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HEMORRHAGE (BLEEDING)

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HEMORRHAGE (BLEEDING)

Hemorrhage also knew as bleeding is the loss of blood from the circulatory system or the escape of blood from the blood vessels into the surrounding tissue.

  • Bleeding can be internally and externally or visible.
  • In internal bleeding, blood leaks from blood vessels inside the body such as the liver or spleen, while in external bleeding, blood leaks from blood vessels either through a natural opening such as the mouth, ear, nose, vagina, or anus or through a break in the skin.
  • In internal bleeding, the patient may notice blood either in the urine or stools.
  • Hemorrhage continues as long as the vessel remains open and the pressure in it exceeds the pressure out of it.
  • Hemorrhage can occur from the artery (Arterial Hemorrhage), capillary (Capillary Hemorrhage), vein (Venous Hemorrhage).
  • A healthy person can endure a loss of 10-15% of the total blood volume without any serious medical difficulties.
  • Excessive bleeding can be fatal and lead to several complications and can result in organ failure
  • The American College of Surgeons’ breaks hemorrhage is broken down into four classes:
  • Class I Hemorrhage involves up to 15% of blood volume. In this type, there is no change in vital signs and there is always no need for fluid resuscitation.
  • Class II Hemorrhage involves 15-30% of total blood volume. At this stage, the body may start to look pale and be cool to touch. The patient may exhibit different changes in behavior. Blood transfusion may not be required.
  • Class III Hemorrhage involves loss of 30-40% of blood volume. At this stage, the patient’s blood pressure drops, heart rate increases and mental status gets worse. Fluid resuscitation and blood transfusion are usually necessary.
  • Class IV Hemorrhage involves loss of blood volume greater than 40%. At this stage, the limit of the body’s compensation is reached, and aggressive resuscitation is required to prevent death
  • Hemorrhage can occur in any part or tissue in the body and each one has its own specific name:
  • In the upper head, bleeding may occur in the skull (intracranial hemorrhage), in the subarachnoid space (subarachnoid hemorrhage), within the brain tissue (intracranial hemorrhage)
  • In the nose, we have a nosebleed also called epistaxis
  • In the mouth, there may be tooth eruption (losing a tooth), vomiting fresh blood (hematemesis) and coughing up blood from the lungs (hemoptysis)
  • There may be pulmonary hemorrhage in the lung
  • In the urinary tract, there may be blood in the urine from urinary bleeding (Hematuria)
  • Bleeding in the anus can result from upper gastrointestinal bleeding (melena), or lower gastrointestinal bleeding (hematochezia)
  • Vaginal bleeding includes postpartum hemorrhage, breakthrough bleeding
  • In the gastrointestinal tract, there may be upper or lower gastrointestinal bleed
  • Ovarian bleeding may also occur

CAUSES

Hemorrhage can result from traumatic injury to a blood vessel, underlying medical condition or both, including:

  • Cancer
  • Surgery
  • Pile (hemorrhoids)
  • Liver disease
  • Acute bronchitis
  • Open wound
  • Low platelet count
  • Menstrual problems
  • Hemophilia
  • Hypovolemic shock
  • Fracture
  • Threatened miscarriages
  • Peptic ulcer
  • Animal Bite
  • Medications
  • An aneurysm
  • Events such as car accidents, bullet wounds, falls, explosions
  • Ectopic pregnancy
  • Broken bones
  • Heart attack
  • Diabetes
  • Chronic high blood pressure

DIAGNOSIS

External bleeding can be diagnosed just by looking at the site of bleeding, internal bleeding is commonly diagnosed by an imaging test.

TREATMENT

Treatment may depend on the cause, severity of the bleeding