Hemorrhage involves:
Vascular Injury: Damage to blood vessels resulting in bleeding. This can be due to trauma, surgical procedures, or medical conditions that weaken the blood vessel walls.
Disrupted Hemostasis: Impaired clotting mechanisms can lead to uncontrolled bleeding. This may be due to coagulation disorders, anticoagulant medications, or platelet dysfunction.
Blood Loss: Significant or rapid blood loss can lead to hypovolemia (decreased blood volume) and reduced oxygen delivery to tissues.
Complications: Severe hemorrhage can result in shock, multi-organ failure, and death if not promptly managed.
Clinical Evaluation
Symptoms: Assessment of symptoms such as sudden onset of bleeding, weakness, dizziness, fainting, and signs of hypovolemic shock (rapid heartbeat, low blood pressure).
Physical Examination: Examination findings may include visible signs of bleeding (external or internal), pallor, cold and clammy skin, and altered mental status.
Diagnostic Tests: Blood tests to assess hemoglobin levels, hematocrit, coagulation profile (PT, aPTT), and imaging studies (such as CT scan, ultrasound) to identify the source and extent of bleeding.
Visible bleeding from a wound or orifice.
Bruising or hematoma formation.
Signs of hypovolemic shock, including rapid heartbeat, low blood pressure, and cold, clammy skin.
Weakness, dizziness, or fainting.
Pallor and sweating.
Abdominal pain or swelling (in cases of internal hemorrhage).
Management aims to control bleeding, restore blood volume, and treat the underlying cause:
Immediate Hemostasis: Applying pressure to external bleeding sites, surgical intervention to repair damaged blood vessels, or use of hemostatic agents.
Fluid Resuscitation: Administration of intravenous fluids or blood transfusions to restore blood volume and improve tissue perfusion.
Medications: Use of medications to promote clotting (such as tranexamic acid) or reverse anticoagulation effects.
Monitoring and Supportive Care: Close monitoring of vital signs, oxygen therapy, and supportive measures to stabilize the patient.
Addressing Underlying Cause: Treating the root cause of hemorrhage, whether it be surgical repair, discontinuation of anticoagulants, or management of a medical condition causing bleeding.