Bleeding is the name commonly used to describe blood loss. It can refer to blood loss inside the body (internal bleeding) or blood loss outside of the body (external bleeding).
Blood loss can occur in almost any area of the body. Typically, internal bleeding occurs when blood leaks out through damage to a blood vessel or organ. External bleeding occurs either when blood exits through a break in the skin, or when blood exits through a natural opening in the body, such as the mouth, vagina, or rectum.
Bleeding is a very common symptom that can be caused by a variety of incidents or conditions. Possible causes include:
Traumatic bleeding is caused by an injury. Injuries can vary in severity, but most will cause bleeding to some degree. Common types of traumatic injury include:
- abrasions or grazes that do not penetrate below the skin
- hematoma or bruises
- lacerations or incisions
- puncture wounds from items such as a needle or knife
- crushing injuries
- gunshot wounds (caused by a weapon such as a gun)
There are also a number of medical conditions that can cause bleeding. This is generally rarer than traumatic bleeding but can still happen to varying degrees. Conditions that can cause bleeding include:
- liver disease
- Von Willebrand’s disease
- vitamin K deficiency
- brain trauma
- bowel obstruction
- congestive heart failure
- lung cancer
- acute bronchitis
Some medicines can increase your chances of bleeding or even cause bleeding. Typically, you will be warned about this and advised what to do when you are first prescribed the medication.
Medications that may be responsible for bleeding include:
- blood-thinning medications
- antibiotics, when used on a long-term basis
- radiation therapy
If bleeding is severe, call an ambulance immediately. You should also seek emergency help if you suspect internal bleeding, as this can quickly become life threatening.
People who suffer from bleeding disorders or take blood thinners should also seek emergency help in order to stop the bleeding as quickly as possible.
Seek medical help if:
- the person has gone into shock or has a fever
- the bleeding cannot be controlled using pressure
- the wound requires a tourniquet
- the bleeding was caused by a serious injury
- the wound may need stitches to stop bleeding
- foreign objects are stuck inside the wound
- the wound appears to be becoming infected (such as swelling or leaking a yellow or brown fluid, or has redness)
- the injury occurred due to a bite from an animal or human.
When you call for help, the emergency services will advise you on what to do and of their approximate arrival time. In most cases, you will be advised to continue to put pressure on the wound and to keep reassuring the patient. You may also be told to lay the person down to reduce the risk of fainting.
When treating bleeding, it is important to find out why the bleeding is occurring and then to stop it as quickly as possible. If the bleeding is caused by a medical condition, emergency care will be needed immediately.
First Aid for Traumatic Bleeding
It is possible to treat external traumatic bleeding. Be sure to seek emergency help if the patient fits any of the criteria above, or if you need help to stop the bleeding.
First, try to calm the injured person, and reassure him or her. Bleeding can be very scary, and reassurance is essential to avoid shock.
Lay the person down as soon as possible to reduce the risk of fainting. Try to elevate the area that is bleeding, if possible.
Remove loose debris and foreign particles carefully from the wound. Leave large items such as knives, arrows or weapons where they are. Removing these objects can cause further harm and will likely increase the bleeding. In this case, use bandages and pads to keep the object in place and absorb the bleeding.
Use a clean cloth, bandage, clothing, or your hands to put pressure directly onto the wound.
Maintain a medium pressure until the bleeding has slowed, and eventually stops.
Do not remove the cloth when bleeding stops. Use an adhesive tape or clothing to wrap around the dressing and hold it in place.
Place a cold pack over the wound.
Do not look at the wound to see if bleeding has stopped, as this can disturb the wound and cause it to begin bleeding again.
Do not remove the cloth from the wound, even if blood seeps through the material. Add more material on top, and continue the pressure.
Do not move anyone with a head, neck, back, or leg injury. Do not apply pressure to an eye injury.
Tourniquets should only be used as a last resort. Ideally, a tourniquet should be applied by an experienced person. If a tourniquet is needed, follow these steps:
- Identify where to place the tourniquet. It should be applied to a limb between the heart and the bleeding.
- Make the tourniquet using bandages, if possible. Wrap them around the limb, and tie a half knot. Ensure there is enough room to tie another knot with the loose ends.
- A stick or rod should be placed between the two knots.
- Twist the stick to tighten the bandage.
- Secure the tourniquet in place with tape or cloth.
- Check the tourniquet every 10 minutes. If the bleeding slows enough to be sufficiently controllable with pressure, release the tourniquet and apply direct pressure instead.
If bleeding is caused by a serious injury, bleeding cannot be controlled, or if the bleeding is internal, you will need emergency medical care.
Typically, paramedics will attempt to control the bleeding before rushing you to hospital. In some cases, care might be given at home or by using a stretcher. The treatment required will depend on the cause of the bleeding.
In rare cases, surgery may be required to stop bleeding.
Anyone who experiences unexplained bleeding should be seen by a medical professional.
If bleeding is caused by an injury or accident, it may be stopped with minor first aid. Typically, the wound will then heal naturally and no further care is needed.
If bleeding is caused by a medical condition, and the condition is not identified or diagnosed, the bleeding is likely to reoccur.
Any bleeding that is allowed to continue without medical treatment could potentially cause bleeding to death. Typically, people need to lose between one-third and one-half of their total blood before they bleed to death. Bleeding to death is a very uncommon way for humans to die.
Exsanguination (bleeding to death) can occur without any external bleeding. Catastrophic internal hemorrhages can cause a great deal of blood loss, as can aneurysms.