Royal Army Medical Corps training, 1911.

Date:
1911
Catalogue details

Licence: In copyright

Credit: Royal Army Medical Corps training, 1911. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    362/510 (page 328)
    EXTKRNAL HEMORRHAGE. 664. Arterial li8Bmorrhag-e.—In arterial haemorrhage the blood escapes from the arteries. It may be known by (1) the blood escaping in jets or spurts, because it is pumped out by the heart; (2) its bright red colour ; (3) that it may be stopped by pressing on the artery between the wound and the heart. 565. Venous heemorrhage.—In this case the blood escapes from the veins. It may be known by (1) the blood being of a dark, purplish-red colour, (2) its flowing in a continual stream and not escaping in spurts, (3) that pressure applied on the side of the wound furthest from the heart stops it, while pressure applied between the wound and the heart does not do so. A dependent position, muscular exertion or straining, or any obstruction to the veins above a wound, greatly increases venous bleeding. Hence it is much greater after accidents than at operations,. 566. Although the above account of arterial and venous haemorrhage gives the usual signs by which they may be distinguished, certain exceptions may occur. In some instances arterial blood may appear as venous ; for example, when it comes from the bottom of a deep and narrow wound, it may flow continually instead of in spurts ; or when a patient is partly suS'ocated it may become of a dark colour. On the other hand, venous blood exposed to air in its passage from a deep wound, may, owing to its taking up oxygen, become bright and red in colour. 567. Capillary hsemorrhage.—The blood escapes from the capillaries, and oozes from all parts of the wound, trickling down to the deeper parts, where it forms a little pool. 568. Occurrence of hsemorrhage.—Harmorrhage may occur as (1) primary, (2) reactionary, and (3) secondary. (1) Primary haemorrhage.—Is that which occurs at the time when the artery is wounded. (2) Reactionary hcemorrhage.—Is that which occurs after the primary haemorrhage has ceased, and within twenty-four hom's of the injury or operation. It appears when the patient is recoveriBg from the shock of the injury. (3) Secondary haimorrhage.—Is that which occui's any time after the first twenty-four hours following an injury or operation, but seldom before about ten days or a fortnight afterwards. It is now rare because its chief cause (septic infection of the woimd) is now also rare. 569. Arrest of external hsemorrhag-e.—The means of tem- porarily arresting external haemorrhage until more permanent means can be resorted to by the surgeon are (1) pressure, (2) appli- cation of heat or cold, and (3) position of the patient. (1) Pressure.—li the bleeding point be within reach, haemorrhage need' cause no alarm, as pressure will control it, however big the vessel maj^ be.