Hemorrhage
Hemorrhage refers to the loss of blood from the circulatory system, which can range from minor to life-threatening levels. It can be classified into different categories based on the volume of blood lost, with symptoms varying accordingly. Common causes of hemorrhage include trauma, such as injuries from accidents or violence, as well as spontaneous blood vessel ruptures due to conditions like arteriovenous malformations. Certain medical disorders, including hemophilia, and the use of blood-thinning medications can also lead to increased risk of bleeding.
The symptoms of hemorrhage depend on the severity and speed of blood loss, with early stages often showing no symptoms, while more significant losses can cause rapid heartbeat, low blood pressure, and potentially shock or death. Treatment strategies are tailored to the cause and severity of the hemorrhage, ranging from first-aid measures like hand pressure or tourniquets for external wounds to surgical interventions for severe internal bleeding. Understanding the various contexts and factors related to hemorrhage can help in prevention and effective management of this serious medical issue.
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Subject Terms
Hemorrhage
Anatomy or system affected: All
Definition: Loss of blood from an area of the body
Causes and Symptoms
The term “hemorrhage” generally implies a massive loss of blood from the body, but many types involve only a small amount of blood loss. Hemorrhage can connote a slowly evolving process or a rapid, sudden loss of blood. Its causes include trauma, spontaneous blood vessel rupture, bleeding disorder, and medications.
In traumatic hemorrhage, the body experiences some external force that causes a blood vessel or organ to break open. The bleeding may be internal, as in splenic rupture or brain bleed (hematoma), or external, as in an open laceration. Blood vessels may rupture spontaneously if they are malformed or have suffered previous injury as in certain types of strokes caused by arteriovenous malformations and aneurysms.
Other causes of hemorrhage are due to disorders causing easy bleeding such as hemophilia or platelet dysfunction. Hemorrhage can also be incited by the use of blood-thinning medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen or heavier anticoagulants like heparin and warfarin. Heavy or long-term use of substances such as alcohol or tobacco may induce hemorrhages, as well as injuries such as puncture wounds, gunshots, as well as virus such as hemorrhagic fever that damages blood vessels.
The symptoms of hemorrhage depend on how rapidly the bleeding evolves and how much blood is lost. This blood loss is separated into four classes: Class I includes hemorrhage of up to 15 percent of the total blood volume and is asymptomatic. Up to this point, a healthy adult may not exhibit physical symptoms or changes in their vital signs. Serious Class II is 15 to 30 percent hemorrhage and can result in rapid heartbeat and pallor. Class III is 30 to 40 percent hemorrhage, and its symptoms are rapid heartbeat, low blood pressure, altered mental status, and shock. Class IV is more than 40 percent hemorrhage and can result in death.
External bleeding can oftentimes be contained and stopped using first-aid measures. These include the application of hand pressure to the wound. In more serious cases, a tourniquet can be used, and can be fashioned from clothing such as a belt.
Treatment and Therapy
In the 2020s, for Americans, age 46 and younger, a hemorrhage caused by trauma is a leading cause of death. These injuries and subsequent hemorrhages stem from factors as diverse as lifestyle and socioeconomic environment. For example, they can range from traffic accidents to violence. Treatment for hemorrhage depends on its cause and the class of blood loss under which it falls. In traumatic hemorrhage, the bleeding may be stopped with external pressure but also may require sutures or surgery. In spontaneous blood vessel rupture, treatment involves medication or surgery. Bleeding disorders are often treated with medication, and patients are advised to avoid anything that can precipitate trauma, leading to a bleed. If the cause is medication, then a physician may instruct the patient to stop the medication or take precautions, as with bleeding disorders.
Class I blood loss is generally not treated. External bleeding can oftentimes be contained using first-aid measures. These include the application of hand pressure to the wound. In more serious cases, a tourniquet can be used, and can be fashioned from clothing such as a belt. Class II is treated with fluids such as saline solution or Ringer’s lactate. Class III is treated with a combination of fluids and blood transfusion. Class IV is an emergency and requires rapid replacement of blood volume with both blood transfusions and other solutions.
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