Hemorrhages

Overview

Hemorrhage is the sudden loss of blood caused by the rupture of one or more blood vessels.

It can be classified as:

• external: when the hemorrhage is on the surface and visible
• internal: when it is not visible, such as in the abdomen or chest, and may become apparent through the body's natural openings (mouth, nose, ear, etc.)

Types and Causes

• arterial: blood is spurting from an artery. The bleeding is bright red, in jets, pulsing in sync with the heartbeat. Blood loss is rapid and abundant
• venous: blood is flowing from a vein. The bleeding is steady and dark in color
• capillary: blood is oozing from a network of capillaries. The color is red, usually less bright than arterial blood, and the flow is slow

Treatment

In cases of bleeding from arms and legs, try to stop the hemorrhage using one of the methods below:

• ​direct compression: apply direct pressure to the wound using a clean cloth or dressing. Maintain pressure until clotting occurs. Premature interruption of this maneuver may dislodge the newly formed clot, restarting the bleeding
• limb elevation: raise the affected limb above chest level, usually used in combination with direct compression to control bleeding from an extremity
• indirect compression (pressure points): apply pressure with the resc    uer’s hand to compress an artery away from the wound. This is often done on the brachial or femoral artery
• tourniquet: apply a tourniquet only in cases of traumatic amputation of the arm or leg with heavy bleeding that has not responded to the previous techniques, or if medical centers are more than 30 minutes away

In cases of nosebleeds:

• sit the victim down with their head tilted forward to prevent swallowing blood, which can cause nausea and vomiting
• pinch the nostrils using your index finger and thumb in a pinching motion for 10 minutes
• instruct the victim to breathe through their mouth
• after the bleeding stops, advise the victim not to blow their nose, avoid exertion, and stay away from heat
• if the bleeding continues, repeat the procedure up to two more times
• if none of the maneuvers work, take the victim immediately to the nearest healthcare facility (emergency room or hospital)

In cases of mouth bleeding:

• use the direct compression technique for bleeding on the lips
• if the bleeding is from the teeth, the rescuer should locate the bleeding site, prepare a gauze pad, cotton ball, or clean cloth to place directly on the bleeding spot, and ask the victim to bite down for 10 minutes

By Einstein Editorial Board