Bleeding

technically known as hemorrhaging

loss of blood escaping from the circulatory system
Bleeding can happen internally where blood leaks from blood vessels inside
the body, or externally
Hypovolemia- is a state of decreased blood volume; more specifically,
decrease in volume of blood plasma.
Typically, a healthy person can endure a loss of 1015% of the total blood
volume without serious medical difficulties
Exsanguination- is the process of blood loss
Hemostasis
Is a process which causes bleeding to stop, to keep blood within a damaged
blood vessel and an important part in both first aid and surgery.
It is the first stage in wound healing.
Common Causes of Bleeding
Bleeding arises due to either traumatic injury, underlying medical condition,
or a combination.
1. Traumatic bleeding - caused by some type of injury. There are different types
of wounds which may cause traumatic bleeding
a) Abrasion- does not penetrate below the epidermis.
b) Laceration- Irregular wound caused by blunt impact.
c) Puncture Wound- Caused by an object penetrated the skin and underlying
layers.
d) Contusion - known as a bruise
e) Gunshot wounds - Caused by a projectile weapon
2. Medical Conditions- 'Medical bleeding' denotes hemorrhage as a result of an
underlying medical condition. Blood can escape from blood vessels as a result
of 3 basic patterns of injury:
i. Intravascular changes - changes of the blood within vessels
ii. Intramural changes - changes arising within the walls of blood vessels
iii. Extravascular changes - changes arising outside blood vessels
a.) Hemophilia- bleeding disorder in which blood doesnt clot normally
b.) Leukemia- abnormal increase in the number of white blood cells
c.) Mennorhagia- abnormal profuse menstrual flow
d.) Bowel Obstruction- obstruction of the intestines, preventingthe normal
transit of the products of digestion
3. Medicine:
a) Blood-thinning medications- reduce the risk of heart attack and stroke by
reducing the formation of blood clots in your arteries and veins.
b) Antibiotics
c) Radiation therapy
Types of bleeding
1. External bleeding blood leaks through natural openings such as mouth, nose,
ear, urethra, vagina, or anus
- Recognizable bleeding of external body part
-Usually associated with wounds
1.1.Hematemesis vomiting of blood

1.2.Hemoptysis coughing up blood from the lungs

1.3.Hematuria blood in the urine from urinary bleeding
1.4.Hematochezia - commonly associated with lower gastrointestinal bleeding;
blood in stool.
2. Internal bleeding - blood leaks from blood vessels inside the body
- Can only be seen when there is a large amount of blood loss
- occur within tissues, organs, or in cavities of the body including the head,
spinal canal, chest, and abdomen. more difficult to identify.
2.1.Intracranial hemorrhage bleeding in the skull
2.2.Cerebral hemorrhage bleeding within the brain tissue itself
Classification Bleeding
1. Capillary Bleeding- a minor scrape or cut that opens some capilliaries, the
bleeding is almost always very slow and small in quantity.
2. Venous Bleeding- A cut vein typically results in a steady but relatively slow
flow of dark red blood.
3. Arterial Bleeding- The least common and most dangerous type of bleeding.
It involves bright red blood that comes out in large volume, and in spurts
that correspond with each beat of your heart.

Standardized Grading Scale to Measure Severity of Bleeding by the World

Health Organization ( WHO )

Classification of Blood loss

1. Class 1 Hemorrhage - 10-15% blood loss, no change in vital signs and no
need for fluid resuscitation; patient survives
2. Class 2 Hemorrhage - 15-30%, patient is tachycardic (rapid heart rate),
volume resuscitation with crystalloids (Saline solution or Lactated Ringers
solution) is required while blood transfusion typically isnt
3. Class 3 Hemorrhage- 30-40%, tachycardic, blood pressure drops; needs
blood transfusion and fluid resuscitation with crystalloid
4. Class 4 Hemorrhage - more than 40%, needs blood transfusion and CPR to
prevent death
Symptoms of Bleeding:
1.
2.
3.

Blood coming from an open wound

Bruising
Shock, which may cause any of the following symptoms:
Confusion or decreasing alertness
Clammy skin
Dizziness or light-headedness after an injury
Low blood pressure
Paleness
Rapid pulse, increased heart rate
Shortness of breath
Weakness

Treatment:

Wash and disinfect the wound to remove all dirt and debris
Use direct pressure and elevation to control bleeding and swelling
When wrapping the wound, always use a sterile dressing or bandage
Keep the wound clean and dry for five days
Rest