Bleeding from large arteries or veins can be controlled temporarily by pressure directly over the wound.
Temporary control may also be obtained by digital pressure above or below the wound, if in a leg or arm, depending upon whether the escape is chiefly from a vein or an artery, for in any wound some of the bleeding will be capillary. This method, or the application of a tourniquet, will absolutely control bleeding in an extremity.
The pressure in arterial hemorrhage must be applied at a point nearer the heart and in venous hemorrhage at a point away from the heart.
A tourniquet may be devised from a handkerchief, a piece of rope or of rubber tubing wound around the limb and tightened just enough to arrest the main stream; in addition, pressure exerted over the wound will control whatever hemorrhage persists. Such a control can only be temporary, as the arrest of circulation in an extremity below the tourniquet for more than an hour or two might cause gangrene. However, there is no great fear of this occurring, as some blood reaches the parts through deep vessels.
Permanent control of such hemorrhages can only be effected by grasping the severed vessels in the open wound with artery clamps, and then ligating below the clamps with cat gut.
Deep-seated hemorrhages, in the abdomen or chest, can often be controlled by pressure directly over the wound until an open operation can be performed.
Deep pressure, with the fist upon the abdomen just to the left of the vertebral column, will compress the aorta and greatly reduce the escape of blood from any artery supplied by the descending aorta.
Hemorrhage in Chiropody. For the chiropodist, bleeding is an annoying and especially perplexing occurrence. The feet are the most bacteria-laden part of the body; here are warmth and moisture, congenial to bacteria, and a thick epidermis for their safe concealment. When hemorrhage occurs, therefore, its proper control along antiseptic lines is imperative.
The vessels severed are rarely of sufficient size to cause the escape of blood in an actual stream, but rather as a rapid oozing. It is, as a rule, capillary hemorrhage.
The methods for its control have already been described in this chapter, and will always stop such bleeding.