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Первая помощь при капиллярном кровотечении

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17 августа 2019

Кровотечение из капилляров возникает при неглубоких ранах или ссадинах, например, при порезах кухонным ножом, падениях на асфальт, царапинах кошек и т.д. Проще говоря, такое кровотечение возникает при повреждении кожи, мышечной ткани, слизистой оболочки. При таких ранах трудно зацепить вены и артерии, зато легко повредить мелкие кровеносные сосуды – капилляры. Крови при капиллярном кровотечении обычно немного, при нормальной свертываемости крови истечение обычно прекращается самостоятельно. Однако, нередко кровопотеря значительная, в рану можно занести инфекцию, поэтому даже при незначительных царапинах необходимо принять меры первой помощи при капиллярном кровотечении. Давайте поговорим о таких мерах более детально.

Итак, вы случайно поранились, чувствуете боль и стекаете кровью. Осмотрите рану: если ранение поверхностное, количество крови незначительное, вытекает кровь медленно (иногда даже по капелькам), а ее цвет ярко-красный, то это основные признаки капиллярного кровотечения. При кровотечении из капилляров следует обработать израненное место антисептиком, остановить кровь, наложить давящую повязку.

Как остановить кровотечение из капилляров?

В первую очередь обработайте дно и края раны антисептиком – перекисью водорода или хлоргексидином. Также можно использовать раствор йода, спирт или зеленку, но только на края раны и на окружающие ее участки кожи. Если спирт попадет в саму рану, то вызовет раздражение, а вы почувствуете ряд неприятных ощущений – от щипания до сильной боли.

Желательно помазать поврежденный участок ранозаживляющей мазью, например, Левомеколью, Актовегином, Левосином, которые помогут и кровь остановить и воспрепятствуют проникновению инфекции.

Далее накладываем давящую повязку, проще говоря, бинтуем рану. Для этого понадобится бинт и вата. Бинтовать необходимо плотно, но не слишком туго, иначе кожа посинеет и надолго. Если кровь таки пробилась через наложенную повязку, то сверху наложите еще один слой бинта.

Если вы поранили руку, то после наложения повязки поднимите руку выше уровня сердца, что приведет к оттоку крови из руки и уменьшит кровопотерю. Если поранили ногу, то необходимо лечь на спину и поднять ногу вверх – эффект будет такой же.

Также для остановки кровотечения и снижения боли целесообразно приложить к ране холодный предмет, например, лед, бутылку пива из холодильника, мясо из морозилки. Холод препятствует развитию отечности. Однако не стоит прикладывать первые попавшиеся под руку предметы к открытой ране, ведь это может привести к попаданию инфекции, поэтому сначала накладываем бинт, затем – прикладываем холод.

Таким образом, оказание первой помощи при капиллярном кровотечении не представляет особой трудности, однако является важным действием по снижению кровопотери, уменьшению болевых ощущений, профилактике проникновения в рану возбудителей инфекции.

Вытекание крови из мелких сосудов в полость тела или во внешнюю среду – это капиллярное кровотечение. Оно возникает при повреждении сосудов слизистых оболочек, мышечных тканей и кожных покровов.

При капиллярных кровотечениях происходит истечение насыщенно-красной крови равномерно по всей раненной поверхности или небольшой струйкой.

Такое кровотечение редко угрожает жизни пострадавшего и обычно прекращается самостоятельно, но может быть и обильным.

Чем опасно капиллярное кровотечение для человека?

Важной функцией крови является перенос кислорода и питательных веществ. Происходит их доставка к тканям, а оттуда уносятся продукты обмена и углекислый газ. При незначительных повреждениях капилляров и неглубоких ранах угрозы здоровью нет. Однако при обширном капиллярном кровотечении происходит нарушение этой жизненно-важной функции, в результате чего возможен дефицит кислорода. В первую очередь, от кислородного голодания страдает сердечная мышца и нервная система, что угрожает жизни.

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Первая помощь при капиллярном кровотечении необходима не только в случае серьезных ранений, но также если кровь идет из носа, уха, десен, пищеварительного тракта, матки и других органов.

Основным отличительным признаком капиллярного кровотечения является медленное выделение крови по всей раневой поверхности. Различают два вида капиллярных кровотечений: внутренние (наиболее опасные из них – маточное, кишечное и желудочное) и наружные.

Специалисты выделяют несколько причин капиллярных кровотечений, среди которых травматические, коагулопатические и патологические:

Болезни системы свертывания крови – это гемофилия, тромбоцитопеническая пурпура, болезнь Виллебранда;

Травматические повреждения (ссадины, ожоги, порезы). По классификации разделяются на термические, которые возникают от воздействия критически высоких температур, и механические, которые происходят в случае различных экстремальных ситуаций (катастроф, падений, драк);

Болезни сосудов, при которых происходит поражение кожных покровов и тканей (опухоли, гнойные воспаления кожи с вовлечением капилляров);

Общие заболевания (онкологические процессы, ревматоидный артрит, рассеянный склероз, некроз, атеросклероз), при которых поражаются сосудистые стенки по всему телу. Как результат, происходит просачивание плазмы и клеток крови, и возникают обширные внутренние капиллярные кровотечения;

Нарушения гормональных функций.

Внутренние капиллярные кровотечения со временем могут привести к образованию межтканевых и внутрисуставных гематом. Большую опасность представляют такие кровотечения из паренхиматозных органов (печени, селезенки, мозга) при их повреждении.

Как остановить капиллярное кровотечение?

Вовремя оказанная первая помощь при капиллярном кровотечении способствует временному или полному его прекращению. Способы остановки кровотечения зависят от его интенсивности и заключаются в наложении давящей повязки, проведении тампонады и применении холода. В большинстве случаев такое кровотечение не вызывает обширной кровопотери, но оно опасно заражением патогенными бактериями.

В случае возникновения раны на руке или ноге помощь необходимо оказывать так:

Поднять поврежденную конечность выше уровня сердца – в сосудах снижается давление, что приводит к остановке или значительному уменьшению кровотечения;

При ранении небольшой площади для предотвращения инфицирования необходимо смазать кожу вокруг раны йодом или произвести обработку 3% перекисью водорода. Для быстрейшего заживления сверху закрепляют бактерицидный пластырь;

Бинтом или марлей в несколько слоев наложить давящую повязку. Бинтование необходимо производить снизу вверх, после двух слоев бинта приложить ватный тампон и дальше проводить бинтование. Если повязка пропитается кровью, снимать бинты не нужно, следует сверху наложить ещё несколько слоев;

При обширном ранении временно приостановить кровотечение помогает максимальное сгибание сустава, расположенного выше раны, однако самый надежный способ – наложение жгута. Это делается так: максимально близко к ране, но выше нее необходимо положить ткань или бинт, сверху затянуть жгут и под него обязательно подложить записку с точным временем наложения. Зимой жгут держат не дольше часа, летом не дольше полутора. По истечению этого времени необходимо ослабить жгут на 15 минут и затянуть снова;

Для уменьшения болевых ощущений и остановки кровотечения к ране нужно приложить пузырь со льдом.

Первая помощь при внутреннем капиллярном кровотечении в брюшную полость: уложить больного на спину, поднять ноги и запрокинуть голову, приложить к месту предполагаемого кровотечения лед и вызвать скорую помощь. Такие действия помогают предотвратить шок, однако медлить с обращением в медучреждение ни в коем случае нельзя!

Носовое кровотечение – как остановить?

Слизистая оболочка носа богата мельчайшими капиллярами, поэтому любая травма может спровоцировать кровотечение. Различают их по длительности и интенсивности. Часто кровь из носа начинает идти без видимых на то причин, но обычно такое кровотечение бывает вызвано ударом, длительным использованием сосудосуживающих капель в нос, ломкостью и слабостью сосудов, солнечным или тепловым ударом, гипертонической болезнью или анатомическими дефектами носовой полости.

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Оказать первую помощь при капиллярном кровотечении из носа очень просто, важно только правильно все сделать:

Больной должен находиться в вертикальном положении, лучше сидя, а голова слегка наклонена вперед. Это обеспечивает беспрепятственное вытекание крови из ноздрей. Запрокидывать голову назад нельзя, поскольку кровь, затекая в носоглотку, может вызвать рвоту или кашель, а это только усилит кровотечение;

Приложить лед на область носа;

Прижать крылья носа к перегородке на пять минут. Это способствует образованию кровяного сгустка;

В носовой ход установить тампон, смоченный в растворе 3% перекиси водорода.

Все процедуры желательно выполнять в резиновых перчатках, или хотя бы предварительно продезинфицировать руки. При частых носовых кровотечениях нужно проводить регулярные профилактические мероприятия, укреплять сосуды, принимать аскорутин или аскорбиновую кислоту.

Опасность носовых кровотечений

Состояние, при котором выделяется кровь из носовой полости, может нести угрозу человеческой жизни, если причина в серьезном заболевании или травме. Необходимо и очень важно проведение временной остановки кровотечения до прибытия в больницу. Если кровь из носа идет более получаса и не останавливается вышеописанными методами, а объем кровопотери составляет более 200 мл, нужно вызывать скорую помощь, независимо от предполагаемых причин кровотечения.

Автор статьи: Алексеева Мария Юрьевна | Врач-терапевт

О враче: С 2010 по 2016 гг. практикующий врач терапевтического стационара центральной медико-санитарной части №21, город электросталь. С 2016 года работает в диагностическом центре №3.

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Артериальное кровотечение является одним из наиболее опасных кровотечений, несущих прямую угрозу жизни человека. Это связано в первую очередь с тем, что потери крови высоки и интенсивны. Поэтому важно знать его основные признаки и правила оказания первой помощи.

Несмотря на то, что незначительных причин, которые бы могли спровоцировать такое явление, нет, все же ситуации могут быть разными. Иногда можно подождать несколько часов до наступления нового рабочего дня и в обычном режиме отправиться на приём к врачу, а иногда ситуация не терпит отлагательств: следует вызвать врача .

Желудочно-кишечное кровотечение (ЖКК) – это вытекание крови из поврежденных заболеванием кровеносных сосудов в полости органов желудочно-кишечного тракта. Желудочно-кишечное кровотечение – часто встречающееся и серьезное осложнение широкого перечня патологий органов ЖКТ, представляющее угрозу для здоровья и даже.

Маточное кровотечение – это выделение крови из матки. Чаще всего оно является серьезным симптомом заболеваний женского организма. Любое маточное кровотечение должно быть вовремя диагностировано, а женщине оказана врачебная помощь Игнорирование подобного симптома приводит к серьезным последствиям, вплоть до летального.

Кровотечение из носа (по-научному – эпистаксис) – это весьма частая патология человека. При ней отмечается выделение крови из носовой полости, происходящее вследствие разрыва кровеносных сосудов. В некоторых случаях она приводит к большой кровопотери и угрожает жизни человека. В 20% таких кровотечений требуется немедленная помощь врача.

Кровотечение десен – это выделение определенного количества крови, сопровождающееся их воспалением. Чем сильнее воспалительный процесс, тем большее количество крови будет выделяться из десен. В некоторых случаях она появляется даже тогда, когда десна находится в состоянии покоя, например, ночью. Эта проблема является весьма.

При развитии сильного кровотечения из крупных сосудов больному необходимо оказать медицинскую помощь, поскольку значительная потеря крови представляет большую угрозу здоровью и может привести к летальному исходу.

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Причинами кровотечения всегда является повреждение стенки сосуда (артерий или вен), оно может происходить по разным причинам:

  • Травмы от ножевого ранения, ушиба и тд;
  • Онкологических заболеваний или воспалительных процессов в стенке сосудов;
  • Хрупкость стенки сосудов в следствие недостаточности витаминов, инфекций или отравлений;

Кровотечения подразделяются на артериальные (из артерий), венозные (из вен), капиллярные, внутренние (кровотечение во внутренние органы или полости), смешанные (при поражении как артерий, так и вен).

Артериальное кровотечение

Что можно делать

При оказании первой помощи при артериальном кровотечении необходимо:

    нажать большим пальцем руки на артерию выше раны, чтобы остановить или хотя бы ослабить кровотечение;

наложить резиновый или любой другой самодельный жгут (что попадется под руки, например, ремень, шнур и тд) на артерию выше раны, это уменьшит потерю крови;

оставить записку c указанием времени наложения жгута;

  • после оказания помощи пострадавшему, его следует немедленно отправить в специализированное медицинское учреждение (больницу или поликлинику).
  • Что нельзя делать

    • Нельзя оставлять жгут на более, чем 2 часа после его наложения, иначе может наступить омертвление тканей.

    Венозное кровотечение

    Что можно делать

    При оказании первой помощи при венозном кровотечении необходимо:

      поднять поврежденную конечность вверх;

    наложить на рану давящую повязку, сжимающую мягкие стенки поврежденного сосуда (при сильном кровотечении выше раны наложить жгут);

  • отправить пострадавшего в учреждение здравоохранения.
  • Что нельзя делать

    • Нельзя пытаться промыть рану или извлечь из нее мелкие предметы, например, осколки стекла;
  • Нельзя пытаться удалить сгустки крови и тромбы, иначе может открыться кровотечение.
  • Носовое кровотечение

    Что можно делать

    Для оказания первой помощи при носовом кровотечении необходимо:

      поместить в полость носа плотный ватный тампон, а голову слегка наклонить вперед;

    приложить холод к переносице, что позволит сузить сосуды и уменьшить кровотечение;

  • если в течение 15 минут кровотечение не остановилось, необходимо вызвать скорую помощь.
  • Что нельзя делать

    • Нельзя отклонять голову назад. Это может способствовать попаданию крови в дыхательные пути или пищеварительный тракт;
  • после остановки кровотечения в течение некоторого времени нельзя сморкаться, поскольку это может возобновить кровотечение. Следует воздержаться от горячей пищи и напитков, так как это может расширить сосуды.
  • Желудочное кровотечение

    Основными причинами развития желудочного кровотечения являются заболевания желудочно-кишечного тракта и некоторые другие состояния. К ним относятся:

    • язвенная болезнь желудка и двенадцатиперстной кишки;
    • дивертикул желудка;
    • рак желудка;
    • доброкачественные новообразования желудка или полипы;
    • эрозии слизистой оболочки желудка или эрозивный гастрит;
    • прием некоторых групп препаратов, раздражающих слизистую оболочку желудка (ацетилсалициловая кислота, нестероидные противовоспалительные средства и др)
    • стресс;
    • постоперационные ситуации;

    Для внутренних кровотечений в том числе желудочных характерны определенные симптомы:

    • резкая слабость, вплоть до обморока;
    • бледность кожи, посинение пальцев, носа, губ;
    • холодный пот;
    • шум в ушах, «мушки» перед глазами.

    К другим симптомам желудочно-кишечного кровотечения относят тошнота, рвота с со свернувшейся кровью в виде «кофейной гущи», боль в животе, стул характерного черного дегтеобразного цвета.

    Что можно делать

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