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Maximum time for applying a tourniquet in winter and summer - features and technology. Rules for applying a tourniquet: stages, features, control

Tourniquet for arterial bleeding

A tourniquet is necessary when arterial bleeding. Only with its help is it possible to stop intense bleeding that occurs when sufficiently large blood vessels are injured. In order to understand how to properly use a tourniquet to stop bleeding, you need to clearly understand what types of hemostatic tourniquets are available.

What is a hemostatic tourniquet?

This is the name of a special device, the task of which is to gradually press the soft tissues of the limb to stop bleeding in this area for some time. Thus, the limb can be turned off for some time from the general blood flow.

In order to ensure bleeding control, a tourniquet should be applied to the extremity as proximal as possible to the source of bleeding. A bandage should be placed under the tourniquet, and it is also possible to apply the tourniquet to clothing. When applying a rubber tourniquet, it is necessary to wrap it around the limb three times in order to ensure complete cessation of bleeding. This tactic will ensure the end of blood flow from the artery; you also need to additionally secure the tourniquet with a hook. When the tourniquet is applied correctly, blood pulsation in the area of the arteries is eliminated. If it is not applied very well, the arteries are only squeezed, and the blood stagnates in them and this only intensifies the bleeding. After the tourniquet is applied, you should indicate the time when the application was performed. The time is indicated both on the bandage and on the accompanying documents. This requirement is due to the fact that the tourniquet should be kept for no more than two hours. After an hour, you need to loosen the tourniquet for a while, while pressing the main vessel with your finger. A tourniquet can be used after operations if they have caused certain complications. This will reduce blood loss. In particular, this is possible after limb amputations. Its use is also indicated in cases of severe bleeding from damaged veins.

Esmarch's hemostatic tourniquet

This type of tourniquet is most widely used when it is necessary to stop arterial and venous bleeding. It is a rubber tube, the length of which can reach up to one and a half meters. At one end such a harness has a steel hook, at the other a chain. There are some features of the technique of applying it:

to ensure complete clamping of the artery with a tourniquet, it must be applied slightly above the place where the blood is coming from;
if the bleeding has stopped and there is no peripheral pulse, then the tourniquet has been applied correctly;
to ensure that the skin is not pinched during application, a towel is placed under the tourniquet;
to prevent the tissue from becoming dead, the tourniquet is not applied for longer than two hours;
During this time, the tension of the tourniquet should be changed in order to avoid numbness of the limb.

The use of an Esmarch tourniquet has proven itself in cases of venous bleeding. The nuances of such an operation are as follows:

The tourniquet should be applied below the damaged area for up to six hours. This applies to cases of bleeding from fairly large veins that are located directly under the patient's skin;
in other cases, it is quite sufficient to apply a simple pressure bandage, which is sufficiently sterile.

Hemostatic tourniquet Alpha

The tourniquet contains vertical grooves, which make it possible to avoid damage to nerve bundles and arteries, prevent pinching of the skin, and also allow direct application of the tourniquet to skin areas. This is its main advantage over other types of harnesses. The ribbed surface of the tourniquet reliably protects the skin from damage and does not allow harm to nerves and blood vessels. The risk of limb amputation is eliminated by maintaining blood circulation in the vessels located under the surface of the skin.

The use of a hemostatic tourniquet of this type provides the following advantages when using it:

It is quite easy to apply and remove the tourniquet. A standard of ten seconds has been developed for medical workers when carrying out these operations;
it is allowed to apply a tourniquet to uncovered skin areas;
it is allowed to use such a tourniquet almost around the clock;
The possible temperature difference when using such a harness is quite wide. In particular, it is allowed to be used at temperatures from +50 to -50 degrees Celsius;
It is not possible to break such a tourniquet with your hands;
The tourniquet can be easily washed off from dirt.

Technique for applying a tourniquet for arterial bleeding

If there is a need to stop arterial bleeding using a tourniquet, the following sequence of actions must be followed:

Carrying out a thorough examination of the area in which manipulations are carried out, assessing the nature of the damage, will make sure that arterial type bleeding actually occurs.
The artery is pressed against the bone with a finger slightly above the place where bleeding is observed. This is done only to completely eliminate the possibility of additional blood loss.
The correct location for applying the tourniquet is selected.
The presence of contraindications for applying a tourniquet is established. These may be inflammatory processes in or near the bleeding site.
The place where the tourniquet is applied is raised to a height of up to 30 centimeters above the level of the patient’s heart.
A napkin with no folds is placed above the wound and closer to it. It can also be a soft piece of fabric or clothing.
The tourniquet is stretched several times to ensure that the bleeding process stops. This is achieved by stopping the blood circulation process in the damaged area.
A note indicating specific day and the moment at which the tourniquet was applied.
An antiseptic bandage is applied to the wound, and bandaging a tourniquet should be avoided.
The limb must be completely immobilized.
Move the patient to medical institution should only be stationary.

Rules for applying a tourniquet for arterial bleeding

The technique of applying a tourniquet to a patient who is bleeding from a damaged artery requires adherence to certain rules. Their violation often results in significant problems for the patient himself, which are expressed in an increase in the level of blood loss, as well as other problems. Among the basic rules for applying a tourniquet in case of arterial bleeding, several should be highlighted.

Place of application of a tourniquet for arterial bleeding

When bleeding from an artery, a tourniquet should always be applied above the place where the bleeding is observed. In other words, it needs to be applied above the place where the artery is damaged. This is due to the peculiarities of the anatomical structure of the artery and blood circulation in the damaged limb. There is a flow of blood in the limb from its center to the peripheral areas. In this case, it becomes necessary to stop the blood supply precisely in that part of the body that is located as close as possible to the central part. This applies to the area above the injury. In no case, when applying a tourniquet during bleeding, should one forget that in addition to stopping the bleeding, the blood flow in the peripheral part of the body also stops.

Time to apply a tourniquet for arterial bleeding

When applying a tourniquet, a sign indicating the time of application must be attached to it. This is due to the fact that the tourniquet should not be kept on the patient’s body for more than two hours, since in this case, necrosis of the clamped limb is possible as a result of a lack of blood flow to it. If the season is warm, you can keep the tourniquet on the skin for an hour, at most two. During the cold season, it is not recommended to keep the tourniquet on for more than half an hour.

If the maximum permissible time for applying a tourniquet has already passed, and there is no way to untie the tourniquet, the following actions should be taken:

carefully press the artery above the location of the tourniquet;
in order to ensure high-quality restoration of blood supply, loosen the tension of the previously applied tourniquet for half an hour;
after the specified period of time has elapsed, it must be applied to the limb again, but this time in a new place. It should be higher or lower than the previous overlap area;
a sign should be placed on the newly applied tourniquet indicating the time and date the tourniquet was applied;
if such a need arises again, you should first repeat the previously described procedure.

If, eight or ten hours after a tourniquet is applied to the victim for arterial bleeding, he does not receive proper medical care, the situation becomes dangerous to his health. Therefore, after all mandatory measures have been taken to stop the patient’s bleeding, he should be immediately taken to a medical facility. This will make it possible to provide the patient with qualified medical care. If there is insufficient blood circulation in the limb, as a result of applying a tourniquet for quite a long time, necrosis of the limb can develop, which often ends in gangrene. Often in such cases, to save the life of the victim, it is necessary to amputate a limb. In addition, amputation in such cases is often carried out significantly above the place where the damage is noted. If the blood loss is significant enough, it is necessary to transfuse it to the victim in a hospital setting.

Mistakes when applying a tourniquet for arterial bleeding

When applying a tourniquet in case of arterial bleeding, the following errors are possible:

Performing the entire procedure in the absence of sufficient indications for applying a tourniquet.
You should not apply a tourniquet to open areas of the skin, because similar situation is fraught with consequences such as tissue necrosis, as well as pinching of skin areas.
Incorrect choice of the place where the tourniquet should be applied. In no case, for example, should a tourniquet be applied to the shoulder or thigh area if there is damage to the blood vessels of the hand or foot.
Tightening the tourniquet must be done adequately to the injury received and the level of blood flow. If it is stretched weakly, the vein is compressed, which may result in increased bleeding, and also appear congestion in the limb area.
You should not keep the tourniquet on the skin surface for a long time. This may cause damage saphenous nerves, which will lead to paralysis. In addition, all the conditions for the development of anaerobic infection appear.

In order for the bleeding to be completely stopped, it is necessary to immediately transport the patient to a medical facility.

Instructions

Select the material at hand to apply the tourniquet. They can be gauze, a bandage, a piece of fabric, or a cord. It is also advisable to have a pencil, pen or tree branch to secure the harness in the right place.

Determine if the artery is actually damaged. You can tell by the blood. Venous blood has a rich dark red color with a hint of blue. Arterial blood, on the contrary, is bright scarlet. This is caused by the specific concentration of oxygen in each type of blood and carbon dioxide. Also, the type of bleeding can be determined by its intensity. Blood will flow from an artery much more strongly than from a vein. Therefore, bleeding must be stopped with a tourniquet.

Apply a tourniquet. To do this, tighten the strip of fabric or cord so that the pulse stops below it. This will mean that the bleeding will soon stop. You can tie the cord in a knot or twist its end around at measure onto a pencil and secure it. It will be easier this way at need to relieve pressure.

Remember, or better yet, write down the exact time of application of the tourniquet. It should not be left for too long, otherwise it will cause serious problems with the part of the body where the blood flows. In summer and in a warm place, the tourniquet can be kept for one to two hours, and for no more than half an hour. During this time, you need to take the victim to the hospital to provide qualified medical care. As a last resort, if there is still no doctor nearby, you need to loosen the tourniquet, allow the blood flow to restore and, if blood continues to flow from the wound, tighten it back. However, it is highly undesirable to repeat this action more than once.

Video on the topic

A hemostatic tourniquet is a device for stopping blood. It is a rubber tape 125 cm long. Its width is 2.5 cm, thickness - 3 - 4 cm. One end of the tape is equipped with a hook, the other with a metal chain.

How to apply a tourniquet correctly?

When applying a tourniquet, first put rubber gloves on your hands. Then the limb affected by the injury is raised and examined. The tourniquet is not applied to the naked body, but over a fabric pad. This could be a person’s clothing, a towel, a bandage, or cotton wool. A medical tourniquet applied in this way will not cross and will not pinch the skin. You need to take its end in one hand and the middle in the other. Then stretch it harder, and only then circle it around your arms or legs. With each subsequent turn of the winding, the harness stretches less. The loose ends are tied with a knot or secured with a hook and chain. A note must be placed under any one turn of the tape, indicating the time it was applied.

The hemostatic tourniquet should not be left in place for more than two hours, otherwise paralysis or necrosis of the arm or leg may occur. Every hour in the warm season and half an hour in winter, the tourniquet is relaxed for a few minutes (at this time the vessel is pressed with your fingers), the application of the tourniquet during bleeding is done in the same way as the first time, only a little higher. If the bleeding does not stop, the tourniquet is not applied correctly. Their veins could have been accidentally pulled. This will cause the pressure in the blood vessels to increase and bleeding to increase. If the tourniquet is too tight, muscles, nerves, and tissues can be damaged, which leads to paralysis of the limbs. The victim with a tourniquet applied is transported to a medical facility first.

The tourniquet can be applied using a plywood splint. It is placed on the opposite side of the damaged vessel. This method has a gentle effect. If the upper third of the thigh or shoulder is injured, a medical tourniquet is applied in a figure eight when there is bleeding.

A tourniquet is applied to damaged neck vessels using a wooden strip or splint in the form of a ladder. These devices are placed on the side opposite the wound. Due to the splint, the trachea and carotid artery will not be compressed. If you don’t have a splint at hand, you need to put your hand on the back of your head, it will act as a splint. The hemostatic tourniquet can be replaced with a twist, using available material for this: handkerchiefs, scarves, belts, ties.

Application

If necessary, a hemostatic tourniquet is applied to the thigh, lower leg, shoulder, forearm and other parts of the body. If the place of its application is the limbs, choose a place so that it is above the wound, but closer to it. This is necessary so that the portion of the limb left without blood circulation is as short as possible.

When applying a tourniquet, remember that it should not be applied:

In the area of the upper third of the shoulder (the radial nerve can be injured) and lower third thighs (when compressed femoral artery tissue is injured).
There are no muscles in the lower third of the forearm and lower leg, and if a tourniquet is applied to these areas, skin necrosis may begin to develop. These areas of the body are shaped like cones, so the tourniquet may slip off when the victim is moved. It’s easier, more convenient and more reliable to apply the tape to your shoulder or thigh.

Arterial bleeding. First aid before the doctor arrives

Loss of blood through an artery often causes death in the victim, so it must be stopped quickly. In the adult body, the blood volume is 4-5 liters. If the victim loses one third of this volume, he may die. The first thing to do when helping with arterial bleeding is to compress the artery so that blood does not flow into the wounded area and does not flow out. To determine the place where it is located, you need to feel the pulse. Where he is, there is an artery. Confidently press this place with your fingers, but 2-3 centimeters above the wound.

If the victim needs to be transported, applying a tourniquet for arterial bleeding is mandatory. Only this needs to be done correctly, as described above in the article. But if a person loses a leg as a result of a road accident and blood flows from the wound, the application of an arterial tourniquet should be done so that it is 5 centimeters above the damaged area, and not 2-3. Under no circumstances should it be weakened. Not everyone has a tourniquet on hand. It can be replaced with a twist. But under no circumstances should you use narrow ropes or cords made of inelastic material.

When the victim is given first aid, you need to remember that when a tourniquet is applied, the blood supply to all sections that are located below it is stopped. You need to know that blood moves through the arteries from the heart to all peripheral parts.

Venous bleeding. First aid

If upon examination of the victim it turns out that the damage to the vein is minor, it is enough to press the vessel with your finger below the damaged area, since this blood moves from bottom to top, and not vice versa. If this is not enough, a pressure bandage should be applied to the injury site to stop the blood flowing from the vein. This is first aid.

But first, the skin around the injury site is treated with iodine, the wound is closed with a sterile bandage, and a sealing roller is applied on top, along the location of the bones. Now the site of injury needs to be tightly bandaged, and the injured limb must be elevated. The pressure bandage is applied correctly when the bleeding stops and there are no blood stains on the bandage. In cases where such assistance is not enough to stop the bleeding, venous tourniquets are applied, only below, and not above, the site of the vessel lesion. You just need to know that venous blood flows in the opposite direction, that is, towards the heart.

In a hospital setting, first aid for arterial and venous bleeding is carried out surgically. At the site of damage to the vessel, its walls are sutured.

Car first aid kit. Its equipment

Many people believe that this kit is only needed to pass inspection. But this is far from true. No one knows what the situation may be along the route of the car. Perhaps your humane attitude towards another person, knowledge of the rules of first aid to the victim and the necessary kit for a motorist will save someone’s life.

Currently, car first aid kits are equipped according to new standards. It includes: a device with which you can make artificial ventilation lungs, bandages, hemostatic tourniquet, rubber gloves and scissors. Disinfectants and all medications are excluded from the first aid kit. It does not contain analgin, aspirin, activated carbon, validol, nitroglycerin, and even iodine with brilliant green. The contents of a car first aid kit have become much poorer. What caused her to change? First of all, the European practice of providing first aid before the arrival of doctors. They believe that most drivers in Russia do not know about the methods of application necessary medications. Therefore, for them, calling a doctor and stopping the loss of blood to the victims will be the main task.

The nature of vascular damage should be distinguished. This is necessary in order to choose the right method to stop bleeding.

Capillary bleeding is characterized by a low rate of blood loss, oozing from the surface of the wound in droplets or a thin stream.
Venous bleeding. The blood is dark in color and flows out more actively in a continuous stream.
When an artery is damaged, the blood is bright scarlet and flows out in spurts. The bleeding is heavy.

Application of a tourniquet for bleeding is used only in extreme cases- if a large artery is damaged.

When to apply a tourniquet

To stop venous bleeding, in most cases, applying a pressure bandage using a roller is sufficient. If possible, a ligature is tied to the bleeding vessel or a hemostatic clamp is applied. An arterial tourniquet is applied when large arteries of the extremities (arms and legs) are damaged. In order to stop bleeding, the vessel is first pressed with a finger or fist to gain time. They choose a method to stop the bleeding, prepare the necessary materials, and only then apply a tourniquet.

When not to apply a tourniquet

Application of a tourniquet is contraindicated under the following circumstances.

Capillary or venous bleeding.
Inflammation at the site of application of the tourniquet.
Do not apply a tourniquet to the lower third of the shoulder or thigh - this can cause nerve damage.

What can be used

A standard hemostatic tourniquet in the form of an elastic rubber tube or tape is included in first aid kits. A hook and chain are attached to the ends; they serve to secure the tourniquet. May be missing. If a first aid kit is unavailable, a tourniquet is applied using a durable rubber tube of small diameter.

Circular pulling of a limb with a twist onto a stick is carried out in compliance with the principles of applying a rubber band; for this, a trouser belt, a scarf, or a strip of thick fabric are used.

How to apply a tourniquet correctly

A hemostatic tourniquet is applied above the bleeding site, as close to the wound as possible, but without touching the damaged skin. Places for dragging a limb:

Mid-calf.
Middle third of the thigh.
Lower third of the forearm.
Upper third of the shoulder.
The root of the limb with fixation to the body.

A bandage or piece of cloth is placed under the tourniquet to avoid damage to soft tissues. The rubber is stretched and the first turn is applied. It should stop the bleeding completely. Next, the tension of the tourniquet is released, making several turns until the tourniquet can be fixed. If the tension of all the turns is strong, this will lead to injury to the soft tissues. If weak, the tourniquet will cause venous stagnation without stopping the bleeding. The limb will take on a bluish tint.

When a tourniquet is applied correctly, the limb turns pale, the pulse below the compression site cannot be felt, and the bleeding stops immediately.

Applying a tourniquet for bleeding can be done in different ways, depending on the location of the vessel damage.

Gersh-Zhorov technique. The tourniquet is applied using a counter-support pad, while maintaining collateral circulation. On the side opposite to the location of the damaged artery, a wooden splint or piece of plywood is placed under the tourniquet. In this case, circular compression does not occur completely; the blood supply to the limb below the tourniquet is partially preserved. Application time increases. This method is also used when reapplying a tourniquet after it has been loosened, during long-term transportation of the victim.
A figure-of-eight tourniquet is used if necessary to stop bleeding in the upper limb. With this method, the tourniquet does not slide down. If there is bleeding on the shoulder, the tourniquet is applied to the armpit, wound around the body, crossed over the shoulder girdle and fixed in the armpit of the opposite side. To compress the femoral artery, use a dense roller, fixed with a tourniquet in the area of the pubic bone. The tourniquet is drawn in a figure eight around the body.
In case of bleeding from the carotid artery, the roller is pressed with a tourniquet secured to the neck using a counter support made of a wooden splint applied on the opposite side. Do not over-tighten the tourniquet. The blood supply to the head is carried out through the carotid artery, protected from compression by a splint. For the same purpose, it is possible to bandage a thick roller to the artery; the opposite hand, raised up, is used as a counter support.

In any case, after applying a tourniquet, the limb is immobilized. A note is placed under the tourniquet indicating the time of application.

For how long?

The maximum time for applying a tourniquet is 2 hours. After this, the process of tissue death begins. For control, place a note under the tourniquet indicating the time of application. It is forbidden to cover the application site with clothing, bandages or cloth. If the victim is not taken to the hospital within 2 hours, then it is necessary to loosen the tourniquet for 10 - 15 minutes, while simultaneously pressing the artery with a finger. It is reapplied to another place, higher or lower than the previous one, the compression period is reduced to 1 hour in winter and 1.5 hours in summer.

It must be remembered that stopping bleeding in this way should only be done in extreme cases. At the same time, measures are taken to prevent injury to soft tissues at the site of application of the tourniquet, using lining material. The time of compression of the limb is strictly controlled; if necessary, the tourniquet is loosened and reapplied.

First aid for bleeding

Bleeding is the leakage of blood due to damage to the walls of blood vessels.

There are 4 types of bleeding:

Capillary bleeding

This bleeding occurs as a result of damage to the smallest vessels (capillaries), and this also includes nosebleeds.

Causes of capillary bleeding

It occurs as a result of cuts and abrasions, usually in everyday life.

Symptoms of capillary bleeding

Blood oozes over the surface of the skin from a wound or abrasion, no blood vessels are visible, the bleeding is small, and in most cases it stops on its own.

First aid for capillary bleeding

Arterial bleeding

This is the outflow of blood from a damaged artery, such bleeding is the most dangerous, because... blood flows out very quickly, in powerful pulsating bursts, life-threatening blood loss occurs within 20 minutes.

Symptoms of arterial bleeding

blood is bright scarlet;
comes out of the wound like a fountain;
pulsating.

First aid for arterial bleeding

Help with arterial bleeding consists of immediately applying a twist, a tourniquet, pinching the artery above the injured area, and then urgently sending the victim to the hospital.

The temporal artery is pressed against the temporal bone thumb.
The mandibular artery is pressed against lower jaw.
The carotid artery is compressed in the neck area and a pressure bandage is fixed using a roller made of bandage or dense fabric.
The subclavian artery is fixed to the rib in the supraclavicular fossa.
Arterial bleeding in the shoulder area is stopped by pressing brachial artery to the humerus.
If there is bleeding from the radial artery, it is necessary to clamp it in the wrist area, closer to the thumb.
The femoral artery is pressed with a fist to the pubic bone in the groin area.
Arterial bleeding in the lower leg area is stopped by pinching the popliteal artery in the area of the popliteal fossa as follows: the thumbs are on the kneecap, the rest are fixing the damaged artery to the bone.
Arterial bleeding of the foot is stopped by applying a pressure bandage and fixing the damaged artery to the underlying bones.

How to apply a tourniquet?

treat the wound with a sterile cloth;
apply a tourniquet above the damaged area; if there is no special tourniquet, you can use improvised means: a twist, rope, belt, etc. p;
It is better to apply a tourniquet to a bandage, cloth or clothing so as not to injure the skin;
The tourniquet must be applied tightly enough to stop the bleeding; if you tighten the damaged artery loosely, the bleeding may increase due to squeezing of the veins. Excessive pressure on soft tissue can damage nerve endings. When the tourniquet is applied correctly, there is no pulse below the bandage.
The tourniquet is applied for no more than 1.5-2 hours; the application time must be indicated in the note.
The tourniquet must be reapplied if the limb turns blue and swells;
After applying a tourniquet, the injured limb is placed higher and covered warmly, but under no circumstances should heating pads be used!
If two hours have passed since the initial application of the tourniquet, then the tourniquet must be loosened for a minute, during which time the damaged artery is pressed with your fingers, then the tourniquet must be applied again, but slightly higher than the first time.

If it is not possible to apply a tourniquet, injured limb It is necessary to bend it as much as possible and fix it in this position.

Venous bleeding

This is bleeding as a result of a violation of the integrity of the veins.

Signs of venous bleeding

blood dark cherry color;
blood flows continuously, quite intensely,
there is no pulsation.

First aid for venous bleeding

The wound is treated with an antiseptic;
It is necessary to apply a pressure bandage: the damaged area, including the area before and after the wound, is bandaged quite tightly; if necessary, a roll of bandage or gauze soaked in hydrogen peroxide can be placed in the wound itself.
The victim should be sent to a medical facility to have the edges of the wound and damaged vessels sutured if the bleeding is profuse and a pressure bandage is not enough to stop it.

Internal bleeding

This is the flow of blood into the internal cavity of the body, such as the lungs, stomach, bladder, etc.

Signs of internal bleeding

dizziness;
weakness;
loss of consciousness.

Internal bleeding is difficult to diagnose and poses a great threat to the patient's life.

The causes of internal bleeding are injuries or some chronic diseases.

First aid for internal bleeding

If internal bleeding is suspected, the patient must be immediately taken to the hospital!
The victim should be laid on a flat surface and kept at rest.
In case of intrapleural or pulmonary bleeding, the patient is left in a semi-sitting position.
An ice pack is placed on the bleeding area.
Under no circumstances should you heat the damaged area, take laxatives or drugs that increase cardiac activity.

Nosebleeds in children

Nosebleeds occur as a result of damage to the capillaries of the nasal mucosa. In most cases, nosebleeds occur in the Kisselbach area - the front part of the nasal septum; such bleeding is not dangerous and is quite easy to stop.

IN in rare cases The cause of nosebleeds is damage to large vessels of the nasal cavity; stopping such bleeding is difficult and requires the help of a specialist.

Causes of nosebleeds in children

nasal injuries;
inflammatory processes in the nasal mucosa due to chronic respiratory diseases;
tumors, polyps;
high blood pressure;
poor blood clotting;
heat, sunstroke;
hormonal changes;
deficiency of vitamins and microelements.

First aid for nosebleeds

The child should take a reclining position, or sitting, with his head tilted forward. The head should be positioned higher than the body. In lying positions, or with the head tilted back, there is a risk of blood getting into the respiratory tract and esophagus.
Apply cold to the bridge of your nose.
Apply vasoconstrictor drops and press the nostrils against the septum.
If the bleeding is quite heavy, you need to insert a gauze swab soaked in hydrogen peroxide into the nasal cavity.
If bleeding does not stop within 20 minutes, call ambulance.

You should call an ambulance immediately if:

the child has a nose injury;
bleeding is very heavy, there is a risk of rapid blood loss;
bleeding combined with nasal discharge clear liquid after a head injury;
combined with vomiting, blood from the nose foams heavily;
the child is suffering diabetes mellitus, hemophilia, blood pressure disorders;
the child lost consciousness.

Applying a tourniquet for arterial bleeding

Tourniquet for arterial bleeding

A tourniquet is necessary for arterial bleeding. Only with its help is it possible to stop intense bleeding that occurs when sufficiently large blood vessels are injured. In order to understand how to properly use a tourniquet to stop bleeding, you need to clearly understand what types of hemostatic tourniquets are available.

What is a hemostatic tourniquet?

Esmarch's hemostatic tourniquet

to ensure complete clamping of the artery with a tourniquet, it must be applied slightly above the place where the blood is coming from;
if the bleeding has stopped and there is no peripheral pulse, then the tourniquet has been applied correctly;
to ensure that the skin is not pinched during application, a towel is placed under the tourniquet;
to prevent the tissue from becoming dead, the tourniquet is not applied for longer than two hours;
During this time, the tension of the tourniquet should be changed in order to avoid numbness of the limb.

The use of an Esmarch tourniquet has proven itself in cases of venous bleeding. The nuances of such an operation are as follows:

The tourniquet should be applied below the damaged area for up to six hours. This applies to cases of bleeding from fairly large veins that are located directly under the patient's skin;
in other cases, it is quite sufficient to apply a simple pressure bandage, which is sufficiently sterile.

Hemostatic tourniquet Alpha

The use of a hemostatic tourniquet of this type provides the following advantages when using it:

It is quite easy to apply and remove the tourniquet. A standard of ten seconds has been developed for medical workers when carrying out these operations;
it is allowed to apply a tourniquet to uncovered skin areas;
it is allowed to use such a tourniquet almost around the clock;
The possible temperature difference when using such a harness is quite wide. In particular, it is allowed to be used at temperatures from +50 to -50 degrees Celsius;
It is not possible to break such a tourniquet with your hands;
The tourniquet can be easily washed off from dirt.

Technique for applying a tourniquet for arterial bleeding

If there is a need to stop arterial bleeding using a tourniquet, the following sequence of actions must be followed:

Carrying out a thorough examination of the area in which manipulations are carried out, assessing the nature of the damage, will make sure that arterial type bleeding actually occurs.
The artery is pressed against the bone with a finger slightly above the place where bleeding is observed. This is done only to completely eliminate the possibility of additional blood loss.
The correct location for applying the tourniquet is selected.
The presence of contraindications for applying a tourniquet is established. These may be inflammatory processes in or near the bleeding site.
The place where the tourniquet is applied is raised to a height of up to 30 centimeters above the level of the patient’s heart.
A napkin with no folds is placed above the wound and closer to it. It can also be a soft piece of fabric or clothing.
The tourniquet is stretched several times to ensure that the bleeding process stops. This is achieved by stopping the blood circulation process in the damaged area.
A note is placed under a certain section of the tourniquet indicating the specific day and moment at which the tourniquet was applied.
An antiseptic bandage is applied to the wound, and bandaging a tourniquet should be avoided.
The limb must be completely immobilized.
The patient should only be moved to a medical facility while stationary.

Rules for applying a tourniquet for arterial bleeding

Place of application of a tourniquet for arterial bleeding

Time to apply a tourniquet for arterial bleeding

If the maximum permissible time for applying a tourniquet has already passed, and there is no way to untie the tourniquet, the following actions should be taken:

carefully press the artery above the location of the tourniquet;
in order to ensure high-quality restoration of blood supply, loosen the tension of the previously applied tourniquet for half an hour;
after the specified period of time has elapsed, it must be applied to the limb again, but this time in a new place. It should be higher or lower than the previous overlap area;
a sign should be placed on the newly applied tourniquet indicating the time and date the tourniquet was applied;
if such a need arises again, you should first repeat the previously described procedure.

Mistakes when applying a tourniquet for arterial bleeding

When applying a tourniquet in case of arterial bleeding, the following errors are possible:

Performing the entire procedure in the absence of sufficient indications for applying a tourniquet.
You should not apply a tourniquet to open areas of the skin, since such a situation is fraught with consequences such as tissue necrosis, as well as pinching of skin areas.
Incorrect choice of the place where the tourniquet should be applied. In no case, for example, should a tourniquet be applied to the shoulder or thigh area if there is damage to the blood vessels of the hand or foot.
Tightening the tourniquet must be done adequately to the injury received and the level of blood flow. If it is weakly stretched, the vein is compressed, which may result in increased bleeding, as well as congestion in the limb area.
You should not keep the tourniquet on the skin surface for a long time. This can cause damage to the saphenous nerves, leading to paralysis. In addition, all the conditions for the development of anaerobic infection appear.

In order for the bleeding to be completely stopped, it is necessary to immediately transport the patient to a medical facility.

How long does a tourniquet last for bleeding?

A tourniquet can be applied to a limb summer time year for no more than one and a half to two hours, and in winter time year for 1-1.5 hours. A tourniquet is applied only when there is sufficiently severe arterial bleeding. For venous - do not apply.

Depending on the climate and the condition of the victim, from 40 minutes to 2 hours, but no more than 2 hours, because tissue death will begin later. If there is a risk of repeated bleeding, the tourniquet can be loosened for a few minutes to restore normal blood flow, and then tightened again. In order not to overdo it with time, the time for applying the tourniquet (under it or on the tail of the bandage) is indicated.

If the bleeding cannot be stopped in some way, then a tourniquet is applied, after application, a note is inserted with time, since it cannot be held for more than two hours, during which time it is advisable to send the patient to the hospital to see a doctor. In case of arterial bleeding, a tourniquet is applied 1.5-2 centimeters above the wound.

It depends on the bleeding. I once had to apply a tourniquet for 7 hours. Every minute I changed the location of the tourniquet a few centimeters, now higher, now lower. This is necessary so that the limb does not begin to die. I think the ambulance will arrive earlier and the doctors will be able to help the victim.

Good question. Applying a hemostatic tourniquet is one of the ways to quickly stop bleeding, and sometimes a human life can depend on a correctly applied tourniquet, so you need to be able to do it correctly. As a rule, the tourniquet is applied one and a half to two centimeters above the damaged vessel, and some soft cloth must be placed under it so as not to damage the exposed skin of the victim. After applying a hemostatic tourniquet, you must indicate on some information carrier, for example, a piece of paper, the date and exact time of its application and your last name, this will help the doctor provide assistance faster and more efficiently. The time for applying a tourniquet in summer is no more than one hour and in winter no more than thirty minutes.

In winter (during the cold season), if there is bleeding, a tourniquet can be applied for 40 minutes - maximum. Otherwise, the limb may become frostbitten, since there is practically no blood circulation in it.

In summer, the time for applying the tourniquet can be increased to 2 hours. If you cannot get to the nearest medical facility during this time, then after you remove (relax the tourniquet), wait 30 minutes so that blood circulation in the limb resumes and apply it again. While there is no tourniquet, the wound should be pressed with your hand to reduce blood loss.

Often there are accidents with people far from populated areas and if you are faced with a choice: the person will die from blood loss or lose a limb.

No more than 2 hours, otherwise tissues die that do not receive oxygen through the blood. In winter up to 1 hour. But every minute to wash the tissues with oxygen, the tourniquet must be loosened, but not to the point of excessive bleeding.

A tourniquet is applied to the limb when heavy bleeding. The tourniquet must be applied above the wound.

The maximum time for applying a tourniquet is 2 hours. Longer application of a tourniquet can lead to tissue death. Therefore, when applying a tourniquet, I be sure to include a note (so it can be seen) with exact time start of overlay.

The tourniquet can be applied for up to two hours; longer tightening may impair blood circulation. If it is necessary to withstand the tourniquet for more than two hours, then after two hours it will need to be loosened in order to restore blood flow. In two hours the tissues will not yet begin to die. In winter, it is not recommended to apply a tourniquet for more than 30 minutes, because the tissue may freeze.

Most instructions for providing first aid to a victim indicate that the tourniquet should be applied for no more than two hours, but if necessary, keep it for more than long time, you can loosen it for a moment to restore blood circulation in the limb, and then move the tourniquet a few centimeters above the wound. Moreover, one should take into account weather conditions, because 2 hours is the time during which the tissues have not yet begun to die, but can freeze if the temperature is below zero. Therefore, in winter, the time for applying the tourniquet is reduced, sometimes up to 30 minutes, after which the tourniquet is moved slightly above the previous application site.

There are time limits for applying a hemostatic tourniquet. In the summer you can hold it for no more than two hours, loosening it for a while every half hour so that necrosis of the limbs does not occur and during this time pressing the wound with your fingers.

And in winter, this time is limited to only one hour and the tourniquet is also loosened after half an hour. Be sure to note the time of application in the attached note.

If the tourniquet is rubber, then it is first stretched, wrapped around the limb a couple of times and fixed.

If it is made from improvised materials, bandages or cloth, then tie it into two knots, insert a stick between them and twist until the bleeding stops.

20 minutes for children and adults. When the tourniquet is applied, leave a note indicating the time the tourniquet was applied. A break of about half an hour between re-applications.

World after the end of the world

Good day, preppers!

In this article I want to cover such a section as bleeding and ways to stop it, because... V extreme situations, especially during PA, and before it, each of us may encounter such unpleasant injuries as bleeding. In such cases, the main thing is not to panic, to control yourself, and most importantly not to waste precious time, which similar cases"ticks" against you.

According to their types of bleeding, they are divided into:

To stop bleeding, use: a) a pressure bandage; b) tourniquet; c) pressing the vessel with your fingers; d) ligation of the protruding end of a ruptured vessel.

During arterial bleeding, the flowing blood has a bright red color, it flows in a strong intermittent stream (fountain), the blood ejects correspond to the rhythm of heart contractions.

The first thing to do is apply a tourniquet (an important aspect must be taken into account here - in case of arterial bleeding, the tourniquet is applied above the wound). If you don’t have a medical tourniquet at hand, then instead you can use a rubber bandage or a regular bandage, braid, rubber tubes (similar to those from an IV), in general, anything that can reliably tighten the limb. It is also necessary to take into account that the force of pulling with a tourniquet should be sufficient to stop the bleeding, but not to squeeze the limb until it turns blue and not to damage its tissues.

The tourniquet is clamped for a certain time (depending on the time of year) - in winter for 1 hour, in summer for 1.5 (to prevent tissue necrosis). If it is necessary to hold the tourniquet longer, then every 40 minutes (after 1 or 1.5 hours have passed), the tourniquet is loosened for 3-4 minutes, after first pressing the bleeding vessel with your fingers. After applying the tourniquet, apply a pressure bandage to the wound. 1 layer of the bandage consists of sterile gauze soaked in peroxide, then it is all tightly bandaged with a sterile bandage.

With venous bleeding, blood flows out of the wound in a stream, but does not pulsate, the color is darker (cherry red)

Elimination of such bleeding is the same as arterial bleeding (see point 1)), but it must be taken into account that with venous bleeding, the tourniquet is applied below the wound.

a - arterial, b - venous

If large vessels, such as the femoral artery, are damaged, the vessels should be pressed more firmly with your fingers to the underlying bone before applying a tourniquet and bandage.

3) Caillary bleeding (abrasions) is caused by the release of blood from the entire surface of the wound in drops or a sluggish stream.

This bleeding can be eliminated as follows: apply a sterile bandage soaked in peroxide to the wound, and wrap it all tightly. The bandage can be left on for 1.5-2 days

It is observed in cases of penetrating wounds, closed injuries (ruptures of internal organs without damage to the skin as a result of a strong blow, a fall from a height, compression), and some diseases of the internal organs.

If bleeding into the chest cavity is suspected (this is manifested by increasing shortness of breath, pale skin, expectoration of foamy blood), the victim should be seated and not allowed to drink or eat. If there is a penetrating wound to the chest, then a sealing bandage must be applied. In the event that bleeding into the abdominal cavity is suspected, it is necessary to lay the victim on his back, put an ice pack on his stomach, and do not give him food or drink.

There are several ways to stop external bleeding.

The arm or leg is raised so that the wound on the limb is above the level of the heart. This helps to stop bleeding or reduce its intensity due to a hydrostatic decrease in pressure in the damaged vessel. This method is used in combination with other methods - applying a pressure bandage or tourniquet.

Finger pressure on the artery

The method is based on pressing the artery to the bone at points where the arteries pass close to the bone and are accessible for compression. By pressing the damaged artery at the appropriate point, you can quickly temporarily stop arterial bleeding in order to then use a more reliable method.

Maximum limb flexion.

Extreme flexion of the limb in the joint located above the wound, and subsequent fixation of it in this position with a bandage, belt or other available material allows you to compress the main vessel and stop the bleeding. This method is used to temporarily stop bleeding.

Method of temporarily stopping (finger pressure) arterial bleeding: a - diagram of the location of the main arteries and points of their pressure (indicated by arrows); b, c - compression of the common carotid artery; d - compression of the subclavian artery; d - compression of the external maxillary artery; e - pressing temporal artery; g, h - compression of the brachial artery; and - pressing axillary artery.

Using a waist belt as a hemostatic tourniquet: a, b, c, d - stages of applying a tourniquet; d, f - preparation of a double loop.

Methods for stopping bleeding from the vessels of the extremities by forcing them to flex: a - general mechanism actions of forced flexion of the limb (1 - blood vessel, 2 - cushion, 3 - limb); b - when the subclavian artery is injured; c - when the axillary artery is injured; d - with injury to the brachial and ulnar arteries; d - when the popliteal artery is injured; e - when the femoral artery is injured.

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useful and informative even without PA)

Everything is written correctly, but these are ways to TEMPORARILY STOP bleeding.

Without alloying the bleeding vessel, arterial bleeding cannot be stopped. You don’t have to worry about capillary and internal ones: in the first case there is no threat to life, in the second - guaranteed death without surgery. Remember that these rules for stopping c/t give you 1.5 - 2 hours to find a specialist and save your life in case of serious bleeding.

You are absolutely right, these methods are aimed at gaining an extra 1-2 hours (first aid), but then you should contact a specialist and under no circumstances try to eliminate these injuries yourself (suturing, treating, making any injections), if you do not have the necessary skills and training.

God created people strong and weak, and Colonel Colt made them equal.

Sorry, but am I the only one who was wary of the advice to apply a tourniquet BELOW the wound?

In addition, “capillary” is written with two “l”

The spelling error can be attributed to a typo, but the method for stopping bleeding surprised me. In case of arterial bleeding, the damaged artery must be pressed against the bone; if the wound is in a limb, the latter must be bent as much as possible. After this, apply a tourniquet or twist where possible.

With venous wounds, you don’t need to press anything; just apply a tourniquet and a pressure bandage to the wound.

The tourniquet is ALWAYS applied ABOVE the wound.

There is no need to mix everything at once. This won't make it any better.

Every schoolchild should know this, if not from a biology course, then at least from life safety.

In general, the topic of first aid is always relevant) You need to know, at least in theory.

Lies and provocation. But I delivered the part about applying a tourniquet for venous bleeding. Idiocy, because in such cases it is necessary to apply a pressure bandage at the site of damage to the skin. No tourniquet.

As for the arterial wound, the tourniquet must be applied to the shoulder, even if the wound is on the forearm. The structure of the bones in the latter does not allow the artery to be compressed - it simply “hides” between them. In addition, material for a tourniquet is not always available; in some cases it can be easier to make a twist. Keep it for no longer than an HOUR! After forty minutes, the likelihood of crash syndrome greatly increases.

Otherwise everything seems to be fine

Animo et corpore semper fidelis

Well, I'll add my two cents. Fortunately, these are not all ways to stop bleeding; there are also thermal, chemical, and medicinal options. With the first one, you can cauterize the wound, then the tissues will form a kind of plug and will not allow blood to flow, the chemical is the same, only we get chemical burn, for example lime. Medicine. It will not completely stop the bleeding, but it can lower the blood pressure. In combination with the first or second, it will be guaranteed to stop the bleeding.

Let me express my opinion - a chemical burn is unlikely to stop the bleeding.

I don’t agree, a mixture of lime and copper sulfate can quite stop the bleeding

“God created people, and Colonel Colt gave them equal rights.”

a mixture of lime and copper sulfate -

It is unlikely that anyone will wear this mixture on purpose.

A soldier has eternity ahead, don’t confuse it with old age

but fortunately, they can be found on any livestock farm in the veterinarian’s office) and I very much doubt that in the case of a scribe, many people will run to scam these wonderful cabinets. and in them you can find a bunch of dual-use drugs, that is, which can be used by people, as well as the simplest medical instruments from tourniquets to surgical kits, believe me, most of the people at this time will steal livestock and feed) and there are also antebiotics and painkillers in that including navocaine, noshpa and a bunch of other things. again, glucose and alcohol-containing tinctures, for example, tincture of wormwood, chemiritsa, which are quite possible and even healthy to drink and there they are often like at a distillery)

“God created people, and Colonel Colt gave them equal rights.”

Good afternoon, dear ones.

I read it here and became scared that they weren’t writing. I'm afraid in case of BP deaths it will be immeasurable. And not from the wounds themselves, but from the incorrect provision of PDMP, read on the Internet.

What the hell are burns, especially chemical ones? Yes, you are wounded from painful shock will bend.

So, we don’t treat internal bleeding, but quickly drag the victim to the first aid station. We'll make it in time - we consider him lucky. But we won’t have time - . 🙁

Capillary - no big deal, apply a bandage. If there is peroxide, pour it on the wound. No, that's not it. And apply a sterile bandage. We don’t go into the wound with dirty fingers.

Venous. NO HARNESSES FOR VENOUS BLEEDING.

Lifting a limb or fixing it with compression and a TIGHT PRESSURE BANDAGE. ALL.

Arterial. The most dangerous thing. A bright scarlet pulsating stream. Critical blood loss within ten seconds. That's why we do everything quickly.

1. Finger pressing the artery to the bone right hand above the wound at such a distance that between the edge of the wound and the hand there is space left for applying a tourniquet (10 centimeters or roughly the width of the palm).

2. With the thumb of your right hand, press the end of the tourniquet and with your left hand, apply the first round (turn) of the tourniquet. We pull with all our might, as much as possible. We also impose a second round. If the tourniquet is tightened correctly, the bleeding should stop. If it goes, we pull even harder. Apply the tourniquet DIRECTLY to the clothing. If the limb is bare, then be sure to place a cloth under the tourniquet.

3. Fix the tourniquet with another 3-4 rounds and release the finger pressure. The bleeding should stop.

4. Under the last rounds of the tourniquet, we place a piece of paper (cardboard, polyethylene, wrapper) on which we write TIME TO APPLY THE tourniquet. We write the same time on the forehead of the wounded person or in another visible place. NECESSARILY. Because of such a small mistake, a wounded person can lose a limb.

5. Apply a sterile pressure bandage to the wound. DO NOT COVER THE TURNINESS WITH A BANDAGE. and we carry out the whole complex related procedures- painkillers, etc.

6. The time for which the tourniquet is applied is 1 hour in summer and 0.5 hour in winter. In winter, we make sure to insulate the limb - this is where the inscription on the forehead is needed - so that everyone knows that the wounded person has a tourniquet.

7. After the allotted time, SLOWLY (especially the last round in order to avoid detachment of the blood clot) release the tourniquet. If the bleeding resumes, immediately apply it again. No - great. We give 2-3 minutes to recover and apply again, a little higher than the previous place by a couple of centimeters - just as tightly as before and write again on a piece of paper and on the forehead =)

Monitoring the correct application - absence of pulse in the limb below the tourniquet.

8. We quickly drag him to the doctor.

Thank you for your attention. 😀

z.y. Practice is important when applying a tourniquet. It is not necessary to cut yourself - you can do it on a healthy limb. 😉

Hello, please tell me, if a person’s arm or leg was cut off with a chainsaw, then it is possible to stop the bleeding by treating the cut site with a blowtorch. ((Thanks in advance.

First, in any case, you should apply a tourniquet to the affected stump. Otherwise, while you are “igniting” the lamp, the victim runs the risk of bleeding to death.

Is it okay that they invented bandages that are stuffed into wounds? To absorb all the blood and stop the bleeding for a while?

By the way, don't joke with body armor.

We must assume that these same “bandages that are stuffed into wounds” are at your fingertips?

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Depending on the type of damaged vessel:
View	What does it look like?	Characteristic
Arterial bleeding		The color is bright scarlet. The blood flows out in a pulsating stream, quickly, under pressure. High rate of blood loss.
Venous bleeding		Cherry color of blood. Constant, uniform flow of blood without pulsation. The bleeding rate is less than with arterial bleeding.
Capillary bleeding		Occurs as a result of damage to capillaries, small veins and arteries. Bleeding wound surface. Bleeding is not as severe as with arterial or venous bleeding.
Parenchymal bleeding		Occurs due to damage to internal organs, such as the liver, spleen, lungs, kidneys. Similar to capillary bleeding, but poses a greater health threat.
Depending on the reason that led to the release of blood from the vascular bed:
1.Haemorrhagia per rhexin		Bleeding as a result mechanical damage vessel walls. The most common.
2. Haemorrhagia per diabrosin		Bleeding due to ulceration or destruction vascular wall at pathological processes(inflammatory processes, tumor decay, peritonitis, etc.).
3. Haemorrhagiaperdiapedesin		Bleeding as a result of impaired permeability of the vascular wall. Increased wall permeability is more common in the following conditions: decreased vitamin C in the body, hemorrhagic vasculitis, scarlet fever, uremia, sepsis, etc.
In relation to the external environment
External bleeding		Blood flows from the wound into the external environment.
Internal bleeding		Blood pours into the internal cavities of the body, into the lumen of hollow organs and tissues. Such bleeding is divided into obvious and hidden. Explicit: blood, even in a changed form, appears outside after a certain time Example: stomach bleeding– vomiting or bloody stool (melena); Hidden: blood pours into various cavities and is not visible to the eye (into the chest cavity, into the joint cavity, etc.
By time of occurrence
Primary bleeding		Bleeding occurs immediately at the time of injury when a vessel is damaged.
Secondary bleeding		There are: early and late bleeding. Early ones that occur from several hours to 4-5 days after damage. Causes: slipping of the thread from the vessel applied during the initial operation, washing out of the blood clot from the vessel when pressure increases, blood flow accelerates or the tone of the vessel decreases. Late ones appear 4-5 days or more after damage. This is usually associated with destruction of the vascular wall as a result of the development of infection in the wound.
Downstream
Acute bleeding		The bleeding occurs in a short period of time.
Chronic bleeding		The bleeding occurs gradually, in small portions.
By severity
Lightweight		The volume of blood loss is 500-700 ml;
Average		Loss 1000-1400 ml;
Heavy		Loss 1.5-2 liters;
Massive blood loss		Loss of more than 2000 ml; A sudden blood loss of about 3-4 liters is regarded as incompatible with life.

Common symptoms of bleeding

Classic signs:

The skin is pale, moist;
Rapid heartbeat (tachycardia);
Reduced blood pressure.

Patient complaints:

general weakness and malaise, anxiety,
dizziness, especially when raising the head,
“floaters” before the eyes, “darkening” in the eyes,
nausea,
feeling of lack of air.

Local symptoms of bleeding
For external bleeding:

direct leakage of blood from the damaged vessel.

For internal bleeding:

Gastrointestinal bleeding: vomiting blood, unchanged or altered (“ coffee grounds); change in color of stool, black stool (melena).
Pulmonary hemorrhage: coughing up blood or foaming blood from the mouth and nose.
Bleeding from the kidneys: scarlet color of urine.
Accumulation of blood in cavities (thoracic, abdominal, joint cavity, etc.). When bleeding into the abdominal cavity, the abdomen is distended, physical activity digestive tract reduced, possible pain syndrome. When blood accumulates in the chest cavity, breathing and motor activity weaken chest reduced. When there is bleeding into the joint cavity, there is an increase in its volume, severe pain, and dysfunction.

Providing first aid for bleeding

Methodstemporary stop of bleeding

Pressing the artery
Fixing a limb in a certain position
Elevated limb position
Pressure bandage
Wound tamponade
Vessel clamp

Tourniquet for bleeding

Rules for applying a tourniquet
Applying a tourniquet is a very reliable way to stop bleeding, however, if used inappropriately, it can lead to very serious complications.
Standard tourniquet (Esmarch tourniquet) is a rubber band 1500 cm long, with special fastenings at the ends. Available means (belt, rope, etc.) can be used as a tourniquet. Modern tourniquets have the ability to self-tighten.

Types of harnesses:

Name of the tourniquet	What does it look like?
Rubber tape tourniquet (Langenbeck tourniquet)
Esmarch's tourniquet
Tourniquet with dosed compression
Tourniquet NIISI RKKA
Atraumatic tourniquet "Alpha"

When to use?

Arterial bleeding
Any massive bleeding on the limbs.

Placing a tourniquet in the axillary and groin area, and also on the neck

Rules for applying a tourniquet:

Before applying a tourniquet, it is necessary to elevate the limb;
You cannot apply a tourniquet to a bare limb; you must substitute a cloth (towel, clothing).
If possible, a tourniquet should be applied as close to the wound as possible, on the blood flow side;
When placing a tourniquet, perform 2-3 rounds, evenly stretching the tourniquet so that the tourniquets do not overlap one another, the tourniquet should press the vessel to the bony protrusion;
In case of bleeding from the wrist area, a tourniquet is applied to the shoulder;
After installing the tourniquet, be sure to indicate the exact time of its installation (hour and minutes);
The part of the body where the tourniquet is placed must be accessible for inspection. This is necessary to monitor changes that may occur in the absence of blood supply;
The victim who has a tourniquet applied must be transported to a medical facility and treated there first;
The tourniquet should be removed gradually, loosening it little by little, after performing anesthesia;
The tourniquet should be kept for no more than 2 hours on the lower extremities and no more than 1.5 hours on the upper extremities, with the condition that the tourniquet will be loosened for 20-30 seconds every 30-40 minutes. In the cold season, the tourniquet holding time is reduced to 40-60 minutes on the lower extremities and 30-40 minutes on the upper extremities. Low temperatures impair circulation in tissues, especially in the extremities, this is due to reflex vasoconstriction under the influence of cold. During long-term transportation of the victim, a tourniquet is applied every 30-40 minutes, regardless of external temperature, should be removed for 20-30 seconds until the skin below the tourniquet turns pink. You can do this for several hours; do not change the time originally written in the note. This technique allows you to avoid irreversible processes in the tissues of the limb. Temporary delivery of blood to tissues will help maintain their viability.
If, after applying a tourniquet, the limb suddenly begins to swell and turn blue, the tourniquet should be immediately removed and reapplied. At the same time, controlling the disappearance of the pulse below the application of the tourniquet.

Method of applying a tourniquet to a limb

The upper third of the shoulder is where a tourniquet is applied for bleeding from blood vessels upper limb, a tourniquet is applied. In case of bleeding from blood vessels lower limb, a tourniquet is applied in the middle third of the thigh.
A towel or the victim’s clothing should be placed under the tourniquet so as not to pinch the skin and the pressure on the vessels is uniform.
The limb is raised, a tourniquet is placed under it, stretching it as much as possible. Then wrap it around the limb several times. The tours should lie next to each other without pinching the skin. The first round is the tightest, the second is applied with less tension, the subsequent ones with minimal tension. The ends of the tourniquet are secured over all tours. The tissues should be compressed until the bleeding stops, no more, no less. It is important to make sure that there is no pulse in the artery below the applied tourniquet. If the disappearance of the pulse is incomplete, after 10-15 minutes the limb will swell and turn blue.
Apply a sterile bandage to the wound.
Attach a piece of paper with the exact time of application of the tourniquet (hours and minutes).
Secure the limb using a transport splint, bandage, scarf or other available means.

Method of applying a tourniquet to the neck
In emergency situations, applying a tourniquet to the vessels of the neck is vital and can save lives. However, placing a tourniquet on the vessels of the neck has some peculiarities.
The tourniquet is applied in such a way as to press the vessels only on one side of the neck and not on the other. To do this, use a Kramer wire splint or other available means on the opposite side of the bleeding, or use the victim’s hand behind the head. This helps maintain blood flow to and from the brain.

Staging technique: A cloth cushion is applied to the bleeding wound (preferably a sterile bandage, if not, you can use improvised means). The roller is pressed with a tourniquet and then wrapped around the arm or splint. Pulse arrest control is not required. You can keep the tourniquet on your neck for as long as necessary.

Criteria for a correctly applied tourniquet:

Bleeding from the damaged vessel has stopped;
The pulse on the limb below the tourniquet cannot be felt;
The limb is pale and cold.

Errors when applying a tourniquet:

Do not apply a tourniquet to the upper third of the thigh and middle third shoulder, this can lead to serious damage nerve trunks and be ineffective in stopping bleeding.
The wrong type of bleeding has been determined, and applying a tourniquet only intensifies it (for example: venous bleeding);
The tourniquet is not tightened enough or large vessels are not pressed against the bony protrusions;
Excessive tightening of the tourniquet can cause severe damage to soft tissues (muscles, blood vessels, nerves), which can lead to paralysis of the limb.
Exceeding the time limit for applying a tourniquet can subsequently lead to the loss of a limb;
Applying a tourniquet to a bare leg. Sufficient pressure on the vessels does not occur, and the skin under the tourniquet is injured.
Apply a tourniquet far from the wound. However, if the source of bleeding is not identified in an emergency situation, applying a tourniquet as high as possible from the wound is a vital action. So bleeding from the femoral artery within 2-3 minutes leads to death, therefore there is no time for long discussions and applying a tourniquet at the base of the leg, just below the inguinal ligament would be the best option.

Finger pressure on the artery

A simple method that does not require any auxiliary equipment. The advantage is that it can be completed as quickly as possible. Disadvantage - it is used for a short time, for 10-15 minutes. The method is especially important in emergency situations, when it gives time to prepare for another method of stopping bleeding (application of a tourniquet). The arteries are pressed at certain points. At these points, the arteries lie most superficially and can be easily pressed against bone structures.

Indications:

Arterial bleeding

The main pressure points of the arteries

Pressing the temporal artery, 2 cm upward and anterior to the auditory canal.
Pressing the maxillary artery, 2 cm anterior to the angle of the lower jaw.
Pressing the carotid artery, the middle of the edge of the sternocleidomastoid muscle (upper edge of the thyroid cartilage).
Pressing the brachial artery, the inner edge of the biceps.
Pressure of the axillary artery, the anterior border of hair growth in the armpit.
Pressure of the femoral artery, middle of the inguinal ligament.
Pressing the popliteal artery, the top of the popliteal fossa.
Pressing abdominal aorta, navel area (pressure is made with a fist).

Fixing a limb in a certain position

This method stop bleeding will be used when transporting the victim to the hospital. The technique is more effective if you place a gauze or cotton roll in the flexion area. The indications are generally the same as when applying a tourniquet. The method is less reliable, but also less traumatic.

When bleeding from the subclavian artery, bent arms at the elbows are pulled back as far as possible and tightly fixed at the level of the elbow joints (Fig. b).
In case of bleeding from the popliteal artery, the leg is fixed with maximum flexion knee joint(Figure D).
When bleeding from the femoral artery, the thigh is brought as far as possible towards the abdomen (Fig. e).
When bleeding from the brachial artery, the arm is bent at the elbow joint as much as possible (Figure D).

Elevated limb position

The method is simple, but quite effective in the case of venous or capillary bleeding. When the limb is raised, the inflow to the vessels decreases, the pressure in them decreases, which creates favorable conditions for the formation blood clot and stopping bleeding. The method is especially effective for bleeding from the lower extremities.

Pressure bandage

Required materials: bandage and dressing material.
Indications:

Moderate venous or capillary bleeding
Bleeding from varicose veins of the lower extremities

Technique:
Several sterile napkins are applied to the wound, sometimes with a special roller on top, then bandaged tightly. Before applying the bandage, place the limb in an elevated position. The bandage is applied from the periphery to the center.

Wound tamponade

Indications:

Capillary and venous bleeding from small vessels in the presence of a wound cavity.
Often used in operations.

Technique:
The wound cavity is filled tightly with a tampon, which is left for some time. The method allows you to gain time and prepare for a more adequate method of stopping bleeding.

Circular dragging of a limb

For twisting, use a special tourniquet or rubber tube, a belt, a piece of cloth, or a scarf. The object used for twisting is loosely tied at the desired level. A board, stick, etc. is inserted into the formed loop. Then, rotating the inserted object, the loop is tightened until the bleeding stops completely. After which the board or stick is fixed to the limb. The procedure is painful, so it is better to put something under the twist knot. When twisting, the dangers of the procedure and complications are similar to those when applying a tourniquet.

Clamping a vessel

The method is indicated to stop bleeding during surgery. A Billroth clamp is used as a hemostatic clamp. Vessel clamping is used briefly to prepare for the final method of stopping bleeding, most often ligation of the vessel.

How to stop arterial and venous bleeding?

Step by step guide for bleeding

Take measures to protect yourself for people who are helping a bleeding victim. It is necessary to wear rubber gloves, avoid contact of blood with mucous membranes and skin, especially if they are damaged. This is the prevention of various infectious diseases (viral hepatitis, HIV, etc.).
If the bleeding is massive, be sure to call an ambulance or take the victim to a medical facility yourself, having first temporarily stopped the bleeding.
Stop bleeding using the methods listed above depending on the type and location of bleeding.
To prevent the development of acute anemia and carry out the first therapeutic measures when it occurs:

For this you need the following. Place the victim in a horizontal position. At massive blood loss If the victim has fainted, place him or her in such a way that the head is lower than the body. Raises the upper and lower limbs, thereby increasing the flow to vital important bodies(brain, lungs, kidneys, etc.). With preserved consciousness and no organ damage abdominal cavity You can give the victim tea, mineral or ordinary water, which will help replenish fluid loss from the body.

Capillary bleeding

Regular bandage on the wound easily stops bleeding. It is enough just to raise the injured limb above the body and the bleeding decreases. At the same time, blood flow to the wound decreases, pressure in the vessels decreases, which contributes to the rapid formation of a blood clot, closing the vessel and stopping bleeding.

Venous bleeding

To stop bleeding you need to: pressure bandage. Place several layers of gauze over the wound, a thick wad of cotton wool and bandage tightly. This leads to the fact that under the bandage in the vessels the blood turns into blood clots, which reliably stop the bleeding. Of particular danger are bleeding from large veins of the neck and chest, which normally have negative pressure. And if they are damaged, air can enter them, which can subsequently cause blockage of vital vessels in the lungs, heart, brain and lead to death. Therefore, in case of bleeding from large venous vessels, a tight, airtight bandage should be applied. And if the bandage is completely saturated with blood, you should not remove it; you should put another clean one on top of it.

Arterial bleeding

If the bleeding is small, it can be stopped with a pressure bandage. When bleeding from a large artery, finger pressure on the vessel in the wound is used to immediately stop the bleeding while the tourniquet is being prepared. Stop bleeding by applying a clamp to the bleeding vessel and tightly tamponade the wound with a sterile napkin. The clamp should only be used by a surgeon or an experienced paramedic. Ditto for emergency stop bleeding is applied by pressing the artery throughout. The arteries are pressed against the underlying bone formations. Stopping bleeding with finger pressure is performed only as a short-term measure.

For the person providing assistance this method requires a lot physical strength and patience. However, the method helps to gain time for setting up a more reliable method - tourniquet application. The artery is usually pressed with a thumb, palm, or fist. The femoral and brachial arteries are most easily pressed.

And so, the methods used to temporarily stop arterial bleeding are as follows:

1) finger pressure of the vessel in the wound;
2) pressing the artery throughout;
3) tight tamponade;
4) application of a tourniquet;
5) circular tugging of the limb
6) hemostatic clamp.

How to stop bleeding from the femoral artery?

Simple actions that will save lives when bleeding from the femoral artery:

Signs of bleeding from the femoral artery: bleeding from a wound on the leg, in which the pool of blood increases to 1 m in a matter of seconds.
Immediately press the arteries below the inguinal ligament with your fist, then press with a hard object (for example: a rolled bandage), through which apply a tourniquet to the thigh. Include a note with the time the bandage was applied. The tourniquet must not be removed until medical personnel arrive, even if their arrival is delayed.
Bleeding from the femoral artery for more than 2-3 minutes leads to death.

Indications:

? arterial bleeding from great vessels upper and lower limbs, common carotid artery (arterial tourniquet);
? bleeding from large saphenous veins when they are wounded or rupture of varicose veins (venous tourniquet) - Fig. 4.10. For arterial bleeding, use an elastic tourniquet

Esmarch, tourniquet “Alpha” and available means (cloth tourniquet-twist or belt).

Esmarch's tourniquet is an elastic rubber band up to 1.5 m long, at one end of which there are plastic buttons, and at the other - holes corresponding to their size (Fig. 4.11a).

Rice. 4.10.

Rice. 4.11.

The “Alpha” harness is an elastic corrugated rubber band with a fastener in the form of a rubber loop (Fig. 4.116).

Rules for applying an Esmarch tourniquet for arterial bleeding:

? bleeding is temporarily stopped by pressing the vessel with fingers;
? a pad of clothing or soft fabric (scarf, bandage, napkin) is placed over the wound at the site of application of the tourniquet without forming folds on it;
? for the outflow of venous blood, the limb is raised by 20-30 cm;
? the tourniquet is grabbed with the right hand at one of its edges, with the left - 30-40 cm distally;
? the tourniquet is stretched as much as possible by hand (Fig. 4.12) and as close as possible to the wound, starting from the back surface of the limb, the first circular tour is applied so that the initial section of the tourniquet overlaps the subsequent tour (lock); the criterion for the effectiveness of applying the first round of a tourniquet is the cessation of bleeding from the wound and the disappearance of the pulse;

Rice. 4.12. Stages of applying a tourniquet [B]

? after applying the first round, in order to prevent excessive compression of the soft tissues by the tourniquet, it must be loosened somewhat until capillary bleeding appears, and then tightened again until it stops;
? the second and third rounds of the tourniquet are applied when it is stretched;
? subsequent rounds are applied without stretching the tourniquet in a spiral so as to half cover each previous round (soft tissues are not pinched), after which the buttons are fixed;
? apply an aseptic bandage to the wound;
? the limb with a tourniquet is immobilized using a transport splint or improvised means; the tourniquet is not bandaged, it should be clearly visible;
? a note is attached to the tourniquet or clothing of the victim indicating the date and time (hours and minutes) of application of the tourniquet, or similar information is noted on the forearm (Fig. 4.13);

Rice. 4.13.

? the victim with a tourniquet is immediately evacuated to medical institution for final hemostasis; analgesics are pre-administered;
? the patient is transported lying down with the head down, accompanied by medical personnel;
? in the cold season, cover the limb with a tourniquet to prevent frostbite;
? when transporting a patient with a tourniquet for more than 2 hours in summer and 1 - 1.5 hours in winter, it is necessary to change the place where the tourniquet is applied. To do this, you should apply finger pressure to the main artery above the tourniquet, remove the tourniquet and after 10-20 minutes (until the hands pressing the artery get tired) apply it to a new place slightly higher or lower than the previous one, but as close to the wound as possible. If necessary, remove the tourniquet again, in winter - after 30 minutes, in summer - after 50-60 minutes.

Features of the “Alpha” tourniquet application technique for arterial bleeding:

? apply with the corrugated surface outward, like the Esmarch tourniquet;
? after applying all rounds of the tourniquet, the fastener loop is wrapped around it, pulled back and placed under the free end of the tourniquet;
? A note is placed under the elastic band of the loop indicating the time of application of the tourniquet.

Taking into account the location of the artery and nerve trunks in relation to the adjacent bone, a tourniquet is applied in certain places (Table 4.1).

Typical sites for applying a tourniquet for arterial bleeding

Table 4.1

In the middle and lower third of the shoulder, a tourniquet is not applied due to the risk of damage to the radial nerve with subsequent development of paresis or paralysis of the arm (Fig. 4.14). A tourniquet is applied in the form of a figure eight to the axillary fossa and base of the lower limb (Fig. 4.15), squeezing the bleeding vessel through the cap.

Rice. 4.14.

Rice. 4.15.

Stopping bleeding from the vessels of the neck (Fig. 4.16.):

? a cotton-gauze roll (pelote) is applied to the site of damage to the carotid artery;
? through a cotton-gauze roller carotid artery compressed with a stretched tourniquet;
? the tourniquet is fixed on the opposite side on an arm thrown back over the head or a ladder splint, a wooden plank, which prevents compression of the trachea (asphyxia) and the intact carotid artery.

Rice. 4.1

Using a cloth tourniquet and belt (improvised means) for arterial bleeding:

? from available means, you can use a scarf, a towel, a tie, a sheet, or a handkerchief as a cloth tourniquet;
? a cloth tourniquet or belt is applied to clothing or padding;
? a cloth tourniquet is tied around the limb above the injury (Fig. 4.17a);
? A stick is passed under the loop, with which a homemade tourniquet is twisted until the bleeding stops (compression of the vessel occurs gradually - Fig. 4.176);
? after the bleeding has stopped, the twist is fixed to the bandage (Fig. 4.17c).

When using a belt, thread its end into the buckle so that it ends up inside the resulting ring; then this end is again brought out through the buckle from the inside to the outside, as a result of which a double ring is formed, which is put on the limb; pulling strongly on the end of the belt, tighten both loops (Fig. 4.18).

Rice. 4.17.

ATTENTION!

It is prohibited to use material of rigid thin structures (wire, lace) as a tourniquet, since when compressed they cause deep tissue damage.

Possible complications of applying a tourniquet for arterial bleeding:

? gangrene of a limb when it is compressed with a tourniquet for more than two hours;
? paralysis and paresis, especially on the upper limb, due to excessive compression of the nerve trunks;
? development of thromboembolism when a tourniquet is applied to a limb with thrombophlebitis, both superficial and deep veins;

Rice. 4.18.

? generalization of infection when a tourniquet is applied to a limb with signs of an inflammatory process in the lymphatic vessels (lymphangitis), soft tissues or bone, therefore, during operations on the affected limb, including amputation, in patients indicated in the previous three positions, a tourniquet is not applied;
? creation of favorable conditions (tissue ischemia) for the development of anaerobic infection (gas gangrene, tetanus) in wounds;
? increased bleeding with weak tourniquet tension (due to the formation of venous stasis).

Features of applying a venous tourniquet:

? the limb is raised for 10-15 minutes;
? finger pressure of a bleeding vessel in the wound or below the wound;
? applying a tourniquet with a force that causes compression of only the superficial veins;
? The tourniquet application period is up to 6 hours.

Fixation of the limb in the position of maximum flexion (hemostatic position of the limb) - table. 4.2.

Hemostatic position of the limb depending on the location of bleeding

Table 4.2

Flexion of the limb at the joint should be carried out to failure using a pelota and reliable fixation of the bent segment of the limb, which ensures compression of the main arterial trunk (Fig. 4.19). The technique for placing a limb in a hemostatic position is shown in Fig. 4.20-4.22.

Nosebleed is the discharge of non-foaming blood from the nostrils or its flow down the back wall throats. In 90-95%, the source of nosebleeds is the anterior inferior part of the nasal septum, in other cases it develops in the middle and posterior parts of the nasal cavity. Nosebleeds can be caused either by a sharp increase in blood pressure (in which case measures should be immediately taken to reduce it), or by pathology in the nasal cavity (most often by increased permeability of the walls of blood vessels due to

Rice. 4.19.

Rice. 4.20.

Rice. 4.21.

popliteal artery to stop bleeding from the leg and foot

Rice. 4.22. Maximum flexion of the hip with pressing of the femoral artery with a pelot to stop the bleeding of acute or chronic inflammation), and also traumatic injuries nose; hypovitaminosis with a lack of vitamin C; heat due to its drying effect on the nasal mucosa, due to heat or sunstroke.

At hypertension the appearance of blood from the nose is a kind of compensatory process that prevents overload of the blood vessels of the brain, and is characterized by its duration. Heavy bleeding from the nose at high blood pressure can lead to its rapid fall, which can provoke acute heart failure (collapse).

Another cause of frequent spontaneous nosebleeds is atrophic rhinitis. With this disease, the nasal mucosa becomes thin and dry. This contributes to the disruption of the integrity of blood vessels at the slightest touch.

Nosebleeds due to heat or sunstroke are accompanied by headache, dizziness, nausea, and fainting.

Classification of nosebleeds

1. According to the predominant release of blood from the anterior or from posterior sections In the nasal cavity, nosebleeds are divided into anterior and posterior.
2. According to the nature of the damaged vessel, nosebleeds can be capillary, arterial and venous.
3. According to the main causative factor, primary (due to local causes) and secondary (due to common diseases) nosebleeds.

First aid for nosebleeds:

? calm the patient, since with excitement there is a rapid heartbeat, and this, in turn, increases nosebleed;
? unbutton the collar, loosen tight clothing parts, ensure the flow fresh air(for example, open a window), make him breathe deeply, inhaling through his nose and exhaling through his mouth. Breathing through the nose helps increase blood clotting and stop bleeding;
? sit the patient on a chair or on the floor, slightly tilt his head forward;
? do not throw your head back. This makes it difficult for blood to flow through the veins of the neck, which can result in increased nosebleeds. In addition, this position of the head creates a false impression of reduced bleeding. In fact, blood usually flows into the throat, then enters the lower respiratory tract, and if swallowed, bloody vomiting may occur;
? place a container in front of your face to collect the blood flowing from the nose and spit out the blood flowing into the throat;
? it is necessary to blow your nose to remove blood clots, the presence of which prevents the nasal mucosa from contracting;
? put cold on the bridge of the nose for 30 minutes (an ice pack or ice wrapped in a thick cloth, or a napkin moistened cold water), a heating pad to your feet;
? if the use of cold is ineffective, instill vasoconstrictors into the nasal cavity: galazolin, naphthyzin, otrivin or press the wing of the nose to the nasal septum;
? if these measures do not help, then a ball of sterile cotton wool or gauze, moistened with a 3% solution of hydrogen peroxide, should be inserted into the anterior section of the nasal cavity and held for 10-15 minutes, pressing it through the wing of the nose to the septum.

If measures are ineffective first aid and continued bleeding, it is necessary to call an ambulance team.

Maximum time for applying a tourniquet in winter and summer - features and technology. Rules for applying a tourniquet: stages, features, control

Tourniquet for arterial bleeding

What is a hemostatic tourniquet?

Esmarch's hemostatic tourniquet

Hemostatic tourniquet Alpha

Technique for applying a tourniquet for arterial bleeding

Rules for applying a tourniquet for arterial bleeding

Place of application of a tourniquet for arterial bleeding

Time to apply a tourniquet for arterial bleeding

Mistakes when applying a tourniquet for arterial bleeding

How to apply a tourniquet correctly?

Application

Arterial bleeding. First aid before the doctor arrives

Venous bleeding. First aid

Car first aid kit. Its equipment

When to apply a tourniquet

When not to apply a tourniquet

What can be used

How to apply a tourniquet correctly

For how long?

First aid for bleeding

Capillary bleeding

Causes of capillary bleeding

Symptoms of capillary bleeding

First aid for capillary bleeding

Arterial bleeding

Symptoms of arterial bleeding

First aid for arterial bleeding

How to apply a tourniquet?

Venous bleeding

Signs of venous bleeding

First aid for venous bleeding

Internal bleeding

Signs of internal bleeding

First aid for internal bleeding

Nosebleeds in children

Causes of nosebleeds in children

First aid for nosebleeds

Applying a tourniquet for arterial bleeding

Tourniquet for arterial bleeding

What is a hemostatic tourniquet?

Esmarch's hemostatic tourniquet

Hemostatic tourniquet Alpha

Technique for applying a tourniquet for arterial bleeding

Rules for applying a tourniquet for arterial bleeding

Place of application of a tourniquet for arterial bleeding

Time to apply a tourniquet for arterial bleeding

Mistakes when applying a tourniquet for arterial bleeding

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Common symptoms of bleeding

Providing first aid for bleeding

Tourniquet for bleeding

Finger pressure on the artery

Fixing a limb in a certain position

Elevated limb position

Pressure bandage

Wound tamponade

Circular dragging of a limb

Clamping a vessel

How to stop arterial and venous bleeding?

Capillary bleeding

Venous bleeding

Arterial bleeding

How to stop bleeding from the femoral artery?