Gastric bleeding first aid

Short-term
loss of consciousness (from a few seconds
up to several minutes), depth from
stun to stupor, amnesia for the period
events immediately preceding
an injury. Consciousness recovery
headaches complaints are characteristic
weakness, dizziness, ringing
and tinnitus, sweating, disturbance
sleep Single vomiting is possible.
Light asymmetry detected
pupils, tendon and skin reflexes,
intermittent finely spread nystagmus.

Lay the victim down.
With vomiting – prevention of ingestion
vomiting into the respiratory tract by turning
the victim’s head on its side. Chill on
head.

Peace
inside 0,5 g of analginum, 0,005 g of diphenhydramine and
0,1 g of caffeine-sodium benzoate.

Medical emergency
help at the medical center.

Peace.
Airway Relief
vomit. With the lowering of the tongue –
fixing it with a pin to the cheek. Intramuscularly
2 ml of 50% analgin solution. When loosened
heart activity and weak pulse
inject subcutaneously 1 ml of 10% caffeine solution,
subsequently (if necessary) 2 ml
cordiamine.

Hospital evacuation
on a stretcher lying accompanied by a doctor
(paramedic).

More
severe type of closed head injury
brain damage
its structure.

Loss
consciousness with mild bruising
brain from a few minutes to
1 – 2 hours, with moderate to severe – up to several
hours, with severe – up to 3 – 4 weeks.
Tachycardia. Neurological symptoms
mild to mild
to gross focal symptoms. maybe
psychomotor agitation.

Often
revealed fractures of the bones of the skull. At
severe brain contusion
– deep (from stupor to coma) violation
consciousness, often motor
excitement, gross focal symptoms
not only from the hemispheres, but also
brain stem (anisocoria, nystagmus,
floating eyes, swallowing disorder,
paresis and paralysis of limbs, atony
or hypertension in the limbs, pathological
reflexes, etc.).

Lay the victim down.
With vomiting – prevention of ingestion
vomiting into the respiratory tract by turning
the victim’s head on its side. Chill on
head.

Peace. Intramuscularly
2 ml of 50% analgin solution. Fixation
tongue, toilet of the oral cavity.

Peace.
Put the patient on his side, remove the mucus
and vomit from the mouth, subcutaneously enter
1 ml of 3% phenazepam solution, (2 ml of 0,5%
Relanium solution), 1 ml of a 20% solution
caffeine and 2 ml of cordiamine solution. IN
stop breathing immediately
start artificial respiration (way
“Mouth to mouth”). Optionally enter
intravenously 20 ml of a 40% glucose solution
or 20 mg of lasix.

RџSЂRё
lack of severe respiratory distress
and cardiac activity of patients
should be evacuated immediately
hospital on a stretcher, accompanied
a doctor. Enter before evacuation
intramuscularly 5 ml of 50% analgin solution
and 1 ml of 1% diphenhydramine solution. Be ready
en route in case of deterioration
conditions for repetition of the above
events. Not subject to evacuation
agonized patients
condition.

How to provide emergency care for gastrointestinal bleeding?

Medical care for internal bleeding is required regardless of the severity of the condition. After calling the medical team, the algorithm for emergency care for stomach bleeding is as follows:

  • provide the patient with complete rest and immobility, lay him on a flat surface or raise his legs slightly with symptoms of severe bleeding;
  • if there is vomiting, the patient needs to be turned on his side so that he does not choke;
  • put ice on the stomach, you can use a heating pad or a bottle of cold water, this will help stop the bleeding and calm the pain;
  • blood loss is accompanied by oxygen starvation, so the patient needs an influx of fresh air;
  • do not leave the patient and carefully monitor his condition.

During bleeding, thirst begins to torment. In no case should he be given a drink. It is only permissible to rinse your mouth with cold water. In general, nothing should enter the stomach — neither liquid, nor food, nor medicine. It is forbidden to rinse the stomach, put an enema.

During a blood loss a person has fear, a panic state. Emergency care for bleeding is also to reassure the patient. It is undesirable for him to talk and generally to strain somehow.

First aid is especially important in severe conditions when a person begins to lose consciousness. In this case, it must be “returned” with the help of ammonia (a few drops per cotton wool – and allowed to inhale). Pulse and respiration control is important. To alleviate the condition, from time to time you need to wipe the face and neck of the patient with a damp cloth.

If the injured person is close or familiar, the doctor who arrives at the call must be informed about diseases that could cause gastrointestinal bleeding. This will facilitate diagnosis and accelerate the provision of emergency medical care.

Ammonia allows you to bring the patient into consciousness during a serious condition

Emergency medical care

A patient with internal bleeding is hospitalized in the surgical department. Perhaps, with mild bleeding, conservative therapy will be prescribed. Emergency care is provided in an endoscopic manner. The doctor rinses the stomach with cold water, which causes a narrowing of the vessel and its blockage. Adrenaline is injected into the stomach through a probe and chipped off at the site of blood flow, it also spasms bleeding vessels.

In mild or moderate cases, endoscopic manipulations are performed, which include the following methods of stopping bleeding:

  • cauterization of vessels from which blood flows by electricity or laser;
  • applying special medical glue;
  • Sewing threads or applying special clips.

If the bleeding is massive, anti-shock therapy is performed and hemostatic agents are used. During the operation, the bleeding site is sutured or part of the stomach is removed, depending on the degree of damage that caused the bleeding.

11.2. Damage to the spine and spinal cord.

Pain in place
spinal injuries, paresis,
disorders of sensitivity and function
pelvic organs.

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В
severe cases – spinal shock,
characterized by violation of all kinds
sensitivity below damage
spinal cord and flaccid paraplegia.
Cardiovascular Disorders
and breathing.

Lay down
injured to shield in position on
back. It is strictly forbidden to set
the patient to his feet, sit down.

Peace.
Intramuscularly 1 ml of a 2% solution of promedol,
2 ml of cordiamine. For breathing problems
– mechanical ventilation.

Painkillers
funds intramuscularly inject 2 ml of 50%
Analgin solution, 1 ml of 3% solution
phenazepam. Antishock events
and catheterization of the bladder – by
indications. The use of heating pads
contraindicated.

Hospital evacuation
by ambulance (best
by plane or helicopter), accompanied
a doctor.

Can I deal with stomach bleeding at home?

Any bleeding is life threatening. It requires medical attention. Even mild but prolonged bleeding leads to serious consequences in the form of anemia. Along with the medication prescribed by a doctor, you can help yourself and folk remedies.

Herbs – pepper mountaineer, viburnum bark, horsetail, pink immortelle will help prevent and stop light stomach bleeding. They have not only a hemostatic effect, but also affect the cause of the bleeding.

After the bleeding has been stopped, the patient is prescribed bed rest, a special diet and no physical exertion. Constantly monitoring his condition.

In total, two types of treatment are divided: with the help of drugs and surgery. The second method is usually used as a backup.

There are three ways to treat with medication:

  1. Directed to the patient’s hemostasis system, drugs are administered intramuscularly or intravenously (Etamsylat, Octreotide, Vikasol).
  2. Aimed at the source of bleeding (omeprazole).
  3. Aimed at restoring blood (Reopoliglyukin (with a slight loss of blood).

In addition to medical treatment, the stomach is washed with cool water from time to time. This is necessary in order to remove blood discharge from it and cause a spasm, which will lead to a decrease in bleeding.

In addition, they examine for the presence or absence of Helicobacter pylori bacteria that destroy the gastric mucosa. In the case of a positive test, antibiotic treatment is prescribed until the bacteria are destroyed.

Important! Surgical intervention is used only in extreme cases, when there is severe uncontrolled bleeding.

There is for a method of conducting operations:

  • Laparoscopic, which is carried out through a small incision with the help of special tools – endoscopes.
  • Laparotomy – an incision is made into the entire stomach. This is necessary for hard to reach lesions.

Which method to choose is decided by the attending physician. Usually, bleeding in the stomach stops without surgery. Usually this is twenty percent when the help of a surgeon is needed.

Reference: in case there are contraindications for the operation, it is decided to carry out conservative treatment with the help of special medications.

What and how to treat is decided only by doctors – self-medication is harmful. This can only aggravate your condition, and in some cases lead to the death of the patient.

11.3. Tissue Compression Syndrome

Syndrome
prolonged tissue compression develops
after the resumption of blood circulation
when released from prolonged compression
tissues.

Complaints
on pain in the limb exposed
compression, when released from compression
– blanching and swelling of the affected
plot. Compression Duration
– more than 2 hours.

Right Away
after limb release – moderately
tightly bandaging her
ice bubbles, immobilization
limbs. Alkaline drink. Warming
the victim.

Dressing control and
immobilization. Subcutaneously 2 ml of 2% solution
promedol, 2 ml of cordiamine solution.

Medical emergency
help at a medical center –

Treatment
traumatic shock prevention
acute renal failure:
narcotic analgesics, procaine
conduction blockade, intravenously –
saline solutions, furosemide (lasix) 40
-80 mg, antibiotics. With extensive destruction
limbs – tourniquet above the site of compression.

Emergency evacuation
to hospital by ambulance
lying on a stretcher, in
accompanied by a doctor (paramedic).

11.7.1. Rib fractures

Limitation
breathing on the side of the injury, when feeling
local soreness, crepitus
bone fragments, pathological
mobility, and with a rib valve –
paradoxical chest tour
cells. With an increase in acute respiratory
insufficiency of the skin is gray,
there may be cyanotic, tachycardia,
hypertension (due to hypoxia).

First aid and
first aid.

When isolated
fractures – the introduction of painkillers
funds and evacuation to a medical center.

With multiple
casement rib fractures introduction
painkillers overlay
circular pressure dressing evacuation
to the medical center.

Emergency medical
help at the medical center.

Paravertebral
novocaine blockade (on one rib
above and below the fracture sites); fixation
rib valve silk stitches
(subcutaneously) to a fragment of a staircase tire,
which should be pre
fixed to the chest, i.e. must
rib stretching
valve and thus eliminated
paradoxical chest tour
cells; oxygen inhalation, administration
cardiac and vascular preparations.

Emergency evacuation
to the hospital by ambulance in
sitting position (on a stretcher) accompanied
medical worker.

11.7.2. Traumatic asphyxia

RџSЂRё
sudden compression of the chest
heart pressure rises sharply and
venous vessels. This leads to soaking.
blood of the lungs, mediastinal tissue,
subcutaneous fat, mucous membranes
(including the mucous membrane of the trachea)
and skin. Tissue hemorrhage causes
swelling of the tissues, especially the mucosa and
submucosal layer, which leads to narrowing
lumen of the trachea from the inside and to asphyxiation.

Leather
face, neck, upper chest is cyanotic
with multiple petechiae, in heavy
cases, respiratory quickly builds up
failure, loss of consciousness,
motor excitement.

Exemption
chest, oral cleansing,
Mechanical ventilation, painkillers
and evacuation to the MP.

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Intramuscular
2 ml of a 50% solution of dipyrone, 2 ml of cordiamine,
30 mg prednisolone, performing cervical
vago-sympathetic blockade on one
side ventilation, oxygen delivery, urgent
evacuation to a medical institution.

Genital Injury

Pain,
often so intense that
accompanied by shock. Intense
bleeding in case of closed injuries
terminates spontaneously and
manifested only by an increase in size
scrotum, however, after the “bright”
interval of 2-3 days there is a deterioration
conditions and signs join
inflammation indicating
joining an infection.

First aid.
First aid

Emergency evacuation
in MP pogo. Anesthesia 1 ml of 2% solution
Promedola.

Emergency medical
help at the medical center.

Peace
primary surgical treatment
wounds, procaine blockade seminal
cord, dressing of the scrotum,
the fight against shock and bleeding.

RџSЂRё
damage to the prostate gland and
seminal vesicles – imposing pressure
bandages on a crotch, fight against shock
and bleeding.

In case of damage
penis – fight against shock and
bleeding.

Emergency evacuation
to the medical institution
lying down
accompanied by a paramedic.

11.11.1. Overheating. (thermal, sunstroke)

Develops
with prolonged exposure to the body
high temperature features in
combined with high humidity, at
long stay in funds
protection in the warm season. Reason
sunstroke is a long
direct solar exposure
rays.

Head
pain, dizziness, thirst, tinnitus,
nausea, vomiting. In severe cases –
psychomotor agitation, loss
consciousness, cramps, rapid breathing,
pulse, body temperature – 40 – 42 °.

Remove
the victim from the overheating zone, in
shadow, take off tight clothing, chill on
head, inguinal area. Urgent
evacuation.

Moistened inhalation
oxygen. Intramuscularly – 3 – 4 ml 50%
analgin solution Continuation
first aid measures.

First
medical assistance at a medical center.

The total
and local hypothermia using
dampened wraps
cold water, on the head, inguinal
areas are ice bubbles. Intravenously
– introduction of chilled solutions: 400 ml
0,9% sodium chloride solution, 400 ml 5%
glucose solution, 400 ml of reopoliglyukin.
With a drop in blood pressure intravenously – 0,5 – 1 ml 1%
mesatone solution, with the development of cardiac
failure intravenously slowly
– 1 ml of a 0,06% solution of corglycon or 0,5 – 1
ml of a 0,05% solution of strophanthin. At
psychomotor agitation – introduction
1 – 2 ml of 3% phenazepam solution (solution
relanium).

In case of severe overheating, the introduction
medication – only in the vascular
channel!

Urgent
escorted to a hospital
doctor, lying on a stretcher,
continuing local activities
hypothermia and infusion therapy.

8.6. Physiological birth

Medical emergency
help at the medical center.

Diagnostic
algorithm:
anamnesis; determination of the period of childbirth –
the presence of regular labor
the degree of opening of the uterine pharynx, the presence of
water;


full cervical dilatation ends
disclosure period;


from full disclosure of the cervix to
child birth – period
exile;


from the birth of the child to the birth of the afterbirth
– last
period.

в
disclosure period
– monitoring the condition of the woman in childbirth,
nature of labor
(frequency, regularity of contractions),
listening to the fetal heartbeat every
15 – 20 minutes – evacuation to obstetric and gynecological
hospital

в
exile period
– listening to the fetal heartbeat after
every effort, obstetric
allowances; for the prevention of hypoxia
fetus – intravenously 5 ml of 5% solution
ascorbic acid per 20 ml of a 40% solution
glucose, for the prevention of bleeding
– intravenously 5 ml of a 1% solution of vicasol.
With weak labor
intravenously 10 ml of a 10% chloride solution
calcium, B vitamins;

в
last
period – active waiting
tactics – after
birth of a child wait 20 – 25
minutes of the birth of the afterbirth, after which
empty the bladder with a catheter.
If the last is not born – select and
to separate the last one of the ways
prescribe antibiotics for 5 to 7 days.

В
case of childbirth in a medical setting
paragraph to take measures to call a specialist
upon yourself, as soon as possible –
evacuate to the obstetric hospital.

Section 9. Coma

As soon as the patient enters the hospital, all measures are taken to stop the bleeding, if it was confirmed during the examination.

  1. Hemostatic drugs are introduced, for example: Vikasol, Etamzilat and others.
  2. Also, the patient is injected with blood or plasma, but after his blood type is determined. This is also done if it becomes necessary to take him to the operating room. All this is done in the front desk, where he is simultaneously examined.
  3. In the event that the patient has hypertension syndrome, they try to stop the bleeding with the help of the Blackmore probe and drug therapy aimed at stopping the bleeding.
  4. In the event that this does not help, they use shunting – they transfer blood from veins with high pressure to those where it is less.

9.1. Renal eclampsia

Meets
in patients with acute nephritis, exacerbation
chronic jade, as well as
nephropathy of pregnant women. Pathogenesis
eclampsia is associated with a brain disorder
blood circulation due to edema
brain tissue and microcirculation disorders.

К
harbingers of a seizure
include headache, dizziness,
nausea. Characteristic combination of high
diastolic pressure with bradycardia,
oliguria. Seizure is manifested
tonic and clonic convulsions
whole body lasting no more
30 min with biting tongue, soporous
condition.

Urine decreased
(up to 500-600 ml per day), specific gravity of urine
reduced or normal with microscopy
urinary sediment – pathological
changes characteristic of jade.
Residual nitrogen, urea,
blood creatinine increased. With eclampsia
pregnant seizure preceded
headache, nausea, blurred vision,
fibrillar twitching of the muscles of the face,
century.

During a seizure
– Prevention of bodily harm.

Intramuscularly 1 ml
2,5% solution of chlorpromazine, 2-4 ml of 1% solution
dibazole, 10-15 ml of a 25% solution of sulfate
magnesia. Oxygen inhalation

Intramuscularly
1 ml of 0,01% clonidine solution, 40-80 mg
furosemide (lasix), 1 ml of 3% solution
phenazepam. In the absence of furosemide
– inside 50 mg of dichlothiazide. With persisting
arterial hypertension with
acute nephritic syndrome – intramuscularly
0,5-1 ml of 5% pentamine solution (with eclampsia
pregnant ganglion blockers
contraindicated).

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After
stopping an attack of eclampsia and
lowering blood pressure
hospital evacuation
transport lying on a stretcher, in
accompanied by a doctor or paramedic.
Pregnant women with renal eclampsia
sent to the maternity ward
hospital or maternity hospital.

9.3. Diabetic (ketoac >Ketoacidotic
coma is a complication of sugar
diabetes and develops as a result
severe insulin deficiency,
characterized by reduced disposal
glucose tissues, hyperglycemia and
severe energy starvation
tissues.

Gradual
development: appears
thirst, polyuria, polydipsia, weakness,
nausea, headache, drowsiness,
smell of acetone from the mouth. When starting
coma – confusion. At full
coma consciousness absent breathing
rare, noisy (Kussmaul), pungent odor
acetone, lowering blood pressure, oliguria,
dehydration of the body. In blood
increase in sugar level more than 20 mmol / l
(350 mg%), glucosuria, ketonuria.

If
sick conscious, you need to get
information about his sugar
diabetes. With preserved consciousness –
any unsweetened drink; with absence
consciousness – lay the patient by turning
head to one side, when vomiting – toilet cavity
the mouth.

10.1. External bleeding

Any
the wound is accompanied by bleeding
due to damage to the walls of the blood
vessels. Distinguish arterial,
venous, mixed and capillary and how
its kind of parenchymal
bleeding.

Evidence
arterial bleeding: blood
flows out of the wound with a pulsating stream
scarlet (bright red) color. If damaged
arteries death of the wounded may occur
in a few minutes, even tens
seconds. Therefore, first aid should
be rendered immediately. To stop
bleeding, the vessel must be pressed
fingers to the bone above the site of injury.

Femoral artery bleeding
stop pressing it with both hands,
covering the upper thigh in the inguinal
fold so the thumbs fit
at the middle of the thigh and crushed the artery
to the bone. When bleeding from an artery in
crotch area
abdominal aorta to the spine. Artery
pressed for the short time necessary
to prepare a twist or tow.

For
stop arterial bleeding
use a hemostatic tourniquet,
twists of various designs or henchmen
tools: belts, handkerchiefs, items
uniforms. Tourniquet impose
on top of clothing or lining
from matter is always higher than the site of injury
as close to the wound. Tighten
tourniquet until the bleeding stops completely,
but not excessive so as not to cause injury
a nerve.

In the absence of a wound harness
limb can be pulled coiled
medical scarf or scarf.
Having tied the ends of the scarf, they bring
stick and spin to a stop
bleeding from a wound. To spin
not weakened, the end of the stick is tied to
limbs. Stop the bleeding
possible with maximum bending
limbs in the joint and fixation of the limb
in this position with a scarf (harness).

Overlay
tourniquet (twist), the wound is closed with a bandage
on which the overlay time is marked
harness. The same entry can be made on
paper, securing it with the last layers
bandage. The tourniquet is superimposed for a period not
more than two hours. Two hours after
the application of the tourniquet gradually weakens it,
pressing an artery with a finger above a place
damage. When the limb turns pink
and warmer, the tourniquet is imposed again
above or below the previous place.

RџSЂRё
venous bleeding
uniform stream, has dark red
color. Such bleeding stops
tight bandaging of the wound, pressing bandage.

Arteriovenous
(mixed) bleeding has signs
both bleeding, but help is needed
render like arterial
bleeding.

Capillary
bleeding
blood like a sponge. Stop is reached
applying a pressure bandage.

internal
bleeding occurs when injured
skull, chest, abdomen,
usually hidden, accompanied
significant blood loss and very
life threatening. Such a wounded man needs
in urgent evacuation.

Specified
the need for applying a tourniquet (twist),
– if necessary, corrected,
The blending time is specified. For refund
volume of circulating blood is transfused
blood substitute fluid (saline
solution, hemodesis, polyglucin).

stop
external bleeding carried
by introducing a tampon into a wound with application
skin sutures, flashing vessels in the wound,
applying a clamp to a bleeding vessel.
Correctness control
and the appropriateness of applying a tourniquet and
applying a tourniquet if indicated.
Corrective action
acute respiratory failure.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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