Internal bleeding

Sometimes blood leaks inside the body.

You cannot see it on your skin. This can be very serious. It can happen from a hard hit or an injury. It can also happen from being sick.

When you lose blood, you might feel very weak. You might feel dizzy or thirsty. Your skin might feel cold.

Your body tries to help you. Your heart may beat much faster. This helps move blood to your organs.

Doctors must help right away. They can give you fluids or more blood. This helps you get better fast.

Internal bleeding is when blood leaks from a vessel inside the body.

You usually cannot see it on the skin. This can be a medical emergency. It happens when the closed loop of blood vessels breaks.

There are many causes for this. Trauma can cause it. This means a direct injury. A person might have a stab wound. They might also have a blunt injury. This can happen in a fast car crash. Other causes include sickness or certain medicines. High blood pressure can also make a vessel burst.

Your body tries to fix the problem. Your heart may beat faster. This is called tachycardia. This helps move blood to your organs. Your blood pressure might also drop. This is called hypotension. If you lose too much blood, you may enter shock. This is called hemorrhagic shock.

Doctors must act fast to help. They may give fluids through a tube. They might also give a blood transfusion. This replaces the lost blood. They must also stop the bleeding. They may use special tools like a tourniquet.

This helps stop blood from leaving the vessels.

Internal bleeding is a serious medical emergency. It happens when blood leaks from a vessel inside the body. This blood collects where it should not be. Most of the time, you cannot see this bleeding from the outside. The severity depends on how fast the blood is leaving. It also depends on where the bleeding is happening. Bleeding in the head or torso is very dangerous. Severe bleeding in the chest, abdomen, or pelvis can lead to death. This happens if medical professionals do not act quickly.

Our bodies use a closed loop system to move blood. Blood travels through vessels to reach all major organs. If a vessel breaks, the loop is disrupted. Your body tries to fix this through the autonomic nervous system. First, the muscles around your vessels contract to help. This can keep your blood pressure normal at first. Then, your heart pumps faster to move blood to vital organs. This fast heart rate is called tachycardia. If blood pressure drops too low, it is called hypotension. Together, these signs can mean a person is in hemorrhagic shock.

Many different things can cause this type of bleeding. Trauma is a very common cause of death. There are two main types of trauma. Penetrating trauma happens from a stab wound or a ballistic injury. Blunt trauma can happen during a high speed car accident. There are also non-traumatic causes. These include sicknesses like cancer or Vitamin K deficiency. High blood pressure can cause a vessel to rupture. Some medicines, like anticoagulants, can also increase the risk. Even rare viruses like Ebola can cause it.

Doctors use many ways to find where the blood is going. They check vital signs like heart rate and breathing. They might use a tool called a doppler ultrasonography. For the abdomen, they may perform a FAST exam. If a person is stable, they might get a CT scan. Doctors also look for visible signs like bruising or a hematoma. A hematoma is a collection of blood. They may also check for blood in the urine or dark stools. Some people may feel lightheaded, thirsty, or very weak.

Treating internal bleeding is a very hard job. You cannot stop it with simple pressure like an external cut. Doctors must find the cause and stop the bleeding. They often use intravenous fluids to help blood pressure. For severe cases, they perform a blood transfusion. This replaces red cells, plasma, and platelets. They may use a device called a REBOA to slow bleeding. For injuries on arms or legs, they might use a tourniquet. In the groin or armpit, they may use special dressings.

Internal bleeding, also known as internal haemorrhage, occurs when blood escapes from a blood vessel and collects inside the body. Unlike a cut on the skin, this loss of blood is usually not visible from the outside. This condition is a serious medical emergency because it can be difficult to detect quickly. The severity of the situation depends on two main factors: the rate of the bleeding and its location. Bleeding in the head or torso is especially dangerous. Severe bleeding in the chest, abdomen, pelvis, or thighs can lead to hemorrhagic shock or death if medical professionals do not intervene immediately.

To understand why this is so dangerous, we must look at how the body moves blood. The body uses a closed loop system to circulate blood to all major organ systems. When a blood vessel is damaged, this closed loop is disrupted. The autonomic nervous system (ANS) attempts to compensate for this loss in two primary ways. First, the ANS causes the muscles surrounding the blood vessels to contract. This action can initially keep blood pressure within a normal range. Second, the heart begins to pump faster to deliver blood to vital organs more quickly. This rapid heart rate is known as tachycardia. If the blood pressure falls below the normal range, it is called hypotension. When a person experiences both tachycardia and hypotension, they may enter a state called hemorrhagic shock.

Medical professionals use the Advanced Trauma Life Support (ATLS) system to classify the severity of hemorrhagic shock. This system is based on estimated blood loss and changes in vital signs. Class I hemorrhage involves losing less than 15% of blood volume, with heart rates remaining mostly normal. Class II involves a loss of 15% to 30%, often resulting in cool, clammy skin and a heart rate between 100 and 120 beats per minute. Class III is more severe, with 30% to 40% blood loss, causing a drop in systolic blood pressure and altered mental status. Finally, Class IV hemorrhage occurs when more than 40% of blood volume is lost. At this stage, the patient may experience a significantly decreased or absent urine output and a very high heart rate. It is important to note that a patient can lose more than 30% of their blood volume before their vital signs or consciousness change.

There are two large categories of causes for internal bleeding: traumatic and non-traumatic. Trauma is a leading cause of death, accounting for 1.5 million of the 1.9 million annual deaths caused by bleeding. Penetrating trauma, such as a stab wound or a ballistic injury, is the most common cause of vascular injury. Blunt trauma is another cause, which can occur during high-speed deceleration in an automobile accident. Non-traumatic causes include pathological conditions or diseases. For example, high blood pressure can cause a blood vessel to rupture. Other causes include aneurysms, peptic ulcers, or an ectopic pregnancy. Diseases like cancer, hematologic disease, or Vitamin K deficiency can also lead to bleeding. Even rare viral hemorrhagic fevers, such as Ebola, Dengue, or Marburg, are linked to this condition.

Identifying the source of internal bleeding requires careful observation and testing. Doctors look for visible signs such as bruising, known as ecchymosis, or a blood collection called a hematoma. They may also check for blood in the urine, dark black stools, or bright red stools. Other symptoms include lightheadedness, fatigue, confusion, and thirst. To find the bleeding, medical teams assess circulation through palpation of pulses or doppler ultrasonography. For suspected bleeding in the abdomen, a FAST exam may be performed. If a patient's vital signs are stable, they may undergo a CT scan. However, if the patient is unstable, they may need immediate surgery instead of diagnostic imaging.

Treatment focuses on two goals: replacing lost fluids and achieving hemostasis, which means stopping the bleeding. Because most internal bleeding cannot be stopped with direct pressure, medical intervention is vital. For patients with low blood pressure, doctors use intravenous fluids or a blood transfusion. If a patient requires more than 4 units of blood in one hour, clinicians initiate a massive transfusion protocol. This protocol replaces red blood cells, plasma, and platelets in specific ratios. In the abdomen or pelvis, doctors may use a REBOA device to slow the bleeding. For bleeding in the arms or legs, a tourniquet may be used. At "junctional sites" like the groin or armpit, doctors may use an Abdominal Aortic and Junctional Tourniquet (AAJT) or special hemostatic dressings.

Internal bleeding is deeply connected to how we understand trauma care and emergency medicine. The speed of treatment is critical for survival. For example, a patient with acute internal bleeding in the thorax after trauma should be diagnosed and stabilized in the Emergency Department in less than 10 minutes. The longer it takes to achieve hemostasis for causes like a pelvic fracture or a ruptured abdominal aortic aneurysm, the higher the death rate becomes. This highlights the importance of rapid response systems in hospitals and the ongoing work of campaigns like "Stop The Bleed" to improve care for all types of injuries.