Third question Consequences of blood loss
The average amount of blood in the body of an adult is 6-8% of the total mass, or 65-80 ml of blood per 1 kg of body weight, and in the body of a child - 8-9%.
That is, the average blood volume in an adult male is 5000-6000 ml. A decrease in the total blood volume is called hypovolemia, an increase in blood volume compared to the norm is hypervolemia. Acute blood loss develops when a large vessel is damaged, when a very rapid drop in blood pressure occurs to almost zero. This condition is observed with a complete transverse rupture of the aorta, superior or inferior veins, or pulmonary trunk. The volume of blood loss is insignificant (250–300 ml), but due to a sharp, almost instantaneous drop in blood pressure, anoxia of the brain and myocardium develops, which leads to death. The morphological picture consists of signs of acute death, a small amount of blood in the body cavities, damage to a large vessel and a specific sign - Minakov's spots. In acute blood loss, bleeding of internal organs is not observed. With massive blood loss, there is a relatively slow flow of blood from damaged vessels. In this case, the body loses about 50–60% of the available blood. Over several tens of minutes, a gradual drop in blood pressure occurs. The morphological picture is quite specific. “Marbled” skin, pale, limited, island-shaped cadaveric spots that appear at a later date than in other types of acute death. Internal organs are pale, dull, dry. A large amount of spilled blood in the form of clots (up to 1500–2500 ml) is found in the body cavities or at the scene of the incident. During internal bleeding, sufficiently large volumes of blood are needed to saturate the soft tissue around the injury.
The clinical picture of blood loss does not always correspond to the amount of blood lost. With slow bleeding, the clinical picture may be blurry, and some symptoms may be completely absent. The severity of the condition is determined primarily on the basis of the clinical picture. With very large blood loss, and especially with rapid blood flow, compensatory mechanisms may be insufficient or may not have time to turn on. In this case, hemodynamics progressively worsen as a result of a vicious circle. Blood loss reduces oxygen transport, which leads to a decrease in oxygen consumption by tissues and the accumulation of oxygen debt; as a result of oxygen starvation of the central nervous system, the contractile function of the myocardium is weakened, IOC decreases, which, in turn, further worsens oxygen transport. If this vicious circle is not broken, then increasing violations lead to death. Sensitivity to blood loss is increased by overwork, hypothermia or overheating, time of year (in the hot season, blood loss is less tolerated), trauma, shock, ionizing radiation, and concomitant diseases. Gender and age matter: women are more tolerant of blood loss than men; Newborns, infants and the elderly are very sensitive to blood loss.
Blood loss is a lack of circulating blood volume. There are only two types of blood loss - hidden and massive. Hidden blood loss is a deficiency of red blood cells and hemoglobin; the plasma deficiency is compensated by the body as a result of the phenomenon of hemodilution. Massive blood loss is a deficiency in circulating blood volume, leading to dysfunction of the cardiovascular system. The terms “hidden and massive blood loss” are not clinical (related to the patient), these are academic (physiology and pathophysiology of blood circulation) study terms. Clinical terms: (diagnosis) posthemorrhagic iron deficiency anemia corresponds to hidden blood loss , and the diagnosis of hemorrhagic shock corresponds to massive blood loss . As a result of chronic hidden blood loss, you can lose up to 70% of red blood cells and hemoglobin and save your life. As a result of acute massive blood loss, you can die, losing only 10% (0.5 l) of your blood volume. 20% (1l) often leads to death. 30% (1.5 l) of blood volume is an absolutely fatal blood loss if it is not compensated. Massive blood loss is any blood loss exceeding 5% of the blood volume. The volume of blood that is taken from the donor is the boundary between hidden and massive blood loss, that is, between that to which the body does not respond and that which can cause collapse and shock.
- Minor blood loss (less than 0.5 l) 0.5-10% of blood volume. Such blood loss is tolerated by a healthy body without consequences or manifestation of any clinical symptoms. There is no hypovolemia, blood pressure is not reduced, pulse is within normal limits, slight fatigue, skin is warm and moist, has a normal shade, consciousness is clear.
- Average (0.5-1.0 l) 11-20% bcc. Mild hypovolemia, blood pressure reduced by 10%, moderate tachycardia, pale skin, cold extremities, slightly increased pulse, rapid breathing without rhythm disturbance, nausea, dizziness, dry mouth, possible fainting, twitching of individual muscles, severe weakness, adynamia, slow reaction to others.
- Large (1.0-2.0 l) 21-40% bcc. Moderate severity of hypovolemia, blood pressure reduced to 100-90 mm Hg. Art., pronounced tachycardia up to 120 beats/min, breathing is very rapid (tachypnea) with rhythm disturbances, sharp progressive pallor of the skin and visible mucous membranes, lips and nasolabial triangle are cyanotic, the nose is pointed, cold sticky sweat, acrocyanosis, oliguria, consciousness is darkened, excruciating thirst, nausea and vomiting, apathy, indifference, pathological drowsiness, the appearance of yawning (a sign of oxygen starvation), pulse - frequent, small filling, weakened vision, flickering of spots and darkening in the eyes, clouding of the cornea, tremors of the hands.
- Massive (2.0-3.5 l) 41-70% bcc. Severe degree of hypovolemia, blood pressure reduced to 60 mm Hg, sharp tachycardia up to 140-160 beats/min, thread-like pulse up to 150 beats/min, not palpable in peripheral vessels, detected much longer in the main arteries, absolute indifference of the patient to the environment environment, delirium, consciousness is absent or confused, severe deathly pallor, sometimes a bluish-gray skin tone, “goose bumps”, cold sweat, anuria, Cheyne-Stokes type breathing, convulsions may be observed, a haggard face, pointed features, sunken dull eyes , an indifferent look.
- Fatal (more than 3.5 l) more than 70% of the bcc. Such blood loss is fatal for a person. Terminal state (preagonia or agony), coma, blood pressure below 60 mm Hg. Art., may not be detected at all, bradycardia from 2 to 10 beats/min, agonal breathing, superficial, barely noticeable, dry, cold skin, characteristic “marbling” of the skin, disappearance of pulse, convulsions, involuntary release of urine and feces, dilated pupils , then agony and death develop.
Question 4: basic requirements when performing blood transfusions
The main task in the treatment of hemorrhagic shock is to eliminate hypovolemia and improve microcirculation. From the first stages of treatment, it is necessary to establish a jet transfusion of fluids (saline solution, 5% glucose solution) to prevent reflex cardiac arrest - empty heart syndrome.
Immediate stopping of bleeding is possible only when the source of bleeding is accessible without anesthesia and everything that accompanies a more or less extensive operation. In most cases, patients with hemorrhagic shock have to be prepared for surgery by infusing various plasma-substituting solutions and even blood transfusions into a vein, and continue this treatment during and after surgery and stop the bleeding.
Infusion therapy aimed at eliminating hypovolemia is carried out under the control of central venous pressure, blood pressure, cardiac output, total peripheral vascular resistance and hourly diuresis. For replacement therapy in the treatment of blood loss, combinations of plasma substitutes and preserved blood products are used, based on the volume of blood loss.
To correct hypovolemia, blood substitutes with hemodynamic action are widely used: dextran preparations (reopolyglucin
, polyglucin), gelatin solutions (gelatinol), hydroxyethyl starch (refortan
Signs of rapid blood loss
Acute blood loss is a process that occurs against the background of bleeding. With acute blood loss, the patient experiences rapid blood loss in a short period of time.
It is accompanied primarily by a sharp decrease in blood pressure, as well as symptoms such as shortness of breath, tachycardia and depression of consciousness.
The cause of blood loss can be either a disease or an injury that leads to damage to the vessel.
The general signs of blood loss are influenced by the amount of blood that the patient has lost. The degree of blood loss is measured as a percentage of the bcc, since measuring the amount of blood in milliliters is not advisable, taking into account the individual differences of each individual patient.
According to severity, acute blood loss is divided into 4 degrees:
- Small. The BCC deficit is insignificant – from 10 to 20%. Pulse: up to 100 beats per minute. The patient's mucous membranes and skin are pale or pink, sBP (systolic blood pressure) is within normal limits or slightly reduced, at least 90-100 mmHg. Art.
- Average. BCC deficit is 20-40%. Pulse – up to 120 beats per minute. The patient develops stage II shock. The skin and lips are pale, the body is covered with drops of cold sweat, the palms and feet are cold. Oliguria begins to develop due to insufficient urine production by the kidneys. The SBP level reaches 85-75 mm Hg. Art.
- Big. BCC deficit is 40-60%. Pulse – up to 140 or more beats per minute. III degree shock develops. The skin is clearly pale, has a grayish tint, and is covered with sticky cold sweat. The SBP level drops to 70 mm Hg. Art. and below.
- Massive. BCC deficiency – 60% or more. The pulse in the peripheral arteries disappears. The skin is sharply pale, cold and moist. The subungual bed and lips of the patient are gray in color. Blood pressure is not determined. The patient's heart rate can only be determined from the femoral and carotid arteries. Arrhythmia is observed.
- Deadly. BCC deficiency: more than 70%. The skin is cold, dry; pupils are dilated. The patient experiences convulsions, agony, and a coma. Blood pressure and pulse are not determined, death occurs.
Classification of the degree of blood loss
Danger of blood loss
Blood is the most important substance in the human body, one of the main functions of which is to transport oxygen and other essential substances to the heart and tissues. Therefore, the loss of a significant amount of blood can significantly disrupt the normal functioning of the body or even lead to death.
In total, the average adult's body contains about 5 liters of blood. At the same time, he can lose some of it with virtually no harm to himself: for example, the volume of blood taken from a donor at a time is 450 milliliters. This amount is considered completely safe for an adult. A more or less serious problem may be the loss of 20% of the total blood volume or more.
Volume and nature of blood loss
Doctors say that the degree of danger of blood loss to a person’s life in a particular case depends not only on its volume, but also on the nature of the bleeding. Thus, the most dangerous is rapid bleeding, in which a person loses a significant amount of blood within a short period of time, not exceeding several tens of minutes.
With the loss of approximately one liter of blood, or about 20% of the total blood volume circulating in the body, the heart ceases to receive a sufficient volume of blood for circulation, a person experiences interruptions in heart rhythm, and the level of blood pressure and pulse rate sharply decrease. However, if blood loss can be stopped at this stage, it usually does not pose a significant threat to human life, and with sufficient nutrition and rest, the body is able to restore the lost volume on its own.
In case of loss of 20% to 30% of blood in a relatively short time, which is equivalent to a volume of 1-1.5 liters of blood for an adult, there is increased sweating and thirst, nausea, and possible vomiting. The person becomes short of breath, becomes apathetic, his hands tremble, and his vision becomes blurred. In this case, even when the bleeding stops, independent restoration of the lost volume is usually difficult, and the person needs a transfusion.
With a rapid loss of 2-3 liters of blood, that is, 30% or more of the total amount available in the body, the surface of a person’s skin becomes cold, the person himself becomes noticeably pale, and the face and limbs acquire a bluish tint. In most cases, such blood loss is accompanied by loss of consciousness, and often by falling into a coma. In this case, only an immediate blood transfusion can save a person’s life. A rapid loss of 50% or more of the total amount of blood present in the body is considered fatal.
If the blood loss is gradual, for example, with internal bleeding, the body has time to adapt to the situation and is able to withstand significantly larger volumes of blood loss. For example, medicine knows cases of survival with a loss of 60% of blood after timely intervention.
Hemorrhagic shock
The result of a sharp decrease in blood volume by 40-50% of the total amount of blood is called hemorrhagic shock. For patients with poor health, this figure may differ slightly to a lesser extent. The degree of hemorrhagic shock and the development of the clinical picture are influenced by:
- rate of hemorrhage;
- absolute amount of blood loss.
Due to the fact that during slow bleeding, even with significant blood loss, the body triggers compensatory mechanisms, it is easier to tolerate than rapid blood loss.
Acute blood loss
Acute blood loss
is an irreversible loss of blood over a short period of time. Occurs due to bleeding from damaged vessels. Affects the condition of all organs and systems. The loss of a significant volume of blood is accompanied by the development of hemorrhagic shock, which poses a threat to the patient's life. Acute blood loss can be caused by trauma and certain diseases. Manifested by pallor, tachycardia, decreased blood pressure, shortness of breath, euphoria or depression of consciousness. Treatment is elimination of the source of bleeding, infusion of blood and blood substitutes.
General information
Acute blood loss is a condition in which the body quickly and irreversibly loses a certain amount of blood as a result of bleeding. It is the most common injury to the human body throughout history. Occurs due to injuries (both open and closed) and destruction of the vessel wall in certain diseases (for example, ulcerative processes in the gastrointestinal tract). The loss of a large volume of blood is life-threatening due to a sharp decrease in blood volume and the subsequent development of hypoxia, hypoxemia, hypotension, insufficient blood supply to internal organs and metabolic acidosis. In severe cases, the development of disseminated intravascular coagulation syndrome is also possible.
The greater the volume of blood loss and the faster the blood is shed, the more severe the patient’s condition and the worse the prognosis. In addition, the body's reaction is influenced by factors such as age, general condition of the body, intoxication, chronic diseases and even the time of year (in the warm season, blood loss is more difficult to tolerate). A loss of 500 ml (10% of bcc) in a healthy adult does not lead to significant hemodynamic disturbances and does not require special correction. If a patient suffering from a chronic disease loses a similar volume, it is necessary to replenish the volume of blood volume using blood, blood and plasma substitutes. This condition is most difficult for elderly people, children and pregnant women suffering from toxicosis.
The most common cause is injury: injuries to soft tissues and internal organs, multiple fractures or damage to large bones (for example, a severe pelvic fracture). In addition, acute blood loss can occur as a result of blunt trauma with rupture of an organ. Wounds with damage to large vessels, as well as injuries and ruptures of parenchymal organs are especially dangerous. Among the diseases that can cause blood loss are stomach and duodenal ulcers, Mallory-Weiss syndrome, cirrhosis of the liver, accompanied by varicose veins of the esophagus, malignant tumors of the gastrointestinal tract and chest organs, gangrene of the lung, pulmonary infarction and other diseases in which destruction is possible vessel walls.
With acute mild blood loss, the receptors of the veins are irritated, resulting in persistent and total venous spasm. There are no significant hemodynamic disturbances. Replenishment of BCC in healthy people occurs within 2-3 days due to the activation of hematopoiesis. With a loss of more than 1 liter, not only the venous receptors are irritated, but also the alpha receptors of the arteries. This causes excitation of the sympathetic nervous system and stimulates the neurohumoral reaction - the release of large amounts of catecholamines by the adrenal cortex. In this case, the amount of adrenaline exceeds the norm by 50-100 times, the amount of norepinephrine – by 5-10 times.
Under the influence of catecholamines, first the capillaries, and then larger vessels, spasm. The contractile function of the myocardium is stimulated, and tachycardia occurs. The liver and spleen contract, releasing blood from the depot into the vascular bed. Arteriovenous shunts open in the lungs. All of the above allows you to provide the necessary amount of blood to vital organs within 2-3 hours, maintain blood pressure and hemoglobin levels. Subsequently, the neuro-reflex mechanisms are depleted, and vasodilation replaces vasodilation. Blood flow in all vessels decreases, and erythrocyte stasis occurs. Metabolic processes in tissues are further disrupted, and metabolic acidosis develops. All of the above forms a picture of hypovolemia and hemorrhagic shock.
The severity of hemorrhagic shock is determined taking into account pulse, blood pressure, diuresis and laboratory parameters (hematocrit and hemoglobin content in the blood). Under the influence of aldosterone, arteriovenous shunts open in the kidneys, as a result, blood is “dumped” without passing through the juxtaglomerular apparatus, which leads to a sharp decrease in diuresis up to anuria. Due to hormonal changes, plasma does not exit the vessels into the interstitial tissues, which, along with deterioration of microcirculation, further aggravates tissue metabolism disorders, aggravates acidosis and provokes the development of multiple organ failure.
The listed disorders cannot be completely stopped even with immediate replacement of blood loss. After restoration of bcc, the decrease in blood pressure persists for 3-6 hours, disturbances in blood flow in the lungs - for 1-2 hours, disturbances in blood flow in the kidneys - for 3-9 hours. Microcirculation in tissues is restored only on days 4-7, and complete elimination of the consequences takes many weeks.
Why is large blood loss dangerous for human life?
As noted above, blood loss develops as a result of a violation of the integrity of blood vessels, organs and tissues. In this case, the volume of lost blood does not have to be large. It is enough to lose just 300 ml in a short time for anemia to develop and blood pressure to drop.
When blood is lost in large volumes, up to approximately 60%, a gradual decrease in pressure occurs. This lasts for 20-30 minutes or even longer. With such loss, a person’s skin becomes marble-colored. On examination, the internal organs are pale.
Volumes of blood loss
Blood loss is divided into several types, differing in the amount of blood lost.
- Small. The loss volume is less than 200 ml. This is how much a person can lose without harm to health. A healthy body tolerates this condition without any consequences. Symptoms do not appear. The pulse is normal, blood pressure does not decrease, but slight fatigue is observed.
- Average. Volume 200 – 500 ml. Blood pressure drops by about 10%, there is a slight disruption in heart rate, skin color becomes paler than usual, pulse and breathing become slightly faster. A person experiences dizziness, weakness, inhibited reaction to stimuli, a feeling of dry mouth, and nausea. Sometimes fainting is possible.
- Big. Losses are 500 ml - 1 liter. Blood pressure drops to 90 mmHg. Art. Rapid heartbeat up to 120 beats per minute, pulse up to 150 beats. The emotional state is indifference, the person is delirious, there is no consciousness. The covers are white or bluish-gray. Cold sweat appears, goosebumps appear on the skin, and convulsions occur.
- Deadly. The volume of losses is from two to five liters. Such a large loss of blood is fatal to a person. The pressure drops to below 60 mmHg. sometimes it is not defined at all. The pulse disappears, the skin is white, dry and cold. Convulsions and involuntary bowel movements may occur. The pupils dilate, agony begins, and then death occurs.
Types of bleeding
Depending on the type of bleeding, the amount of blood loss and measures of assistance will be different.
- Arterial. Occurs as a result of damage to large vessels. The pulsating jet is a fountain. The color is bright red.
- Venous. The stream is sluggish and flows slowly. The blood contains a lot of carbon dioxide, which is why its color is dark red.
- Capillary. This is the least dangerous type of bleeding, since the capillaries are on the outside and the blood often stops on its own.
- Intracavity. A very dangerous look. The blood vessels of internal organs are damaged. In this case, the blood does not come out, but accumulates in the cavities of the body. The danger is that it is not visually diagnosed, the process occurs hidden from the person, and symptoms do not appear immediately. And how much blood a person lost is difficult to determine in this situation.
Each of these types of bleeding can be fatal if action is not taken promptly and treatment is not started.
Death from blood loss
they contain many capillaries, thanks to which the respiratory system works. The work of all internal organs is based on blood exchange. Blood carries oxygen, without which the body cannot fully function. When blood circulation in the brain is disrupted, the supply of oxygen stops, which leads to hypoxia and brain cells begin to die.
Several factors influence the outcome of bleeding:
- Volume and rate of bleeding. A loss of more than 50% is considered incompatible with life. Although there are unfortunate situations where a person dies from a loss of less than 30%, these are usually small losses, but they last a long time.
- Type of bleeding vessel. With arterial bleeding, the risk of death is greater.
- General state of human health. A healthy person who does not have any chronic diseases tolerates blood loss more easily. The body can use protective and reserve mechanisms for recovery.
- External factors: hypothermia and overheating negatively affect the recovery process.
- People who regularly donate blood and women tolerate this condition more easily, while children and the elderly experience it more severely. For an infant, even a few milliliters of blood loss can be fatal.
Treatment of blood loss
In order to take adequate measures to treat blood loss, it is necessary to first determine its magnitude. There is a simple method for determining it:
- by location of injury, pressure level, volume of damaged tissue and general signs of blood loss;
- according to blood parameters: number of red blood cells, hemoglobin level and density.
The treatment method for this condition comes down to several principles.
- It is necessary to replenish the volume of fluid inside the vessels using solutions.
- Replenish plasma elements responsible for coagulation.
- Increasing the oxygen content in the patient's blood.
- Increase in the number of red blood cells.
If blood loss is acute, medical intervention should be carried out immediately.
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Classification
There are several systematizations of acute blood loss. The following classification is most widely used in clinical practice:
- Mild degree – loss of up to 1 liter (10-20% of bcc).
- Average degree – loss of up to 1.5 liters (20-30% of bcc).
- Severe degree – loss of up to 2 liters (40% of bcc).
- Massive blood loss – loss of more than 2 liters (more than 40% of the blood volume).
In addition, supermassive or fatal blood loss is distinguished, in which the patient loses more than 50% of the blood volume. With such acute blood loss, even in the case of immediate volume replacement, in the vast majority of cases, irreversible changes in homeostasis develop.
Diagnostics
Along with clinical signs, there are laboratory indicators that allow you to assess the amount of blood loss. The number of red blood cells decreases below 3x10¹²/l, hematocrit - below 0.35. However, the listed figures only indirectly indicate the degree of acute blood loss, since the test results reflect the real course of events with some “lag”, that is, with massive blood loss in the first hours, the tests may remain normal. This is especially common in children.
Considering the above, as well as the non-specificity of signs of acute blood loss (especially mild or moderate), it is necessary to pay special attention to external signs. With external bleeding, establishing the fact of blood loss is not difficult. In case of internal bleeding, indirect signs are taken into account: hemoptysis with pulmonary hemorrhage, vomiting “coffee grounds” and/or melena with pathology of the esophagus, stomach and intestines, tension of the anterior abdominal wall and dullness upon percussion in the sloping parts of the abdomen in case of damage to parenchymal organs, etc. Examination and anamnesis data are supplemented with the results of instrumental studies. If necessary, radiography, MRI, ultrasound, laparoscopy and other studies are performed, consultations with a vascular surgeon, abdominal surgeon, thoracic surgeon and other specialists are prescribed.
Symptoms indicating blood loss
Symptoms of acute blood loss include:
- severe weakness;
- dizziness;
- thirsty;
- rapid pulse;
- fainting state;
- fainting;
- decreased blood pressure;
- pallor.
In more complex cases, the patient experiences the following manifestations of the pathological condition:
- complete loss of consciousness;
- cold sweat;
- periodic breathing;
- dyspnea.
It is important to know! With extensive blood loss, the number of red blood cells in the blood drops to 3x10¹²/l or lower.
But this figure cannot indicate that the patient is experiencing acute blood loss, since in the first hours laboratory tests may be false, similar to normal values. Therefore, it is important to pay more attention to the external signs of acute blood loss.
Making a diagnosis with external bleeding is not difficult. However, if there is a suspicion of internal bleeding, then the following indirect clinical signs will help confirm this:
- hemoptysis (typical of pulmonary hemorrhages);
- vomiting (vomit resembles coffee grounds);
- melena (for bleeding of the gastrointestinal tract);
- tense abdominal wall.
When making a diagnosis, examination, laboratory tests and anamnesis data are supplemented with instrumental and hardware studies. To do this you may need to do:
- Ultrasound;
- MRI;
- radiography;
- laparoscopy.
Consultation with the following specialists is required:
- abdominal;
- vascular surgeon;
- thoracic surgeon.
Treatment of acute blood loss
The choice of the treating specialist is determined by the nature of the pathology that caused the bleeding. In case of significant blood loss, anesthesiologists and resuscitators are involved in the management of the patient. Treatment tactics depend on the volume of blood lost and the patient’s condition. If a loss of up to 500 ml occurs, no special measures are required; the volume of blood volume is restored independently. With a loss of up to 1 liter, the issue of volume replenishment is resolved in a differentiated manner. In case of tachycardia not more than 100 beats/min, normal blood pressure and diuresis, infusions are not indicated; in case of violation of these indicators, plasma substitutes are transfused: saline solution, glucose and dextran. Decrease in blood pressure below 90 mm Hg. Art is an indication for drip infusion of colloidal solutions. When blood pressure drops below 70 mm Hg. Art. produce jet transfusions.
With an average degree (up to 1.5 l), transfusion of plasma substitutes is required in a volume that is 2-3 times greater than the amount of bcc loss. Along with this, a transfusion of 500-1000 ml of blood is recommended. In severe cases, blood transfusions and plasma substitutes are required in a volume that is 3-4 times greater than the loss of bcc. In case of massive blood loss, it is necessary to transfuse 2-3 volumes of blood and several volumes of plasma substitutes.
Criteria for adequate recovery of blood volume: pulse no more than 90 beats/min, stable blood pressure 100/70 mm Hg. Art., hemoglobin 110 g/l, central venous pressure 4-6 cm water. Art. and diuresis more than 60 ml/h. In this case, one of the most important indicators is diuresis. Restoring urine flow within 12 hours of the onset of blood loss is one of the primary tasks, since otherwise the renal tubules become necrotic and irreversible renal failure develops. To normalize diuresis, infusion therapy is used in combination with stimulation with furosemide and aminophylline.
Is it possible to die from blood loss?
Death from blood loss occurs due to many factors associated with disruption of the integrity of tissues, blood vessels and organs. In many cases, this is caused by various injuries, exacerbations of diseases and injuries.
Blood loss is a process that develops due to heavy bleeding or when donating blood. In other words, this is a decrease in the volume of circulating blood in the body.
As a result of acute blood loss, a dangerous condition called hemorrhagic shock can develop. This condition can lead to death, as blood circulation in the tissues of the brain and lungs stops. Therefore, to prevent death, it is necessary to quickly take measures to prevent it. It is necessary to stop the bleeding and remove everything that prevents the person from breathing. To stop bleeding, you need to apply a tourniquet, bandage, or compress the wound. The buttons on the victim’s neck should be unbuttoned and the tie, if any, should be removed in order to increase the access of oxygen.
The nature of bleeding is very diverse. And if measures are not taken in time, this can lead to death from blood loss.
How much blood is there in a person? Blood volume in an adult, in a child, video
Even with a small cut, sometimes the blood flows so much that it becomes truly scary. And the question arises: how much blood is there in the human body, and how much blood can be lost without causing significant harm to health.
Of course, blood loss is a dangerous phenomenon, and therefore the answers to these questions need to be known. Blood plays a vital function in the human body, and the loss of a large volume of it can indeed lead to loss of consciousness first.
Blood volume in the human body
The volume of blood in the human body varies, and this is quite natural - there is no clear single indicator for all people. After all, in the end, height indicators and weights are different for all people.
Blood volume changes with age, while many other changes occur in the body. On average, blood volume is 4-5 liters .
At the same time, there is less blood in the female body, and its volume is about 3.5 - 4.5 liters .
But again, in pregnant women, blood volume increases rapidly, and there is significantly more of it. In addition, lifestyle also affects blood, its volume and quality.
Those who regularly engage in physical activity, lead an active lifestyle, and choose sports have more blood.
Those who have large muscle mass have more blood, while those who lead a sedentary lifestyle and do not have developed muscles have less blood.
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Dynamics of blood volume
In a newborn, approximately 15 percent of a newborn's weight is blood. And for an adult, the same percentage is approximately 6-8 percent. So the approximate blood volume of any person can be calculated using a simple formula. If the weight is 70 kg, and if we assume that blood takes up 6 percent, then there will be 4.2 liters.
If we take 8 percent as a calculation, it will be 5.6 liters. That is, the real indicator will be between these two figures. But these are rather approximate data, and yet, sometimes the most precise data is required. For example, doctors need accurate data. And they have their own counting system, which provides the most accurate data.
Per kilogram of human weight there is 60 ml of blood for women, and 70 ml of blood for men . And to get accurate information, just multiply your body weight by this number.
But if we are talking about a pregnant woman, then everything is different. In the first stages of pregnancy, blood volume still does not change much, but when the second trimester ends and the third begins, the figure begins to increase significantly.
And from this moment on, calculations are carried out differently - 75 ml of blood are calculated per 1 kg of weight.
Composition of blood and the volume of its various components in the body
Blood plasma
Blood is not homogeneous; it contains both individual formed elements and liquid plasma. The latter forms 52-58 percent of the blood, and the rest is formed elements, including various blood cells.
Plasma, in turn, is 90 percent water, and 10 percent of its composition is dry matter. The percentage of formed elements to plasma, called hematocrit by doctors, is slightly higher in men than in women.
And these indicators are relatively even in nature, without changing significantly in the norm.
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Blood plasma composition
Blood plasma composition
The dry residue of plasma consists of many substances that are useful and necessary for the body. These are proteins and non-protein nitrogenous elements, enzymes and proenzymes, as well as non-nitrogenous organic matter, and much more. Any changes in blood composition affect the functioning of organs and systems, a person’s well-being, and this applies to even minor changes.
Why does blood thickening occur?
Blood thickening, that is, a decrease in the percentage of plasma in relation to other components, usually occurs against the background of severe dehydration of a person, and this is a deadly phenomenon.
In this case, the cardiovascular system begins to experience severe overloads, kidney function is disrupted, thrombus formation and other processes can begin that can lead to the rapid death of a person.
Blood loss and consequences
The human body is prudent, and not all blood constantly circulates in the human body, performing its functions. The body also has so-called blood depots (reserves), where it is stored in case of special need.
Blood is stored in the spleen, liver, and a number of other organs, and with heavy blood loss, as well as in stressful situations, it can be released into the general bloodstream. However, even this reserve may not be enough if we are talking about severe bleeding and large blood losses. This applies primarily to arterial and severe venous bleeding.
Every person should be able to recognize them in order to be able to help themselves and their loved ones if necessary..
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For arterial bleeding, which is especially dangerous and can lead to death. In this case, it is necessary to apply a tourniquet and immediately hospitalize the person.
The tourniquet can only be applied for 2 hours, in cold weather - no more than an hour, otherwise there is a risk of necrosis and limb loss.
In case of venous bleeding, when dark blood flows in a continuous stream, it is necessary to apply a pressure bandage and also consult a doctor.
Chronic blood loss
In addition to such bleeding, which usually occurs due to injuries, there is another category - chronic blood loss. They occur during oncological tumors, ulcers, hemorrhoids and other phenomena.
Symptoms develop gradually, because the body initially strives to compensate for losses. This phenomenon leads to anemia, constant fatigue and loss of strength, dizziness, pallor, and problems with the immune system.
It is necessary to establish the cause of these disorders and undergo treatment, after which the blood condition will improve.
Blood is the most important fluid in the body, and it contains from 3 to 5 or more liters. But losing more than 30 percent of blood is fraught with serious consequences . It is worth taking care of your health and not risking it.
Why is blood loss dangerous?
As noted above, blood loss develops as a result of a violation of the integrity of blood vessels, organs and tissues. In this case, the volume of lost blood does not have to be large. It is enough to lose just 300 ml in a short time for anemia to develop and blood pressure to drop. Such sudden changes cause anoxia (great oxygen deficiency), and then death can occur. These signs characterize acute blood loss. With it, the internal organs do not bleed, since its losses occur in small volumes.
When blood is lost in large volumes, up to approximately 60%, a gradual decrease in pressure occurs. This lasts for 20-30 minutes or even longer. With such loss, a person’s skin becomes marble-colored. On examination, the internal organs are pale.
Physiological processes
Blood loss is not necessarily pathological. In some cases, for example, during menstruation, this process cannot cause significant harm to the body. We are talking about those cases where blood loss is within acceptable limits. During the menstrual cycle, the female body loses an average of 50 to 80 ml.
In some cases, this figure can reach 100-110 ml and this will also be the normal course of menstruation. A violation indicating the possible presence of gynecological diseases can be considered blood loss in a volume that exceeds 150 ml. Such heavy discharge inevitably leads to anemia.
Another natural process for which blood loss by the female body is inevitable is childbirth. Within normal limits, the amount of blood lost should not exceed 400-500 ml.
It is worth noting that in obstetric practice, complex bleeding occurs frequently and can become uncontrollable. This process poses a threat to a woman's life.
The following factors can provoke hemorrhagic shock during childbirth:
- gestosis (late toxicosis) and other pathologies during pregnancy;
- fatigue;
- injuries;
- pain in the prenatal period.
Volumes of blood loss
Blood loss is divided into several types, differing in the amount of blood lost.
- Small. The loss volume is less than 200 ml. This is how much a person can lose without harm to health. A healthy body tolerates this condition without any consequences. Symptoms do not appear. The pulse is normal, blood pressure does not decrease, but slight fatigue is observed.
- Average. Volume 200 – 500 ml. Blood pressure drops by about 10%, there is a slight disruption in heart rate, skin color becomes paler than usual, pulse and breathing become slightly faster. A person experiences dizziness, weakness, inhibited reaction to stimuli, a feeling of dry mouth, and nausea. Sometimes fainting is possible.
- Big. Losses are 500 ml - 1 liter. Blood pressure drops to 90 mmHg. Art. Rapid heartbeat up to 120 beats per minute, pulse up to 150 beats. The emotional state is indifference, the person is delirious, there is no consciousness. The covers are white or bluish-gray. Cold sweat appears, goosebumps appear on the skin, and convulsions occur.
- Deadly. The volume of losses is from two to five liters. Such a large loss of blood is fatal to a person. The pressure drops to below 60 mmHg. sometimes it is not defined at all. The pulse disappears, the skin is white, dry and cold. Convulsions and involuntary bowel movements may occur. The pupils dilate, agony begins, and then death occurs.
Death classification
Biological scientists divide death into two categories:
- Natural;
- Unnatural.
Natural death occurs according to the laws of normal physiology and occurs due to the natural aging of the body or in the case of underdevelopment of the fetus in the womb.
From a legal point of view, death is divided into:
- Non-violent;
- Violent.
Nonviolent death occurs in old age, long-term illness, and in other similar cases. Violent deaths include murder and suicide.
To better understand what a person may experience during death, we can consider the stages of the process, identified from a medical point of view:
- Preagonal stage. At this moment, a malfunction occurs in the blood circulation and breathing systems, causing hypoxia to develop in the tissues. This period lasts from several hours to several days;
- Terminal pause. At this moment, the person stops breathing, the functioning of the myocardium malfunctions;
- Agonal stage. The body is trying to return to life. At this stage, a person periodically stops breathing, the heart works increasingly weaker, which causes malfunctions in the functioning of all organ systems;
- Clinical death. Breathing and blood circulation stop. This stage lasts about five minutes, and it is at this moment that the person can be brought back to life with the help of resuscitation measures;
- Biological death - a person finally dies.
Blood loss leads to a change in blood composition - a decrease in the concentration of formed elements: red blood cells, leukocytes, platelets.
Restoring the composition, depending on the volume of lost blood, can take from several weeks to several months.
In some cases, the body’s own compensatory mechanisms are sufficient to eliminate the consequences, in others it is impossible to do without the help of drugs or blood transfusions.
A decrease in circulating blood volume (CBV) leads to insufficient blood supply to tissues and organs. With minor chronic bleeding, symptoms of posthemorrhagic anemia appear, weakness and dizziness are felt. In acute bleeding, events develop rapidly; if the source of massive blood loss is not quickly eliminated, death is possible.
Reasons for decreased circulating blood volume:
- Heavy menstruation.
- Frequent nosebleeds.
- Injuries.
- Diseases accompanied by chronic bleeding (hemorrhoids, oncology, gastric ulcer, etc.).
- Blood donation.
- Childbirth (natural and caesarean section), termination of pregnancy.
Blood loss of up to 10% is not dangerous to the body and is tolerated without consequences due to compensatory mechanisms:
- Interstitial fluid replenishes the missing volume.
- Small arteries spasm.
- The force of contraction of the heart muscle increases.
- The rate of heart contraction slows down.
If blood loss exceeds this volume, severe hypoxia develops and affects the functioning of the central nervous system. In addition, the composition of the blood changes, so during the recovery period it is important not only to replenish the volume, but also to support the hematopoietic system.
Symptoms may vary depending on the amount of blood lost. With minor chronic bleeding, symptoms may be completely absent due to volume replacement with plasma, but anemia will develop.
Volume of blood loss | Symptoms |
Less than 10% | There are no symptoms, the body quickly recovers on its own. |
Up to 20% | Blood pressure (blood pressure) decreases by 10%, the skin and visible mucous membranes are pale, rapid pulse, rapid breathing, feeling of weakness, nausea. |
Up to 40% | The rate of contraction of the heart muscle increases to 120 beats per minute. Pulse is weak. Breathing is frequent with disturbed rhythm. Pallor of the skin and mucous membranes is very pronounced. Feelings of thirst, tremors, and cold sweat may occur. |
Up to 70% | Heart rate reaches 160 beats per minute. The pressure drops to 60. Consciousness is confused, convulsions. |
More than 70% | Shallow breathing, convulsions. Blood loss can be fatal. |
Any blood loss exceeding 10% of the blood volume requires urgent treatment. Otherwise, the functioning of all body systems will be disrupted and the recovery period will take a longer period.
The main formed elements of blood are leukocytes, platelets and erythrocytes. To restore their normal quantity after bleeding, an integrated approach is required. Since, for example, without sufficient cellular respiration, for which red blood cells are responsible, it is impossible to normalize the process of hematopoiesis.
Restoration of blood cells:
- Platelets. The level increases due to the intake of vitamins (A, group B and C) and hormonal drugs (Prednisolone). Thrombopoietin is prescribed to stimulate platelet formation.
- Leukocytes. The use of stimulants is indicated - Pentoxyl, Leukogen. A balanced diet with plenty of foods that improve the formation of leukocytes (nuts, meat, fish, vegetables and fruits).
- Red blood cells. Treatment with iron supplements. Decreased physical activity. Special diet - you can take diet No. 11 as a basis.
In case of massive blood loss, it is important to quickly eliminate the source and fill the lack of volume with plasma replacement solutions or donor blood. Further treatment in this case is carried out only after the condition has stabilized.
For minor volume losses, treatment can begin immediately after bleeding has stopped.
The general set of measures to restore the composition and volume of circulating blood includes:
- Changing the diet - a person’s menu should include a large number of foods with vitamins and microelements involved in hematopoiesis, as well as an increased volume of fluid (water, natural juices of vegetables and fruits).
- Lifestyle changes - you need to be in the fresh air more often and reduce physical activity.
- Treatment with drugs - iron tablets, vitamins and multivitamin complexes.
Treatment after bleeding may have its own characteristics, depending on the nature of the blood loss.
The difficulty of acute bleeding lies in the need for emergency care. If there is a serious injury or during surgery, a large amount of blood may be lost.
In this case, compensatory mechanisms may not have time to react or will be unable to cope with severe bleeding. If the loss exceeds 30%, a transfusion of whole blood, its components or plasma substitutes is performed.
After this, drugs to stimulate hematopoiesis and iron tablets are prescribed. The recovery period for acute blood loss can last several months.
With chronic bleeding, symptoms do not appear immediately; during this time, the body's compensatory reserves are depleted, and anemia develops. In this case, in addition to taking hematopoietic stimulants, it is important to eliminate the source of chronic blood loss - in men most often these are diseases of the gastrointestinal tract, in women - diseases of the reproductive organs.
Blood donation is considered a safe and even beneficial procedure for the donor. Only completely healthy people with sufficient body weight take part in this procedure. But even donating blood can cause anemia. In this regard, after the procedure the body should be helped to recover.
Blood volume becomes the same quite quickly - in just 2 weeks. But restoration of the number of formed elements takes a longer time - about 1 month. If during this period there is a malfunction in the body, anemia may occur.
For the best effect, taking iron tablets should be supplemented with a balanced diet, a healthy lifestyle, and taking Vitamins C and B.
Donor blood, and especially plasma substitutes, are not able to restore the normal composition of the recipient’s blood. This is a last resort measure in emergency situations. After such an operation, it is necessary to restore the functioning of the patient’s own hematopoietic system and the balance of its formed elements. For this purpose, after the transfusion, the following is prescribed:
- Taking B vitamins.
- Taking iron supplements.
- Erythropoietin injections.
A woman’s body is adapted to minor monthly blood losses. But in certain conditions, representatives of the fair sex need to normalize the composition of the blood and restore its volume:
- After uterine bleeding.
- After delivery.
- After an abortion.
- After heavy menstruation.
- For diseases of the reproductive organs that are accompanied by blood loss.
First of all, it is important to restore hemoglobin levels. To do this, you need to take iron tablets. Hemoglobin may decrease in women for other reasons: due to pregnancy or breastfeeding. Since during these periods the need for iron increases sharply.
Note! Hemobin is allowed to be taken during pregnancy and lactation.
Restoring blood volume after bleeding is not a very long process. BCC is normalized by the body's own efforts or through transfusion. Normalization of the composition will take a much longer time. To shorten this period as much as possible, you need to help the body and strictly adhere to the doctor’s recommendations.
The materials are published for informational purposes only and are not a prescription for treatment! We recommend that you consult a hematologist at your medical institution!
Co-authors: Natalya Viktorovna Markovets, hematologist
Every person sometimes faces such a problem as blood loss. In small quantities it does not pose a threat, but if the permissible limit is exceeded, appropriate measures must be urgently taken to eliminate the consequences of the injury.
Every person from time to time faces the problem of bleeding of one or another complexity. The amount of blood loss may be insignificant and not pose any threat to health. With massive bleeding, minutes count, so you need to know how to deal with them.
Types of bleeding
Depending on the type of bleeding, the amount of blood loss and measures of assistance will be different.
- Arterial. Occurs as a result of damage to large vessels. The pulsating jet is a fountain. The color is bright red.
- Venous. The stream is sluggish and flows slowly. The blood contains a lot of carbon dioxide, which is why its color is dark red.
- Capillary. This is the least dangerous type of bleeding, since the capillaries are on the outside and the blood often stops on its own.
- Intracavity. A very dangerous look. The blood vessels of internal organs are damaged. In this case, the blood does not come out, but accumulates in the cavities of the body. The main danger is that it is not visually diagnosed, the process occurs hidden from the person, and symptoms do not appear immediately. And how much blood a person lost is difficult to determine in this situation.
Each of these types of bleeding can be fatal if action is not taken promptly and treatment is not started.
How does blood loss manifest in the body?
Basically, acute blood loss develops in the event of damage to a large vessel or rupture of the upper or lower vein, pulmonary column, or aorta.
This leads to a rapid drop in blood pressure, which in the most critical cases can drop to zero. Against the background of an almost instantaneous decrease in blood pressure, the patient develops a lack of oxygen (anoxia) of the myocardium and brain, which ultimately leads to death. Depending on how quickly the patient loses blood, his general condition changes. The faster this happens, the more severe the condition. In this case, it is almost impossible to predict a positive course for the patient.
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Each body's response to acute blood loss is individual. The younger the patient and the stronger his health, the higher the chances of a positive prognosis.
In a patient with chronic diseases, blood loss in the same volume will require mandatory replenishment of the blood volume. Also, blood loss in patients with different body constitutions will be accompanied by different consequences.
The patient's condition can also be affected by the weather at the time of injury. This is explained by the fact that during the hot period, blood loss will be much more significant than in cold weather, since in the heat the vessels dilate, which speeds up the process.
Attention! Acute blood loss is a condition that requires emergency medical attention. It is important to understand that if you do not provide timely assistance to the patient, he will soon begin to develop hypovolemia (BCC deficiency). In extreme cases, the lack of adequate measures to prevent this process will lead to death.
Death from blood loss
Untimely treatment of any type of blood loss leads to death. Blood has quite a lot of functions, and if there is a lack of it in the body, then these functions are either disrupted or not performed at all. With blood loss, the heart stops working, since it has nothing to pump, the work of the lungs is also disrupted: they contain many capillaries, thanks to which the respiratory system works. The work of all internal organs is based on blood exchange. Blood carries oxygen, without which the body cannot fully function. When blood circulation in the brain is disrupted, the supply of oxygen stops, which leads to hypoxia and brain cells begin to die. A similar phenomenon occurs in other organs. Therefore, blood loss is very dangerous, and if it is not stopped, the body will not survive. Of course, not all blood loss results in death. Fatal conditions include internal bleeding and acute blood loss.
Several factors influence the outcome of bleeding:
Feelings of dying people
The physical sensations of a dying person will depend primarily on what led him to death. He can experience both severe pain and pleasant sensations.
As for psychological perception, at the moment of dying, most people instinctively feel fear, panic and horror, and try to “resist” death.
According to biology, after the heart muscle stops contracting and the heart stops, the brain continues to function for about five minutes. It is believed that in these last minutes, a person’s mind reflects on his life, vivid memories emerge, and the person, as it were, “sums up” his existence.
The amount of blood depends on age, gender and weight
To live and function fully, the body needs oxygen and various nutrients that the blood delivers. The red color is due to the presence of blood cells - erythrocytes. It also contains white bodies - leukocytes, as well as so-called blood platelets - platelets, a first aid remedy for a cut.
The volume of blood varies from person to person. It depends on the age, gender, weight and individual characteristics of the person.
Using laboratory analysis, you can track deviations from the norm and the presence of a particular disease. As a rule, with a sharp decrease in the amount of blood, blood pressure drops. This can provoke the development of anemia, necrosis and impaired brain activity. In case of an increased amount, frequent nosebleeds appear.
How many liters of blood do women have?
It is generally accepted that the normal amount of blood in women is 3.5–4.5 liters, which is significantly less than in men. In medical practice, there is a method for calculating biological fluid. Its volume is calculated using the formula: 60 milliliters per body weight in kilograms. To get accurate information, just multiply your body weight by this number.
In order to determine how many liters of blood a woman weighing 55 kg should have, it follows: 55 × 60 = 3300 milliliters (3.3 l).
However, you need to remember that this value may differ from the actual one. For example, during the menstrual cycle this figure decreases.
But when it comes to a pregnant woman, the meanings are completely different. During different periods of gestation, the volume of circulating blood in the expectant mother changes. It increases with each trimester and reaches its maximum peak at 30-36 weeks of gestation. This is due to the physiological characteristics of the moment. With a single pregnancy, there is an increase of 30-50%, with a multiple pregnancy, the indicators increase by 45-65%. The total volume should increase enough to provide mother and child with all the necessary components of life.
How many liters of blood do men have?
The male body contains about 5-6 liters of blood. Precisely because this value is higher than in women, they endure blood loss much more severely. In males, the volume is calculated using the formula: 70 milliliters per body weight. To obtain information, you need to make a calculation.
To determine the exact value for an adult man weighing 70 kilograms, you need: 70 × 70 = 4900 milliliters (4.9 l).
This norm may change for athletes who are actively involved in strength training. During physical activity, metabolism increases, which increases the saturation of tissues with oxygen. Work, as an irritant, changes the composition of the blood. There is an increase in red blood cells, hemoglobin increases and the number of leukocytes increases.
People who regularly engage in physical activity and sports get sick less often and tolerate colds more easily. To be healthy, strong, and resilient, you need to activate blood circulation through sports. Running, swimming, and cycling are especially useful.
How many liters of blood do children of different ages have?
In each age period, blood has its own characteristic characteristics. Its volume is larger in children than in adults. So, newborns have approximately 0.5 liters. With age, this figure increases and reaches 4-6 liters in adolescents. In relation to body weight, on the contrary, it decreases: at 1 year – 110 ml, at 6 years – 90 ml, 13-16 years – 70 milliliters per kilogram of body weight. At the same time, boys have higher rates than girls.
In infancy, there is delayed blood clotting (onset within 2-3 minutes) and insufficient platelet activity. Therefore, bleeding in newborns is longer. In the first week of life it accelerates and approaches normal. In preschool children, on average, it is expressed in the same numbers (beginning 1-2 minutes, ending 3-4 minutes).
Only by the age of 14-16 the content and activity of all factors reaches the level of an adult.
Classification of blood loss: what is the danger of injury, degrees and types
The materials are published for informational purposes only and are not a prescription for treatment! We recommend that you consult a hematologist at your medical institution!
Co-authors: Natalya Viktorovna Markovets, hematologist
Every person sometimes faces such a problem as blood loss. In small quantities it does not pose a threat, but if the permissible limit is exceeded, appropriate measures must be urgently taken to eliminate the consequences of the injury.
Every person from time to time faces the problem of bleeding of one or another complexity. The amount of blood loss may be insignificant and not pose any threat to health. With massive bleeding, minutes count, so you need to know how to deal with them.
In general, every person knows the external signs of blood loss. But a wound on the body and traces of blood are not all. Sometimes the bleeding goes unnoticed or is not taken seriously enough. You should pay attention to the general signs:
- pallor;
- cold sweat;
- cardiopalmus;
- nausea;
- spots before the eyes;
- tinnitus;
- thirst;
- clouding of consciousness.
These symptoms may be harbingers of hemorrhagic shock that develops with heavy bleeding.
Symptoms of hemorrhagic shock
Let's take a closer look at the features of different categories of blood loss and why each of them is dangerous.
Types of blood loss
In medical practice, there are several criteria for classifying blood loss. Let's look at their main types. First of all, the following bleedings are distinguished:
- capillary;
- venous;
- arterial;
- parenchymal.
Important: the most dangerous are the arterial and parenchymal (internal) types.
Classification also implies division into the following groups:
- Acute blood loss. A one-time loss of blood in a significant volume.
- Chronic. Minor bleeding, often hidden, lasting for a long time.
- Massive. Loss of large volume of blood, drop in blood pressure.
It will also be useful for you to learn about bleeding from the mouth on our website.
Types of bleeding in one image
There are separate types, depending on what caused the bleeding:
- Traumatic - when tissues and blood vessels are damaged.
- Pathological - pathologies of the circulatory system, internal organs, diseases and tumors.
Severity
The greater the severity of blood loss, the more serious its consequences. There are the following degrees:
- Easy. Less than a quarter of the total volume of circulating blood has been lost, the condition is stable.
- Average. Heavy blood loss, on average 30–40%, requires hospitalization.
- Severe degree. From 40%, poses a serious threat to life.
The degrees of acute blood loss are also characterized by the severity of hemorrhagic shock:
- 1 - about 500 ml of blood was lost;
- 2 - about 1000 ml;
- 3 - 2 liters or more.
Index | Severity of blood loss | |||
1 | 2 | 3 | 4 | |
Heart rate, min | 100 | {amp}gt;120 | {amp}gt;140 | |
Hourly diuresis, ml | {amp}gt;30 | 20-30 | 5-15 | anuria |
Level of consciousness | Mild excitement | excitation | confused | precom |
Capillary refill test | N | delayed | Very slow | No padding |
Volume of blood loss, ml | 2000 | |||
BCC deficit, % | 40 |
Table: Classification by severity
According to the criterion of reversibility, the following phases of the shock state are distinguished:
- compensated reversible;
- decompensated irreversible;
- irreversible.
But how to determine the volume of lost blood? There are such methods of determination:
- by general symptoms and type of bleeding;
- weighing blood bandages;
- weighing the patient;
- lab tests.
To prevent hemorrhagic shock syndrome and other complications, it is important to provide correct and timely assistance to the victim. When blood is lost, the consequences can range from temporary weakness and anemia to organ failure and death. Death occurs when blood loss exceeds 70% of the blood volume.
How much blood can you lose without consequences?
The loss of a small amount is absolutely harmless for people. For example, a single collection from a donor is 450 ml. A healthy, strong body will quickly make up for this loss, and even in excess. Regular blood loss stimulates the functioning of internal organs and systems. It has been proven that the life expectancy of donors is 5 years longer. Therefore, by sharing blood, you not only save someone else’s life, but also improve your health.
Blood loss is divided into several types:
- Small – total volume less than 500 ml. It is tolerated without consequences, pulse and blood pressure remain normal, but fatigue appears.
- Average – 1-2 liters. Blood pressure decreases, nausea and dizziness appear, and fainting is possible.
- Fatal – occurs when there is a shortage of more than 70% of the body’s blood.
Remember, human health depends not only on the quality of blood, but also on its quantity. Significant reductions can contribute to the development of various diseases.
How many liters of blood does an average person have?
In practice, it is possible to determine how much blood is actually in the human body using a contrast agent. Most often, a colloidal dye is used for this, which is absolutely safe for humans. After the contrast agent is distributed throughout all the vessels of the circulatory system, a biological fluid is taken and the volume of circulating blood is calculated based on the concentration of the dye and its main components.
However, it is important to remember that the actual figure is defined slightly differently. This figure is found by summing the following values:
- volume of circulating fluid;
- deposited blood reserves (provide release during maximum mental or physical exertion);
- the volume of elements located in the hematopoietic organs (bone marrow);
- the quantitative value of red blood cells destroyed in the spleen, and lymphocytes in the lungs.
In medical practice, there is another way to calculate the value of biological fluid. It is generally accepted that the normal amount of blood in women is 60 ml per kg of weight. Thanks to this, you can easily perform calculations. To do this, you just need to multiply your body weight by this indicator. However, it is important to remember that how many liters of blood are in a person may differ from the actual value. For example, this indicator decreases during the menstrual cycle.
For representatives of the stronger sex, the norm is 70 ml per kg of weight. For example, 7 liters of vital fluid circulates in the body of a 100-kilogram man. However, in practice, how many liters of blood an adult actually has may differ from the calculated value. This happens if a man regularly takes diuretics.
This indicator may vary at different stages of life. For this reason, it is difficult to say exactly what the ideal volume of circulating blood is.
The value of this indicator during the period of bearing a baby is not constant.
Blood volume changes as follows:
- First trimester – 60 ml. In other words, no significant changes are observed.
- Second and third trimesters – 75 ml. The fetus develops and grows at a rapid pace. In order to simultaneously provide for the needs of the little man and the pregnant woman, special processes are launched in her body. One of them is an increase in the volume of circulating biological fluid.