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Bleeding

Definition

Bleeding is the loss of blood. Bleeding may be:

Bleeding may occur:

Alternative Names

Blood loss; Open injury bleeding

Considerations

Get emergency medical help for severe bleeding. This is very important if you think there is internal bleeding.  Internal bleeding can very quickly become life threatening. Immediate medical care is needed.

Serious injuries don't cause heavy bleeding. Sometimes, relatively minor injuries can bleed a lot. An example is a scalp wound.

You may bleed a lot if you take blood-thinning medication or have a bleeding disorder such as hemophilia. Bleeding in such people requires immediate medical attention.

The most important step for external bleeding is to apply direct pressure. This will stop most external bleeding.

Always wash your hands before (if possible) and after giving first aid to someone who is bleeding. This helps prevent infection.

Try to use latex gloves when treating someone who is bleeding. Latex gloves should be in every first aid kit. People allergic to latex can use a nonlatex glove. You can catch viral hepatitis if you touch infected blood. HIV can be spread if infected blood gets into an open wound, even a small one.

Although puncture wounds usually don't bleed very much, they carry a high risk of infection. Seek medical care to prevent tetanus or other infection.

Abdominal and chest wounds can be very serious because of the possibility of severe internal bleeding. They may not look very serious, but can result in shock.

Blood loss can cause blood to collect under the skin, turning it black and blue (bruised). Apply a cool compress to the area as soon as possible to reduce swelling. Wrap the ice in a towel and place the towel over the injury. Do not place ice directly on the skin.

Causes

Bleeding can be caused by injuries or may be spontaneous. Spontaneous bleeding is most commonly caused by problems with the joints, or gastrointestinal or urogenital tracts.

Symptoms

Symptoms of internal bleeding may also include:

First Aid

First aid is appropriate for external bleeding. If bleeding is severe, or if you think there is internal bleeding or the person is in shock, get emergency help.

  1. Calm and reassure the person. The sight of blood can be very frightening.
  2. If the wound affects just the top layers of skin (superficial), wash it with soap and warm water and pat dry. Bleeding from superficial wounds or scrapes is often described as "oozing," because it is slow.
  3. Lay the person down. This reduces the chances of fainting by increasing blood flow to the brain. When possible, raise up the part of the body that is bleeding.
  4. Remove any loose debris or dirt that you can see from a wound.
  5. Do NOT remove an object such as a knife, stick, or arrow that is stuck in the body. Doing so may cause more damage and bleeding. Place pads and bandages around the object and tape the object in place.
  6. Put pressure directly on an outer wound with a sterile bandage, clean cloth, or even a piece of clothing. If nothing else is available, use your hand. Direct pressure is best for external bleeding, except for an eye injury.
  7. Maintain pressure until the bleeding stops. When it has stopped, tightly wrap the wound dressing with adhesive tape or a piece of clean clothing. Place a cold pack over the dressing. Do not peek to see if the bleeding has stopped.
  8. If bleeding continues and seeps through the material being held on the wound, do not remove it. Simply place another cloth over the first one. Be sure to seek medical attention.
  9. If the bleeding is severe, get medical help and take steps to prevent shock. Keep the injured body part completely still. Lay the person flat, raise the feet about 12 inches, and cover the person with a coat or blanket. DO NOT move the person if there has been a head, neck, back, or leg injury, as doing so may make the injury worse. Get medical help as soon as possible.

Do Not

When to Contact a Medical Professional

Seek medical help if:

Prevention

Use good judgment and keep knives and sharp objects away from small children.

Stay up-to-date on vaccinations, especially the tetanus immunization.

References

Cornwell EE. Initial approach to trauma. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004: chap 251.

Lammers, RL. Principles of Wound Management. In: Roberts JR, Hedges JR eds. Roberts: Clinical Procedures in Emergency Medicine. 5th ed.Philadelphia, Pa. Saunders Elsevier; 2009: chap 39.


Review Date: 1/1/2013
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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