home Diseases Signs of internal bleeding in a child. Bleeding in children

Signs of internal bleeding in a child. Bleeding in children

Bleeding is not uncommon among children. Moreover, the etiology of bleeding is varied. Depending on the etiological factors, bleeding is divided into different groups.

There are, for example, sudden bleeding. That is, they occur unexpectedly under the influence of certain factors. Moreover, factors associated with the influence of mechanical influence.

A group of bleeding associated with various diseases is also considered. For example, with congenital pathology hematopoietic system, which is associated with blood clotting disorders. These could be respiratory diseases.

Pathology various organs leads to the development of recurring bleeding. Bleeding does not occur once, but can bother the child again and again. Which leads to massive blood loss.

What it is?

Bleeding in children is a process of blood clotting disorder or a state of massive blood loss. Massive blood loss in children can be a consequence of trauma. Moreover, injuries of various types.

But it should be noted that bleeding associated with pathology gastrointestinal tract are rarely observed. Precisely in children. Nosebleeds are common in children.

What exactly causes nosebleeds in children? Nosebleeds in children are associated with pathology or exposure to foreign bodies. But your susceptibility to nosebleeds depends on a number of factors. These factors include:

high air temperature;
a certain position of the child’s body;
active games.

Often, nosebleeds in children occur as a result of the influence of infectious agents. These infectious agents are infections. For example, syphilis.

Causes of bleeding

What are the main causes of bleeding in children? The causes of bleeding in children are different. But most often the following etiological factors can be traced:

injuries;
acute infectious diseases;
respiratory diseases.

Hypertension can cause bleeding in children. That's high blood pressure. Children with high blood pressure may develop bleeding. Even with high blood pressure, nosebleeds are not uncommon.

There is also hereditary pathology bleeding. In this case, the cause of bleeding is hemophilia. But hemophilia occurs predominantly in boys.

Any concomitant factor can cause bleeding in hemophilia. Concomitant factors for hemophilia in children include:

skin wounds;
damage to the mucous membranes of the nose and mouth;
hemorrhages.

The cause of bleeding may be thrombopenic purpura. But at the same time there are individual symptoms. As for bleeding from the lungs, they occur as a consequence of tuberculosis. The following diseases contribute to nosebleeds in children:

adenoids;
telangiectasia of the mucous membrane of the nasal septum;
foreign bodies.

Symptoms of bleeding

When bleeding occurs in children, certain symptoms occur. More often, symptoms depend on the causes and type of disease that caused the bleeding. In case of injury, bleeding is temporary. In this case, it is enough to perform hemostasis.

In case of injuries, bleeding can be arterial and capillary in nature. Depending on the damaged body part. In the presence of prolonged bleeding Children experience the following symptoms:

dizziness;
weakness;
pallor;
loss of consciousness;
hemorrhagic shock.

But bleeding may not be significant. What in this case is accompanied by the manifestation pain threshold and bleeding. If the bleeding is caused by an infection, the symptoms may be acute.

The most dangerous thing is repeated bleeding. It is repeated bleeding that leads to the development of massive blood loss and can also cause anemia. With malignant pathology, the disease has the following symptoms:

asthenia;
violation of the child's condition.

In thrombopenic purpura, bleeding symptoms are associated with bleeding from the mucous membranes. This may include nosebleeds. But the disease is not limited to bleeding. In addition to bleeding, hemorrhages may occur.

Hemorrhages occur in the skin. But more often, hemorrhages are observed in the affected area. With tuberculosis, pulmonary bleeding is observed. Moreover, hemoptysis is characteristic.

In children of early age, bleeding from the nose may be observed. In this case, it is often against the background of a disease or the influence of unfavorable factors. If there is a foreign body in the septum, certain symptoms are observed:

violation of nasal breathing;
mucus department;
bleeding;
the presence of swelling in the septum area.

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Be sure to consult a specialist!

Diagnosis of bleeding

To diagnose bleeding in children, it is necessary to conduct an examination. A medical examination suggests the presence of certain clinical signs. For example, if there is an injury, bleeding is detected.

If the bleeding is caused by an infectious disease, then the infection should be identified. To determine the infectious agent, it is enough to conduct a study using laboratory diagnostics:

blood picture;
bacteriological examination of stool;
urine test.

For determining hereditary disease It is enough to use the anamnesis data. After all, anamnesis allows one to identify pathology based on information from the child’s medical history. To determine the heart defect that caused the disease, a study using a cardiogram is necessary.

It is the cardiogram and echogram that can determine heart defects. X-rays are also relevant. X-ray of the lungs allows you to determine the presence of tuberculosis foci.

When measuring blood pressure hypertension can be determined. Pressure is measured using a tonometer. If hemorrhages are present, the diagnosis of hemophilia can be confirmed.

If bleeding is caused by the presence of thrombopenic purpura, then it is advisable to clinical trial. This reveals the following picture:

decreased platelet count;
enlarged spleen.

To determine it, it is important to conduct a sputum examination. Sputum allows you to identify Mycobacterium tuberculosis. During examination, namely, x-ray of the nasal septum, a foreign body can be identified.

Prevention of bleeding

Prevention of bleeding is a complex of preventive measures. Most often, it is necessary to prevent the child from receiving various types of injuries. If you have hemophilia, you must:

prevent injury;
prevent damage to the mucous membrane of the nose and mouth.

It is also important to prevent the development infectious diseases. Or they should be cured on time. In case of heart defects, it is advisable to carry out preventive actions aimed at surgical intervention.

If you have high blood pressure, it is important to use preventive measures. These funds should be aimed at normalizing blood pressure. It is also necessary to treat thrombopenic purpura in a timely manner.

If there is a malignant pathology of hematopoiesis, for example, chemotherapy is necessary. Chemotherapy eliminates bleeding. If a foreign body is present, it is important to immediately provide the child with assistance in removing the foreign body.

If the child is hypertensive and prone to bleeding, then it is necessary to exclude the influence of hot weather. Must be avoided high temperatures. Should also be excluded sitting position during mental activity.

Long, tedious games are also contraindicated for children. Therefore, you should engage in more quiet games to prevent nosebleeds. The following diseases must be treated promptly:

syphilis;
hemorrhagic diathesis.

Treatment of bleeding

For bleeding in children, it is necessary to carry out a complex of therapeutic measures. It is important to create a comfortable psychological environment for the child. That is, the child needs to be reassured. But it is also advisable to determine the etiological factor.

If you have nosebleeds, there are certain treatment measures. To data therapeutic measures include:

place the child in an elevated position;
throw your head back;
prevent the child from blowing his nose;
Avoid nose picking.

Be sure to provide your child with a cotton swab. But the tampon must be moistened with the following solutions:

hydrogen peroxide solution;
table vinegar solution;
pieces of raw meat.

If bleeding from the nose is profuse, then treatment is aimed at pressing the wings of the nose to the septum. It is advisable to put cold lotions on the bridge of the nose and the back of the head. To improve blood clotting function, the following measures are taken:

give the child a solution of table salt to drink;
ten percentage solution calcium chloride;
calcium gluconate orally.

Table salt is diluted using next steps. One teaspoon of table salt per glass of water. Take one dessert spoon every half hour. Calcium gluconate solution is used one dessert spoon several times a day.

Vitamin K is widely used in the treatment of bleeding in children. It is also necessary to use a heating pad when the extremities become cold. In case of pulmonary hemorrhage, the sick child is given a sitting or semi-sitting position.

Give orally for pulmonary hemorrhage table salt. Vitamin K is also used for treatment. An ice pack is placed on the chest. In case of hemoptysis, tourniquets are applied for hemostasis. Medications are also indicated:

camphor;
cardiac drugs.

In case of gastric bleeding, it is necessary to create rest and supine position on the back. It is advisable to place an ice pack on your stomach. For heart failure, heart warmers are used on the legs.

For any bleeding, a blood transfusion must be provided. But besides this, injections must be done. Injection of gelatin is most indicated.

Doctors' forecast for bleeding

With minor bleeding, the prognosis is good. That is, nothing threatens life if the bleeding is minor. Therapy for bleeding also plays a role.

Therapy aimed at stopping bleeding must be comprehensive. Only in this case the prognosis is the best. Especially if the disease is hereditary.

For acquired pathology, treatment should also be comprehensive. Otherwise, consequences may occur. The consequences boil down to the development of shock situations.

Outcome of bleeding

In case of bleeding, it is possible fatal outcome. For example, with massive bleeding and coagulation disorders. Therefore, care not provided properly leads to death.

Once the bleeding is stopped, the outcome is good. This is due to direct hemostasis. But in some cases, bleeding may recur.

At repeated bleeding the outcome is not favorable. Conditions bordering on terminal reactions may develop. Including hemorrhagic shock.

Life expectancy with bleeding

With bleeding, life expectancy is either impaired or increased. But this depends on the reasons that led to the disease. If the cause is not eliminated, bleeding may recur.

Repeated bleeding leads to irreversible processes. They are based on the development of anemia. Moreover difficult character. In this case, the quality of life is impaired.

Life expectancy is also affected by bleeding caused by malignant pathologies. For example, with leukemia. In this case, the development of a fatal outcome is clear.

Gastrointestinal bleeding in children is quite common and can occur from mechanical damage Gastrointestinal tract inadvertently swallowed sharp objects and aggressive liquids, and can be a symptom of a very serious disease. The health and often the life of the baby depends on how quickly parents take action. Of course, self-medication is unacceptable here; you should immediately consult a doctor.

The causes of such bleeding may be different. In children under three years of age, the reasons may be:

intussusception is a type intestinal obstruction caused by the ingrowth of one section of the intestine into another;
Meckel's diverticulum is a protrusion of the intestine into weak point and the formation of the so-called “abnormal sac”;
doubling of the large intestine, which may be accompanied by doubling of other organs;
hernia hiatus in the diaphragm.

In children under seven years of age, gastrointestinal bleeding can be caused by polyps in the intestines; they usually occur in the rectum and sigmoid colon.

In children over seven years of age, the reasons may be:

stomach ulcer, duodenum;
various types of gastritis;
ulcerative colitis;
bleeding from varicose veins in different parts of the gastrointestinal tract;
thermal ileitis or Crohn's disease, this is an inflammation of the ileum small intestine, accompanied by the appearance of ulcers and polyps and destruction of the mucous membrane.

In addition, in children of all ages, bleeding can occur if they swallow any hard or sharp objects, as well as aggressive liquids. It is also possible to contract dysentery or typhoid fever. Infants may have blood in their stool if the mother has cracks in her nipples and through them her blood enters the baby's intestines.

There are several blood diseases that are also characterized by bleeding in the gastrointestinal tract. There can be many reasons for bleeding and parents should not make a diagnosis themselves. Their task is to notice the beginning of bleeding in time.

Symptoms of stomach bleeding in children

Sometimes the warning signs of bleeding are sharp deterioration child's condition. All signs of blood loss occur: lethargy and weakness, the child feels dry mouth and extreme thirst, the skin and mucous membranes become pale, a rapid heartbeat appears, and blood pressure may decrease.

And if bloody vomiting appears, as well as bloody stools, or all together, then this is already acute stage diseases. Moreover, by the color of the blood you can understand in which part the bleeding occurred. If bloody vomiting occurs, the bleeding cannot be below the duodenum. There is red blood in the vomit, if the bleeding is in the esophagus or stomach, if it is dark, then the source of bleeding is further away.

If there is blood in the stool, then the bleeding has occurred in the lower gastrointestinal tract. Dark blood in the stool or even black stool indicates bleeding in the ileum or colon. If the blood in the stool is bright, this indicates that it entered the stool from the rectum or from the anal fissures.

Emergency care for gastric bleeding in children

If these signs appear, you should call an ambulance as soon as possible. Before her arrival, it is necessary to put the child to bed, apply ice to the site of suspected bleeding, and you can even let the child swallow pieces of ice. When vomiting, place the head on one side to prevent the child from choking. There is no need to water or feed the child; you also cannot rinse the stomach or give an enema.

Treatment

The doctor determines the child’s treatment after full examination patient, it is usually performed inpatiently. Depending on the intensity of the bleeding, treatment may be therapeutic for mild or surgical for severe. The operation allows you to identify the focus heavy bleeding and take measures to eliminate it. This can be ligation of veins, or the application of a sigmostoma (this is the removal of a piece of intestine outside), or resection of part of the stomach or intestines. In any case, the treatment is long and serious; restoring the child’s health after surgery requires great dedication from the parents.

Conservative treatment is more gentle and consists of a number of therapeutic measures:

for bleeding resulting from burns chemicals, perform gastric lavage with neutralizing substances;
administration of medications to help stop bleeding;
removing blood from the gastrointestinal tract using a probe or, if there is no danger, using enemas;
restoration of blood loss, usually carried out by transfusion of donor blood;
general support for the body. Since feeding the child on the first day is not recommended, therefore a mixture of glucose and saline is administered intravenously, starting from the second day they begin to feed carefully dietary food recommended by a doctor;

diagnosis and treatment of the disease. Usually this stage is long-term, treatment continues even after the child has been discharged from the hospital. Here, parents are required to strictly follow the recommended treatment.

Children's health is extremely important important role, so parents need to be especially attentive to the well-being of their children and pay attention to the development various violations well-being. Doctors say it is better to be overly vigilant than to ignore various warning signals from the body. One of the frightening conditions faced by pediatricians and gastroenterologists is bleeding from digestive tract in children.

Such bleeding in children may have different reasons occurrence, and in any case are a rather alarming symptom. The main unifying symptom of such conditions is the appearance of bloody vomiting or bloody stools; such symptoms can be combined. If the bleeding is not pronounced, and the blood remains in the stomach for a relatively long time, the vomit becomes like coffee grounds. And with heavy bleeding, scarlet blood can be seen in them. After about eight to ten hours, or when blood is ingested, tarry stools are detected. If bleeding occurs from the lower parts of the intestine, then little changed (scarlet) blood can be seen in the child’s stool.

The type of bleeding from the digestive tract and its causes are largely determined by the age of the children.

Between the ages of three and seven years, bleeding is most often provoked by colon polyposis. And in children over seven years of age, they find varicose veins veins, esophagus or stomach, as well as ulcerative lesions stomach or duodenum, erosive and allergic forms of gastritis.

In addition, gastrointestinal bleeding in children can occur with many blood diseases, including hemophilia, hemorrhagic vasculitis, Wergolf disease, leukemia, applastic anemia, etc.

Dangerous symptoms bleeding

The classic manifestation of bleeding from the digestive tract in children, as we have already written on this page “Popular about health,” is bloody vomiting or bloody stool. If bleeding wears exuberant character, it is accompanied by thirst, drying of the mucous membranes oral cavity, rapid progression of weakness and dizziness. Loss of consciousness is also possible. The skin turns pale, and cold sweat, limbs become cold. Patients may become agitated or prostrated, and their facial features sharpen quite quickly. Sometimes yawning, nausea and repeated vomiting occur.

Pathological processes lead to increased heart rate, but it has weak filling. Over time, the pulse becomes thread-like, breathing becomes more frequent, and blood pressure drops.

The appearance of the described symptoms is a reason for immediate and hospitalization. inpatient department. Young patients with bleeding from the digestive tract are usually sent to the surgery department.

Treatment of bleeding

Transportation of patients with bleeding should be carried out with extreme caution. The child is placed on his back, and an ice pack is placed on the upper half of the abdomen. In case of severe bleeding, blood transfusions are carried out, intravenous infusions of solutions are also carried out. At the same time, administration is carried out vitamin preparations– vitamins K, PP and C.

If bleeding continues, doctors raise the question of whether surgical intervention– to find the source of bleeding and eliminate it.

On the first day after the bleeding stops, children should not be fed. They are shown intravenous administration glucose in combination with saline solution. The next day, doctors prescribe the Meulengracht diet, which consists of thoroughly pureed vegetable purees(they are mixed with pureed meat or fish), cooled milk, eggs, and cream.

Of course, in parallel, doctors carry out active treatment underlying disease.

Uncomplicated bleeding from lower sections digestive tract (with cracks anus or hemorrhoids) can be successfully treated at home - after a full examination, selection proper therapy And dietary nutrition.

Surgical treatment bleeding from the digestive tract in children

Sometimes it is possible to cope with bleeding or prevent its reoccurrence only with the help of surgery. It can be open, or involve a series of minimally invasive procedures. The latter include methods for treating bleeding caused by gastritis and ulcerative lesions of the gastrointestinal tract. In such situations, the doctor may decide to perform an endoscopic intervention - to cauterize or puncture the affected areas. But such measures do not always give lasting results. positive effect, in this case you cannot do without open surgery for suturing the problem area.

Also surgery It is also carried out if bleeding has developed due to diverticulosis and some other pathologies.

It is worth noting that the appearance of any significant bleeding from the digestive tract in a child is a reason to immediately call an ambulance.

Gastrointestinal bleeding requires emergency medical treatment, since, even if small, it can quickly lead to death. Causes: peptic ulcer of the stomach and duodenum, rupture of varicose veins of the esophagus and cardia of the stomach with portal hypertension(cirrhosis of the liver, thrombophlebitic spleen), erosive gastritis, burn of the gastric mucosa due to accidental ingestion of caustic alkalis and concentrated acids, ulcerative lesions of the small and large intestines, typhoid fever, dysentery, ulcerative colitis, terminal ileitis, intussusception, bleeding Meckel's diverticulum, fissures anus. Gastrointestinal bleeding may occur when various diseases blood (hemophilia, hemorrhagic vasculitis, Werlhof's disease, leukemia, aplastic anemia, etc.).

Symptoms. Main feature this state- bloody vomiting or bloody stools. Often they are combined. When diagnosing gastrointestinal bleeding, it is necessary to exclude diseases in which blood may enter the gastrointestinal tract from other organs (upper Airways, lungs, etc.). With hematemesis, the blood is thick, dark in color, or has the appearance coffee grounds with clots. Sometimes it contains residues undigested food. After 8-10 hours, “black” stool appears. In all cases of gastrointestinal bleeding, monitoring of blood pressure and hemoglobin content in the blood is necessary.

Heavy bleeding accompanied by thirst, dryness of the mucous membranes of the oral cavity, rapidly progressing weakness with dizziness, and sometimes loss of consciousness. The skin becomes pale, covered in cold sweat, and the extremities become cold. The patient is either excited or in prostration. Facial features become sharper. Sometimes yawning, nausea and repeated vomiting appear. The pulse quickens, has weak filling, and then becomes thread-like. Blood pressure decreases, breathing quickens.

In addition to the above common features, depending on the causes of bleeding, certain specific symptoms Yes, when peptic ulcer stomach and duodenum there is a pain syndrome with specific localization and a typical daily seasonal rhythm with an appropriate medical history. Bleeding can occur both during exacerbation of the disease and during remission. Heavy bleeding is observed in 5-12% of children with peptic ulcer disease.

With portal hypertension due to liver cirrhosis, a long “hepatic” history, exhaustion of the patient, enlargement of the liver and spleen, a pronounced pattern of collateral saphenous veins, spider veins on the skin, less commonly ascites and intermittent jaundice. Functional status the liver is severely impaired. At x-ray examination esophagus with a contrast mass reveals varicose veins, which can cause profuse, sometimes fountain, bloody vomiting.

With thrombophlebitic spleen there is a rapid, sometimes with pain syndrome enlargement of the spleen, with an equally rapid decrease after bleeding; recurrent nosebleeds and undulating enlargement of the spleen with a history of fever. A combined enlargement of the spleen and liver is often observed.

In case of erosive gastritis and burns of the gastric mucosa with caustic alkalis and concentrated acids - pain along the esophagus, in the epigastric region, gastric history or traces of burns with these substances on the oral mucosa. If alkalis or acids are ingested, shock may occur.

Intussusception has a typical clinical picture acute abdomen.

Bleeding from the stomach and intestines in cases hemorrhagic diathesis combine with others clinical symptoms these diseases: skin hemorrhages, changes in blood clotting, duration of bleeding, retraction blood clot, changes in the quantity and quality of platelets, etc. Other diseases accompanied by gastrointestinal bleeding (nonspecific ulcerative colitis, typhoid fever, dysentery), have a clinical symptomatology well known to doctors. When bleeding from the stomach, bloody vomiting is often observed; from upper sections intestines, including the duodenum - black tarry stool; from the lower intestines - stool containing slightly changed blood.

Treatment. In all cases of bleeding from the gastrointestinal tract, hospitalization of the patient is indicated, since even minor bleeding can become profuse. It is better to hospitalize children in a multidisciplinary hospital, where, along with therapeutic, infectious diseases and others, there is a children's surgical department.

The patient is provided with absolute rest. The patient is transported carefully. The child should lie on his back. An ice pack is placed on the upper half of the abdomen.

A single-group blood transfusion is performed at the rate of 10-15 ml per 1 kg of body weight (it is better to transfuse freshly citrated blood or directly from the donor to the recipient). At rapid decline hemoglobin level up to 70 g/l is transfused by drip large quantities blood (up to 250-400 ml). 3-10 ml (depending on age) of 10% sodium chloride solution and 5-10 ml of calcium chloride are administered intravenously.

At the same time apply large doses ascorbic acid, vitamins PP, K, etc. Ascorbic acid administered intravenously or intramuscularly in the form of a 1% or 5% solution of sodium ascorbate up to 100-300 mg, depending on age. Vitamin PP is prescribed orally at 0.025-0.05 g 2-3 times a day. In the first days of bleeding, it is better to administer vitamin K intramuscularly at 0.5-1 ml (1% solution) per day for 3 days.

In case of profuse bleeding from varicose veins of the esophagus or cardia of the stomach, drip transfusions of the same group or 0 (I) blood group or plasma are immediately started. To narrow the preportal arterioles and thereby reduce the pressure in portal vein 5-10 units are injected dropwise. pituitrin in 100 ml of 5-10% glucose solution. You can also inject a 6% solution of aminocaproic acid (50-100 ml) dropwise. When blood pressure decreases, a 10% caffeine solution, a 1% mezaton solution or a 25% cordiamine solution in an age-specific dosage is prescribed.

For burns of the esophagus and burns of the stomach, vigorous anti-shock therapy is carried out. In case of burn ammonia or caustic soda, wash the stomach with a 0.1% solution of hydrochloric acid or warm water; vinegar essence - boiled water until the smell of vinegar disappears; acids - 2-3% solution of bicarbonate of soda through a probe, which is pre-lubricated with well-boiled vegetable oil.

On the first day after the bleeding stops, you should refrain from feeding the child - glucose mixed with saline is administered intravenously. Starting from the 2nd day, the Meulengracht diet is prescribed, consisting of chilled milk, cream, eggs, butter, well-mashed vegetable purees with carefully chopped and pureed meat or fish. Along with the measures taken, vigorous therapy of the underlying disease is carried out.

If therapeutic measures are ineffective and bleeding continues, consultation with a surgeon is necessary to decide on surgical treatment.
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Emergency care for children with bleeding

Blood is unique liquid tissue, the quantity of which is strictly limited. The blood volume of a newborn child is 500 ml, an adult’s is about 5 liters, and every drop of this volume is priceless. Any blood loss is not indifferent to a person: small bleeding is stress for the body, massive bleeding is a threat to life and health. Bleeding is especially difficult for children and adolescents - it is for them that even a relatively small loss of blood can turn into a big disaster. How not to miss bleeding in a child and stop it correctly? Let's find out...

The cause of bleeding is a violation of the integrity blood vessel– artery, vein or capillary. Moreover, damage to the vessel does not necessarily result from injury or injury - the cause of bleeding can be the rupture of the vessel under the influence of high blood pressure(nosebleeds), damage to blood vessels by a growing tumor, exposure to medicines(gastrointestinal bleeding). The amount of blood loss depends on the type and caliber of the vessel (bleeding from arteries is more abundant than bleeding from veins and capillaries), as well as on the duration of blood loss. Sometimes damage to a relatively small vessel leads to the development of anemia and other severe complications due to late detection of bleeding. The nature of first aid for bleeding depends on the location of the bleeding vessel (external or internal bleeding), the type of vessel (artery, vein, capillary, vessels internal organs) and the intensity of blood loss. It is always easier to recognize and stop external bleeding than internal bleeding, since with internal bleeding, blood is usually not visible, only symptoms of blood loss are visible.

Capillary bleeding . The most common reason capillary bleeding minor injuries occur - cuts, scratches and abrasions. For an adult, such an injury and the associated bleeding are insignificant, and they are not always paid attention to. But for a child’s body there are no insignificant injuries and bleeding - therefore, even in such a “frivolous situation”, first aid should be provided to the victim.

First aid.

Regardless of the location, the abrasion is washed with hydrogen peroxide, the skin around the wound is treated with an antiseptic (iodine, brilliant green) and a sterile napkin is pressed against the wound for a while to stop bleeding. If the abrasion is localized on the skin of the abdomen, chest or head, it is necessary to exclude internal bleeding, damage to the brain and internal organs - for this, the child must be shown to a specialist.

Venous bleeding . As the name suggests, this type of bleeding occurs when the veins are damaged. For those who don’t know: veins are vessels that carry blood from internal organs and different parts body to heart. Venous blood is oxygen-poor and rich in carbon dioxide, so its color is dark red. The blood pressure in a vein is relatively low (much less than the pressure in an artery), so deoxygenated blood relatively slowly flows out of the vessel, spreading over the skin. However, this does not mean that venous bleeding is harmless - if a large vein is damaged, blood loss can reach life-threatening levels within a few minutes.

First aid.

The most in a simple way stopping venous bleeding is pressure on the damaged vessel - as a result, the vein is pinched, the bleeding decreases or stops. You need to apply pressure to the bleeding vein and, accordingly, the wound, with a sterile napkin or a roll of a sterile bandage; in the absence of which, you can use a clean handkerchief or any other piece of clean cloth. If there is no other way out, you can apply pressure to the wound with your palm or fingers. Pressing the vessel to stop bleeding can only be used as a temporary measure - a pressure bandage should be applied to the wound as soon as possible.

Starting to apply a pressure bandage, take several sterile napkins or a roll of sterile bandage, press them tightly to the wound and, without releasing the pressure, firmly bandage it to the body with several tight rounds of bandage. If the bandage is applied correctly, bleeding significantly decreases or stops.

As additional measures To stop venous bleeding from the vessels of the limb, temporary clamping of the vessel below (!) the wound and elevated position of the limb are used.

If the veins of the neck are damaged, applying a conventional pressure bandage is impossible, since such a measure threatens suffocation. In this situation, the child’s hand on the side opposite to the location of the wound is tilted upward, towards the head, and a pressure bandage is applied to the neck, grabbing the hand on the healthy side and using it as a support.

Even if actions to stop venous bleeding are completely successful, the child must be shown to a doctor. To prevent wound infection and recurrent bleeding, the doctor will clean the wound and apply stitches.

Arterial bleeding . Arterial bleeding is the most dangerous look bleeding. It is characterized by the bright scarlet color of the blood, the release of blood from the wound under pressure (a pulsating stream or fountain), rapid rates of blood loss and a high risk of developing shock. Most often, arterial bleeding accompanies injuries to the extremities, including limb avulsion.

First aid.

You need to act quickly and clearly - the rate of blood loss during arterial bleeding They don't give you time for a second try. The first step is to lift and strongly squeeze the limb above (!) the wound - you will have to press really hard, since the arteries are located deep in the tissues and are protected by muscles. If you are injured in the lower leg, foot, forearm or hand, maximum flexion of the leg or arm at the knee or elbow joint and fixing the limb in this position. While continuing to apply pressure on the artery, apply a pressure bandage according to the same rules as for venous bleeding(usually the second rescuer applies the bandage).

After the bandage is applied, we gradually reduce the pressure on the vessel and see what happens. If the bandage remains dry or the amount of blood on it does not increase, measures to stop the bleeding were successful, further actions- for a doctor. If after applying a pressure bandage the bleeding does not stop, it is necessary to apply a hemostatic tourniquet. The purpose of applying a tourniquet is to press the affected vessel to the bone, so the tourniquet is applied to that part of the limb where there is one bone - femur, shoulder. There is no point in applying a tourniquet to the lower leg or forearm - the vessel will not be compressed and bleeding will continue.

When an artery is injured, a tourniquet is always applied above the injury site. The pressure must be sufficient, but not excessive, otherwise there will be traumatic injury nerves, and as a result, dysfunction of the limb. The tourniquet on the limb is tightened until the pulse disappears in the wrist or foot (provided that you can determine the pulse) or until bleeding from the damaged vessel stops. Any long, strong and elastic object can act as a tourniquet - a wide rope, a trouser belt, a belt, a tie, a headscarf. It is not recommended to apply a tourniquet to a naked body - be sure to place any cloth, towel, or piece of clothing under it. After applying the tourniquet, record the time of application - the time factor in this case is very important. The tourniquet should not compress the limb for a long time, as this can lead to irreversible changes in the tissues of the limb. in winter safe period does not exceed 30 minutes, in summer – 1.5 hours. In this case, regardless of the time of year, every 15 minutes the pressure of the tourniquet must be slightly loosened until blood circulation is restored, and then tightened again.

Typically, the application of a hemostatic tourniquet is required in following situations: traumatic amputation (severance) of a limb; a large number of victims and there is no time to use other methods to stop bleeding; the injury to the limb is so significant that it is impossible to determine the type of bleeding; other methods of stopping bleeding are ineffective.

After the bleeding has stopped, while waiting for the ambulance to arrive, the victim must be laid down, if he is conscious, calmed down, warmed up and given hot tea. To maintain normal blood supply to the brain and internal organs, it is recommended that victims with a large volume of blood loss be placed on their back, without a pillow, with their legs elevated 115-20 cm. If your arm is injured, make sure that the injured limb is also in an elevated position.

Let's say a few words about the features of providing assistance to a child with life-threatening traumatic amputation (severance) of a limb or some part of the body. First aid measures in such a situation boil down to stopping the bleeding using any available methods: compression of large vessels supplying blood to the affected area of the body, application of a pressure bandage or hemostatic tourniquet. A sterile bandage is applied to the wound, and the limb is fixed. After the patient’s condition ceases to cause concern, it is imperative to find the severed part of the body so that microsurgeons can subsequently sew it back (this is especially important for children and adolescents). The severed body part (amputee) must be cleaned of visible contaminants or washed, and applied to the place where it was torn off. sterile bandage, put the amputee in a plastic bag, which must be placed in another bag filled with ice, snow, cold water. Such measures will keep the tissue viable for approximately 18 hours. Be sure to include a note in the first bag indicating the exact time of injury and the start of cooling. Do not freeze the rejected part in the refrigerator or freezer.

Internal bleeding, bleeding from internal organs . Internal bleeding can be caused by damage to vessels located outside the organs or damage to the internal organs themselves. Most often, internal bleeding accompanies injuries to the abdomen, lower back, chest and head, but can also be a complication of certain diseases - erosive gastritis, peptic ulcer of the stomach and duodenum (gastrointestinal bleeding), pulmonary tuberculosis ( pulmonary hemorrhage). General symptoms internal bleeding are weakness, rapid heartbeat, cold sticky sweat, impaired consciousness, pallor, pain at the site of the damaged vessel (not always). If there is bleeding in abdominal cavity the child takes a forced position - lying on his side with his knees bent and his legs pressed to his stomach. When bleeding into the lumen of the gastrointestinal tract, vomiting blood appears (vomit may be red or brown due to contact of blood with gastric juice) And bloody diarrhea(usually black). Bleeding in pleural cavity is accompanied by compression of the lung, which is manifested by shortness of breath, blue lips, the child tries to take a sitting or semi-sitting position. A symptom suspicious for kidney damage is the appearance of blood in the urine.

First aid.

First of all, the child must be ensured peace - try not to move the victim unless absolutely necessary. If there is a chest injury, help the child take a semi-sitting position; if there is an abdominal injury and gastrointestinal bleeding is suspected, help the child take a supine position. Place cold on the site of injury - chest, abdomen or lower back - and do not give water or food to the child. Provide access fresh air and at the same time, keep the baby warm. An ambulance should be called immediately after an injury - than more like a child will receive qualified assistance, the greater his chances of recovery.

Nose bleed . The causes of nosebleeds are injuries, diseases of the nose (deviated nasal septum, polyps, tumors) and systemic diseases (arterial hypertension). Nosebleeds often occur suddenly and can vary in intensity and duration.

First aid.

The child must be seated, tilt his head forward, press his nostrils with his fingers, put cold on the bridge of his nose and leave in this position for 10 minutes. You cannot force a child to throw back his head - blood from the nose can get into the larynx and trachea, which is undesirable. If the above measures did not stop the nosebleed or the bleeding recurred after some time, immediately show the child to the doctor.

Hemoptysis . Hemoptysis is the release of blood with or without sputum during a cough. The most common reasons hemoptysis are pulmonary tuberculosis, bronchitis, pneumonia, tumors of the respiratory system, foreign bodies trapped in the respiratory system. The basis of hemoptysis is pulmonary hemorrhage, so hemoptysis is often accompanied by typical signs blood loss: weakness, drowsiness, pallor skin, cold sweat, rapid heartbeat, shortness of breath.

First aid.

When helping a child with hemoptysis, it is necessary to sit him down, calm him down, and provide access to fresh air. A heating pad with ice should be placed on the chest, and at the same time the child should be given small sips to drink. cold water or swallow very small pieces of ice. In this case, an early consultation with a doctor is vital.

Finally

Heavy bleeding is the most dangerous situation, which only a child can get into, and all hope in this case is on the adult closest to the place of injury. Massive external bleeding usually makes a strong impression on others, and despite this, it is necessary to act quickly and clearly. Do not panic under any circumstances and remember that the life of a wounded child depends on your actions in the next few minutes. Take care of your health!