form the palmar arch.

** To control bleeding: 

1 press the thumb against the bone just above the wrists.

2 reassure the casualty.

E) femoral pressure point: 

Femoral arteries are the continuation of the abdominal arota to supply the lower limbs with blood.the artery enters the thigh about midway in the groinfold and runs a little inwards upto the upper 2/3of the thigh.

** To control bleeding.

1 bend the knees slightly and reassure him.

2 grasp the thigh with both hands so that each of the thumbs is at about the centre of the groin.

3 place the left thumb over the right and apply pressure directly backwards aginst the pelvic bone.

4 apply ice pack in case there is swelling.

5 seek for medical aid when necessary.