Ways to Manage Internal Bleeding Due to Cuts and Wounds

What is Bleeding?

Blood loss from the circulatory system is known as bleeding. Bleeding can be classified in two ways:

1. External bleeding - When bleeding occurs outside the body from an external source. For example-cuts and wounds. This kind of bleeding is visible.

2. Internal bleeding - When bleeding occurs inside the body from an internal source, such as the rupture of a blood vessel or injury to any organ. For example, gastrointestinal bleeding and bleeding from coughing. This type of bleeding could be quite serious as this is not visible.

What Are the Possible Causes of Bleeding?

Bleeding could be due to external sources such as injury, trauma, post-trauma accident, or bullet shot.

• In internal sources, it could be due to injury or rupture of any blood vessel.

• Bleeding through natural openings such as bleeding from the nose, vaginal bleeding, bleeding from stools, through vomiting.

What Are the Types of Bleeding?

Bleeding can be classified into three types:

1. Arterial bleeding - This type results from rupture or damage to the arteries. Arteries are the supplier of oxygenated (oxygen-rich blood) from the heart to different body organs and are absorbed by these organs. The oxygenated blood is purer and flows with more pressure. Bleeding from arteries is very rapid due to the high pressure of blood. Due to its purity and high oxygen content, the color of the blood appears bright red. Therefore any damage to these arteries could be a more severe condition. This should be handled with extra care.

2. Venous bleeding - This is a result of damage to the veins. Veins carry deoxygenated blood from the heart to the organs. They carry impure blood. The pressure of the blood is also less. Therefore bleeding is slow. The damage caused to them is less serious as compared to the arteries.

3. Capillary bleeding - Capillaries are small in size and remain intact to the skin. They are also present in our eyes and lungs. Bleeding from the capillaries is the least severe and stops easily.

How Is The Management of Bleeding Done?

• Bleeding can be managed depending on its type.

• The first thing to be done is to apply direct pressure to the bleeding surface if it is visible. This could be done with the help of gauze or a clean cloth.

• The affected area should be slightly elevated.

• Keep the patient from frequently moving.

• Do not scrape or touch the wound again and again to check.

• Quickly call for medical help.

In normal conditions, it will stop if a small cut or wound causes bleeding. This is because the body has clotting factors that help control the blood. If it does not stop immediately, hospitalize the patient. If a patient is taking blood thinners, it could result in excessive blood loss. For such patients, immediate medical assistance is required.

What Is Internal Bleeding?

Internal bleeding is a non-visible form of bleeding. It occurs inside the body from any blood vessel, and blood accumulates inside the body, unlike external bleeding, where blood flows out of the body. It could be a more serious condition, which could be due to trauma or postoperative complications. If this bleeding does not stop, it could be a critical condition. It shows a few symptoms, such as pain and dizziness.

What Are the Causes of Internal Bleeding?

• Trauma/injury: Usually, Internal bleeding is caused by trauma from any blunt object.

• Gastrointestinal bleeding: This is due to many reasons, such as peptic ulcer, gastritis, ulcerative colitis, and inflammation of the esophagus. Bleeding in stools can be seen in GI bleeding.

• Clotting factors: The body has its mechanism to stop the bleeding. If these clotting factors do not work correctly, organs continue to bleed.

• Medication: Some medicines act as blood thinners. They prevent the blood from forming a clot.

• Aneurysm: Aneurysm is the bulging of an artery due to the weakening artery wall. It can be caused due to high blood pressure.

• Bleeding disorder: Hemophilia is a bleeding disorder inherited by birth. It is a genetic condition that prevents blood from clotting. A small injury, too, can bleed profusely in this disorder.

• Ectopic pregnancy: When the fetus is placed outside the uterus, internal bleeding can be seen.

How Is the Diagnosis of Internal Bleeding Done?

It is quite difficult to diagnose internal bleeding. However, the diagnosis begins with the following:

• Examination and taking a thorough history of the patient.

• Blood and urine tests.

• CT (computed tomography) scan or MRI (magnetic resource imaging) - This is done to locate the site of bleeding or any other abnormality at any site in the body.

• Angiography - Once a bleeding site is located, angiography is done to check individual blood vessels.

• ECG(electrocardiogram) - Once the cause of bleeding is identified, an ECG is also suggested to check the proper functioning of the heart and blood flow to the heart.

What Is the Management of Internal Bleeding?

For minors who are bleeding, it is recommended that they rest and stay hydrated. Usually, clotting factors get activated, and the flow of blood stops.

In the event of severe bleeding:

• Firstly ABCs (airway, breathing, circulation) of the patient are monitored and maintained.

• Clotting factors such as fresh frozen plasma, vitamin K, blood, and platelets are administered to the patient.

• In some cases, surgical management is required.

• Antifibrinolytic factors are used in cases of uncontrolled bleeding, such as hemophilia.

Conclusion

Internal bleeding is a serious condition since the flow and site of the blood are not visible. As it is always said, "prevention is better than cure." We should take precautions when dealing with sharp objects, during pregnancy, or after surgery. The diagnosis of internal bleeding is also a challenging procedure. Its management depends on the underlying cause. The body produces various clotting factors in the usual cases; if not, as in hemophilia, they can be administered artificially to control bleeding.