Blood loss; Open injury bleeding
Bleeding is the loss of blood. Bleeding may be:
Bleeding may occur:
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 may 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.
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.
You may have symptoms such as:
Bleeding can also cause shock, which may include any of the following symptoms:
Symptoms of internal bleeding may include:
Blood coming from a natural opening in the body may also be a sign of internal bleeding. These symptoms include:
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.
DO NOT apply a tourniquet to control bleeding, except as a last resort. Doing so may cause more harm than good. A tourniquet should be used only in a life-threatening situation and should be applied by an experienced person
If continuous pressure has not stopped the bleeding and bleeding is extremely severe, a tourniquet may be used until medical help arrives or bleeding is controllable.
DO NOT peek at a wound to see if the bleeding is stopping. The less a wound is disturbed, the more likely it is that you will be able to control the bleeding.
DO NOT probe a wound or pull out any embedded object from a wound. This will usually cause more bleeding and harm.
DO NOT remove a dressing if it becomes soaked with blood. Instead, add a new one on top.
DO NOT try to clean a large wound. This can cause heavier bleeding.
DO NOT try to clean a wound after you get the bleeding under control. Get medical help.
Seek medical help if:
Use good judgment and keep knives and sharp objects away from small children.
Stay up-to-date on vaccinations, especially immunization for tetanus.
Blackwell T. Emergency medical services: overview and ground transport. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 190.
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: Elsevier Saunders; 2009:chap 39.
Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 59.BACK TO TOP
Review Date: 1/12/2015
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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