Printing compound
The pressure bandage is a first aid measure that is performed on a heavily bleeding wound . Stopping heavy bleeding is a top priority, as major blood loss can quickly lead to life-threatening shock and should - if only one helper is available - even be done before the emergency call. The pressure bandage was introduced in medicine by Johann Georg Heine in 1811 . The loss of a liter of blood can already be life-threatening; in children a much smaller amount is sufficient.
Causes and mode of action
If a blood vessel is injured, the natural wound healing mechanisms of hemostasis , including blood clotting , take effect . In the event of an injury, hemostasis must start quickly enough to avoid major blood loss in terms of shock prophylaxis. Minor bleeding stops by itself within a few minutes. If the normal bleeding time is exceeded, hemostasis can be helped by applying pressure to the wound or applying a pressure bandage. For larger bleeding this has immediately by a pressure bandage or a setting to be made. The pressure bandage is intended to counteract the blood pressure without, however, cutting off the blood supply (arterial) and blood drainage (venous) until a surgical intervention to stop the bleeding can take place. This happens e.g. B. by tying off the vessels ( ligature ) or by means of "piercing" (Z-shaped suture around the blood vessel), larger vessels can also be sewn. There are also coagulation , embolization and the like. a. in question.
Applying a pressure bandage
In the case of heavy bleeding, the affected part of the body should be held up, which will reduce the blood flow and thus the blood loss. The classic pressure bandage is used for heavily bleeding injuries to the extremities . Attempts can be made to attach the pressure bandage to the head and torso like on the limbs around the body. If this is not possible, the necessary pressure must be applied to the wound by the first aider or the patient himself. A pressure bandage must not be applied to the neck, as the patient's breathing and blood flow to the brain are significantly disrupted.
If there is heavy bleeding on the arm, the artery can be squeezed out by pressing with the fingertips into the muscle gap between the biceps and triceps on the inside of the upper arm, whereby the blood flow is interrupted for the duration of the connection. In the event of a leg injury, the fist is pressed in the middle of the groin . The pressing in the groin is, however, a measure that is only taught in medical aid and should therefore only be used by the emergency services . The wound is then covered with a sterile wound pad. If necessary, a clean handkerchief or something similar can be used, because stopping bleeding is more important in the case of heavy bleeding due to possible significant blood loss than a germ-reduced procedure (“hemostasis before sterility”). Finally, a non-absorbent pressure body that is larger than the wound (e.g. an elastic bandage that is still packaged) is placed on the already covered wound and fixed. The bandage should apply enough pressure to stop the bleeding. If the first pressure bandage bleeds through, pressure is applied to the existing pressure bandage (manual pressure). The injured part of the body should continue to be held up until help arrives.
In the meantime, in addition to the classic pressure bandage in which a bandage plus pressure pad must be held, trauma bandages are also used which have already incorporated a pressure pad or can have an integrated bracket (including the so-called Israeli bandage or emergency bandage - also known as an emergency bandage in Germany ) with which the pressure is built up. At the moment these are mainly used in the military and civil rescue services, but are now finding their way into classic first aid.
Function of the pressure pad
In principle, it would be possible to stop bleeding on the arm or leg with a tightly wrapped bandage without a pressure pad. However, this bandage would tie off the body part all around and thus completely shut off the venous blood flow (congestion) or even completely prevent the arterial blood flow (binding). The resulting disturbed blood flow would damage the body part. By using a pressure pad, the pressure exerted is concentrated on the wound and on the side of the body part opposite the wound. There are also areas under the bandage that are relatively little pressure exerted. Blood flow should continue to be possible in these areas.
A pressure bandage that has been successfully applied in this sense shows no bleeding through the bandage material, no swelling and no blue discoloration of the affected body part (no congestion). A pulse check on the wrist or foot confirms that no ligament has been established.
Pressure bandage in children
A pressure bandage is usually not required for children under 10 years of age. In this case, it is usually sufficient to put on a tight bandage.
Further supply
After applying the pressure bandage, further measures to care for the patient are started, which are important
- checking the vital functions (consciousness, breathing, circulation) at regular intervals,
- Shock position (patient lies on his back, legs are raised approx. 30 °), if not contraindicated,
- the maintenance of body heat ( see hypothermia ), e.g. B. with the help of a rescue blanket or pieces of clothing.
- psychological care
If not already done by a second helper, the emergency call must be made or initiated after the pressure bandage has been made. Smaller, non-life-threatening wounds can be treated later.
Individual evidence
- ↑ S3- guideline for multiple trauma / treatment of seriously injured persons of the DGU . In: AWMF online (as of 07/2011)
- ↑ Red Cross Vienna, First Aid Tips, Heavy Bleeding. Accessed December 2, 2019.
- ↑ Angelika König: First aid in child emergencies, Arbeiter-Samariter-Bund Deutschland eV, Cologne 2011
