First aid (first aid) for bruises (bruises)

Everyone gets a bruise sometimes. Not least on the soul, but that’s besides the point. A physical bruise is a bruise or subcutaneous bleeding, usually the result of a bump, a blow or an accidental fall. The symptoms include pain, discoloration of the skin and sometimes swelling. There are numerous methods to reduce the risk of bruising. And remedies to treat them. When providing first aid (first aid), it is important to determine whether the victim has suffered other injuries that are much more serious, such as a broken bone. And whether the victim is taking anticoagulation. In line with this, the question arises whether bruises occur at the slightest thing, for example without bumping.

Contents

• Pain, discoloration and swelling
• Blood clotting – a complex chemical process
• First aid (first aid) for a subcutaneous bruise (bruise)

• What to do

• To the doctor
• Petechiae – subcutaneous microbleeds

Pain, discoloration and swelling

In a ‘normal’ bruise ( hematoma ), blood seeps into the subcutaneous, loose connective tissue. In some cases it also causes a swelling that is pink or bright red in the initial phase, but later turns blue to green-yellow. A bruise usually also hurts. Bruises can occur throughout the body, such as just under the skin, but also in the chest and abdominal cavities and in the brain. A subarachnoid hemorrhage is a characteristic example of this.

Hematoma (bruise) / Source: Baedaya, Pixabay

Blood clotting – a complex chemical process

Blood vessels can be damaged by a fall or impact . These oozing vessels then contract to limit blood loss. Blood clotting as such is a complicated chemical process, an interplay between, among other things, the platelets (thrombocytes) and the protein fibrinogen, which leads to the formation of a network of fibrin threads between which the blood cells remain suspended and which form a visible prey in an open wound. or form blood crusts. Numerous other clotting factors are involved.

Disrupted process
This refined interplay, in which vitamin K also plays a major role, can be disrupted for all kinds of reasons. Such as an increased tendency to bleed, but also due to clot formation in the blood, as is the case with the heart rhythm disorder atrial fibrillation. In the case of a subcutaneous bruise, the tissue also breaks down the blood, including the hemoglobin. As a result of this process, a bruise that heals slowly can show all the colors of the rainbow.

First aid (first aid) for a subcutaneous bruise (bruise)

If someone has bumped themselves and a bruise appears , it is important that the first responder first determines whether there is any injury that contributed to the bruising. This is often a bone fracture or fissure. Applying an ice pack is the best treatment for any injury that could lead to bruising. Use a cold pack for this. If you don’t have one on hand, a towel soaked in ice water will do the trick. Or put broken ice cubes in a washcloth or plastic bag. Cold causes the blood vessels to constrict. By administering cold, the natural physiological blood clotting process is aided and less blood seeps into the subcutaneous tissue.

What to do

In summary, first aid for a bruise boils down to the following:

1. First determine how the injury occurred. A bruise is painful, especially when pressed, and usually swells.
2. Have the victim sit or lie down. The person in question may faint due to the emotions about the incident.
3. The underlying injury could be a broken bone. For example, if the victim has fallen hard. Or if, in your opinion, the pain is disproportionate to the visible ‘minor’ injury. Then provide first aid as you would for a broken bone and then refer the victim to rule out a fracture or fissure.
4. Apply a cold compress or use a cold pack as soon as possible. Do that for at least half an hour. You can also hold the affected body part, such as a hand or foot, under cold running water. That has the same effect.

Petechiae, microbleeds / Source: Seasurfer, Wikimedia Commons (Public domain)

To the doctor

It is always suspicious when someone gets bruises at the slightest thing or cannot remember how he or she got them. In that case, the advice to go to the doctor is certainly not an unnecessary luxury. After all, there may be something wrong with the blood clotting . Any blood-thinning medications may no longer work optimally, which requires interim monitoring. Those who take aspirin or similar anticoagulants, such as for heart disease or to prevent stroke in at-risk patients, will notice that they bruise more easily when they bump into something. This also applies to antidepressants and anti-inflammatories. Alcohol and drugs also have that effect.

Petechiae – subcutaneous microbleeds

Petechiae occupy a special place and give every reason to go to the doctor. These are very small bruises the size of a pinhead. The larger hemorrhages are called sugillates . These microbleeds can be the result of a greatly reduced number of thrombocytes (platelets), which is called thrombocytopenia. Abnormalities in the bone marrow, such as leukemia, tumors (metastases) and cytostatics can be the

cause . Lack of vitamins. Due to the poor clotting capacity,
bleeding can occur spontaneously in the skin, but also in the organs (hemorrhagic diathesis). Mucous membrane and nose bleeds are not uncommon. ‘Brittle’ vessel walls and other blood vessel abnormalities are also known to form petechiae . Furthermore, it sometimes concerns a lack of certain vitamins, a dormant infectious disease, a built-up allergy to some medicines and disorders relating to blood clotting factors.

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