[hem- + -rrhage]
Loss of blood. The term is usually used for episodes of bleeding that last more than a few minutes, compromise organ or tissue perfusion, or threaten life. The most hazardous forms of blood loss result from arterial bleeding, internal bleeding, or bleeding into the cranium. The risk of uncontrolled bleeding is greatest in people who have suffered major trauma, or in those who take anticoagulant drugs or who have other coagulation defects.
SYMPTOMS AND SIGNS
Orthostatic dizziness, weakness, fatigue, shortness of breath, and palpitations are common symptoms of hemorrhage. Signs of hemorrhage include tachycardia, hypotension, pallor, and cold, moist skin.
Pressure should be applied directly to any obviously bleeding body part, and the part should be elevated. Cautery may be used to stop bleeding from visible vessels. Ligation of blood vessels, surgical removal of hemorrhaging organs, or the instillation of sclerosants are often effective in managing internal hemorrhage. Procoagulants (such as vitamin K, fresh frozen plasma, cryoprecipitate, desmopressin acetate) may be administered to patients with primary or drug-induced bleeding disorders. Transfusions of red blood cells may be given if bleeding compromises heart or lung function or threatens to do so because of its pace or volume.
For trauma patients with massive bleeding, the experienced nurse or emergency care provider may apply pneumatic splints or antishock garments during patient transportation to the hospital. These devices may prevent hemorrhagic shock.
Standard precautions should be used for all procedures involving contact with blood or wounds.
Common Sites of Bleeding
|Lower GI tract||Hematochezia; melena|
|Upper GI tract||Hematemesis|
|Lungs/bronchi (coughed up)||Hemoptysis|
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