Читать книгу Special Report on Diseases of Cattle - Lowe - Страница 119

The severity of a hemorrhage depends upon the size of the vessel from which the blood escapes, though it may be stated that it is more serious when arteries are severed. If the wound in an artery is in the direction of its length, the blood escapes more freely than if the vessel is completely severed, because in the latter instance the severed ends retract, curl in, and may aid very much in arresting the flow. When the blood merely oozes from the wound, and even when it flows in a small stream, the forming of the clot arrests the hemorrhage in a comparatively short time.

Slight hemorrhages may be checked by the continuous application of cold water, ice, or snow, to the wound, as cold causes contraction of the small vessels. Water from a hose may be thrown on a wound, or dashed on it from the hand or a cup, or folds of cotton cloths may be held on it and kept wet. Ice or snow may be held against the wound, or they may be put into a bag and conveniently secured in position.

Hot water of an average temperature of 115° to 120° F. injected into the vagina or womb is often efficient in arresting hemorrhages from those organs. Tow, raw cotton, lint, or sponges may be forced into a wound and held or bound there with bandages. This is an excellent method of checking the flow of blood until the arrival of an expert. If the flow persists, these articles may be saturated with tincture of iron, but it is not advisable to use it unless necessary, as it is a caustic and retards healing by causing a slough. In cases of necessity, the articles may be saturated with vinegar, or tannic acid or alum dissolved in water may be used instead. Whatever article is used should be left in the wound sufficiently long to make sure that its removal will not be followed by a renewal of the hemorrhage. Sometimes it must remain there one or two days.

An iron heated white and then pressed on the bleeding vessel for three or four seconds is occasionally used. It should not be applied longer, or else the charred tissue will come away with the iron and thus defeat the purpose of its application.

Compression may be applied in different ways, but only the most convenient will be mentioned. To many wounds bandages may easily be applied. The bandages may be made of linen, muslin, etc., sufficiently wide and long, according to the nature of the wound and the region to be bandaged. Bed sheets torn in strips the full length make excellent bandages for this purpose. Cotton batting, tow, or a piece of sponge may be placed on the wound and firmly bound there with the bandages.

Many cases require ligating, which is almost entirely confined to arteries. A ligature is a piece of thread or string tied around the vessel. Veins are not ligated unless very large (and even then only when other means are not available) on account of the danger of causing phlebitis, or inflammation of a vein. The ligature is tied around the end of the artery, but in some instances this is difficult and it is necessary to include some of the adjacent tissue, although care should be taken not to include a nerve. To apply a ligature, it is necessary to have artery forceps (tweezers or small pincers may suffice) by which to draw out the artery in order to tie the string around it. To grasp the vessel it may be necessary to sponge the blood from the wound so that the end will be exposed. In case the end of the bleeding artery has retracted, a sharp-pointed hook, called a tenaculum, is used to draw it out far enough to tie. The ligature should be drawn tightly, so that the middle and internal coats will be cut through.

Another method of checking hemorrhage is called torsion. It consists in catching the end of the bleeding vessel, drawing it out a little, and then twisting it around a few times with the forceps, which lacerates the internal coats so that a check is effected. This is very effectual in small vessels, and is to be preferred to ligatures, because it leaves no foreign body in the wound. A needle or pin may be stuck through the edges of the wound and a string passed around between the free ends and the skin (Pl. XXVII, fig. 10), or it may be passed around in the form of a figure 8, as is often done in the operation of bleeding from the jugular vein.