It occurs as a result of a violation of the integrity of the vessel during injuries, purulent fusion, and an increase in arterial and atmospheric pressure. Changes in the vitamin balance in the body, the action of toxins can also lead to vascular permeability. A number of diseases cause bleeding due to changes in the chemical composition of the blood: hemophilia, jaundice, scarlet fever, sepsis, scurvy, etc. Bleeding can be either internal - in one or another cavity of the body (pleural, abdominal, etc.); in tissue (hematoma); hidden - without pronounced external manifestations is determined by special research methods. Hemorrhage is called diffuse blood impregnation of any tissue (subcutaneous tissue, brain tissue, etc.).
Based on the time allocated: a) primary bleeding that begins immediately after damage, injury; b) early secondary bleeding that occurs in the first hours and days after injury (before the development of infection in the wound). Often there are from pushing a blood clot by a blood stream with an increase in intravascular pressure or with the removal of a vessel spasm; c) late secondary bleeding, which can begin at any time after the development of infection in the wound. They are associated with purulent thrombus melting in a damaged vessel or its wall and are dangerous: it is necessary to carefully monitor a patient with damaged large vessels, always have tows ready at his bed!
According to the severity and the resulting blood loss (acute anemia), four degrees of blood loss are distinguished. Grade 1 - the general condition of the patient is satisfactory, the pulse is somewhat quickened, of sufficient filling, normal blood pressure (BP), hemoglobin content is above 8 g%, circulating blood volume deficiency (BCC) is not more than 5%. II degree - a state of moderate severity, the pulse is frequent, blood pressure is reduced to 80 mm RT. century, the hemoglobin content is up to 8 g%, the BCC deficiency reaches 15%. III degree - a serious condition, pulse - filiform, blood pressure - up to 60 mm RT. Art., hemoglobin content - up to 5 g%, bcc deficiency - 30%. IV degree - the state borders on agonal, pulse and blood pressure are not determined, the hemoglobin content is less than - 5 g%, the BCC deficit exceeds 30%.
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