Internal bleeding
Internal bleeding (also called internal haemorrhage) is a loss of blood from a blood vessel that collects inside the body, and is not usually visible from the outside.[1] It can be a serious medical emergency but the extent of severity depends on bleeding rate and location of the bleeding (e.g. head, torso, extremities). Severe internal bleeding into the chest, abdomen, pelvis, or thighs can cause hemorrhagic shock or death if proper medical treatment is not received quickly.[2] Internal bleeding is a medical emergency and should be treated immediately by medical professionals.[2]
This article is about the medical condition. For the death metal band, see Internal Bleeding.Internal bleeding
Internal hemorrhage
Signs and symptoms of internal bleeding may vary based on location, presence of injury or trauma, and severity of bleeding. Common symptoms of blood loss may include:
Visible signs of internal bleeding include:
Of note, it is possible to have internal bleeding without any of the above symptoms, and pain may or may not be present. [3]
A patient may lose more than 30% of their blood volume before there are changes in their vital signs or level of consciousness.[4] This is called hemorrhagic or hypovolemic shock, which is a type of shock that occurs when there is not enough blood to reach organs in the body.[5]
Diagnosis[edit]
Vital signs[edit]
Blood loss can be estimated based on heart rate, blood pressure, respiratory rate, and mental status.[11] Blood is circulated throughout the body and all major organ systems through a closed loop system. When there is damage to the blood vessel or the blood is thinner than the physiologic consistency, blood can exit the vessel which disrupts this close-looped system. The autonomic nervous system (ANS) responds in two large ways as an attempt to compensate for the opening in the system. These two actions are easily monitored by checking the heart rate and blood pressure. Blood pressure will initially decrease due to the loss of blood. This is where the ANS comes in and attempts to compensate by contracting the muscles that surround these vessels. As a result, a person who is bleeding internally may initially have a normal blood pressure. When the blood pressure falls below the normal range, this is called hypotension. The heart will start to pump faster causing the heart rate to increase, as an attempt to get blood delivered to vital organ systems faster. When the heart beats faster than the healthy and normal range, this is called tachycardia. If the bleeding is not controlled or stopped, a patient will experience tachycardia and hypotension, which altogether is a state of shock, called hemorrhagic shock.
Advanced trauma life support (ATLS) by the American College of Surgeons separates hemorrhagic shock into four categories.[12][4][13]