What is a Hemorrhage?
Hemorrhage describes bleeding from blood vessels that are damaged and can occur internally or externally. The loss of blood is usually profuse and rapid.
This symptom can be minor or potentially life threatening. Whatever the cause if bleeding cannot be stopped then you should seek immediate medical care.
Blood plays an important part in the function of our body. It transports vital oxygen, hormones, nutrients and gets rid of waste products. It also helps regulate body temperature and assists in the healing of trauma by clotting to prevent bleeding.
External bleeding describes a hemorrhage where blood leaves the body through a natural opening or a break in the skin. Internal bleeding contains a hemorrhage within the body and sometimes cannot be seen. We will detail some of the causes of both.
These injuries to the body can be external or internal.
Externally these include, abrasions which scrape the outside layer of the skin and lacerations which tear the skin. Internally we have contusions or bruises which are under the skin and concussions which damage underlying areas of the head with no major external wound.
Wounds that penetrate the skin can cause profuse bleeding. These include stab wounds or cuts from sharp objects like knives and gunshot wounds. They could also be the result of a fall or accident.
There are many other types of wounds that can result in hemorrhage. Exposure to extreme heat, cold, chemicals or electrics might mean internal or external hemorrhage. Being bitten by animals or even other humans can break the skin and cause a hemorrhage. (1)
Von Willebrand Disease
Von Willebrand disease is a disorder that prevents blood from clotting, consequently any injury can hemorrhage.
People with this condition will bruise easily and get frequent nose bleeds that are hard to stop. Any external wound that breaks the skin will bleed profusely and this could include surgical procedures.
Internal bleeding might result in blood in the stools or urine. Gums can bleed for longer than they should after removal of teeth.
Women with this disorder might experience menstrual bleeding that is prolonged and heavy. (2)
This hereditary bleeding disorder is another where the blood is not able to clot properly. As a result any internal or external injury will hemorrhage and be difficult to stop.
Minor injuries like biting the inside of the cheek or a papercut on a finger will bleed more than expected. Nosebleeds can be spontaneous and hard to stem.
Internal bleeding will manifest as blood in urine or stools and large bruises can appear from bleeding in muscles. Tightness, pain and swelling in the joints is also a sign of internal bleeding, which is very common in this condition.
A serious complication of hemophilia is bleeding on the brain, even after a small bang to the head. (3)
Any bleeding within the digestive system is a symptom of another condition or disease. It will be noticeable by bright red or dark blood in stools or red blood in vomit.
There are many conditions and diseases that can cause gastrointestinal bleeding, these include: tumors, polyps, ulcers, colitis, diverticulitis, hemorrhoids, gastritis and esophagitis. (4)
Disseminated Intravascular Coagulation (DIC)
This condition forms blood clots in the small blood vessels in the body. The clots then interfere with blood flow through these blood vessels. The knock on effect is a reduced amount of clotting agents in the blood meaning that hemorrhage can occur.
Things like, infections in the bloodstream (sepsis), cancer, surgery or trauma and complications in pregnancy and childbirth cause this condition. It is also attributable to burns, frostbite or poisonous snake bites. (5)
Bleeding in the brain is a serious condition that requires urgent medical care. High blood pressure or an aneurysm (burst artery) are causes of brain bleeds.
There are two types of brain hemorrhage: a stroke is when an artery leaks, and subarachnoid, when blood vessels on the surface of the brain leak. The resultant swelling and pressure of either can damage the brain. (6)
Henoch-Schönlein Purpura (HSP)
Inflammation and bleeding from small blood vessels are signs of this immune system disease. It is most common in between the ages of two and six but can occur in adults as well.
It happens due to an abnormal immune system response whereby the body’s immune system turns on itself.
The main symptom is a rash which looks like small raised bruises. Factors causing this disease are not fully known. However, it has been linked with upper respiratory tract infections in 30 to 50 percent of cases.
Other associated causes are infections including chicken pox, measles, HIV and hepatitis. Medications, foods, insect bites, trauma and exposure to cold are other contributing factors to this immune response. (7)
Viral Hemorrhagic Fevers
This is a group of illnesses attributed to several different families of virus and includes marburg and ebola. They attack multiple systems in the body and one of the symptoms is hemorrhage. (8,9)
Dengue fever is transmitted by a bite from an infected mosquito and affects about 100 million people worldwide annually. It rarely occurs in the US but it is prevalent in tourist destinations including Puerto Rico, Latin America, the Pacific islands and Southeast Asia.
One of the symptoms of this fever is bleeding in the gums or nose. Bruising easily and small red, brown or purple pinpoint spots on the skin (petechiae) might also occur. (10,11)
This bleeding disorder interferes with blood clotting due to a low amount of platelets in the blood. When you have a scenario of insufficient platelets, clotting will not occur efficiently. This means internal or external bleeding can happen.
Symptoms present as purple bruises (purpura) on the skin or in the mouth caused by bleeding from small blood vessels. Pinpoint sized red or purple dots (petechiae) which look like a rash might also appear on the skin. (12)
Certain medications can increase the risk of hemorrhage, in particular drugs that are prescribed to thin the blood. These anticoagulants help prevent clotting and increase the chance of profuse bleeding. (13)
In certain circumstances hemorrhage will be obvious with bleeding from breakage in the skin or the appearance of bruising.
However, when hemorrhage is internal it can be harder to detect, symptoms include blood in urine or stools or dark tar like stools. With some conditions small red or purple spots might appear under the skin or in the mouth.
Women may experience prolonged heavy menstrual bleeding.
Often hemorrhage will be apparent and diagnosis and treatment will be straightforward, for example stitching or dressing a wound.
If you have bleeding that will not stop or raises concern, you should see a doctor. Likewise blood in the urine, stools or unexplained bruising or petechiae need to be looked at.
Your doctor will take a full medical history and give you a physical examination. If the cause of hemorrhage is not apparent then further tests might be needed.
These could include blood tests and imaging tests, particularly if the bleeding is internal.
Excessive bleeding can be dangerous so it’s important to seek emergency medical care if you are bleeding profusely.
What is a hemorrhage? Hemorrhage describes bleeding from blood vessels that are damaged and can occur internally or externally. The loss of blood is usually profuse and rapid.
What causes hemorrhage? There are many causes of hemorrhage, from the obvious to the obscure. A wound or injury will be easily visible, as will bruising or petechiae. Other causes include immune system issues, infection and diseases.
How do doctors test for hemorrhage? If the cause of hemorrhage is not apparent then a doctor may request blood or imaging tests to locate the source.
When should you go to the doctors with hemorrhage? Small cuts, scrapes and bruising will generally heal on their own accord. Any unexplained bleeding needs medical attention. If bleeding is profuse and cannot be stopped then you should seek emergency medical care.
Can you prevent hemorrhage? Accidents happen and it’s unlikely you can prevent them. Some conditions that cause hemorrhage are hereditary and passed on through genes.
What can relieve hemorrhage? Minor injuries can be treated by cleaning them and applying a dressing. Over the counter analgesics can help manage any associated pain.
Is hemorrhage life threatening? Dependant on the cause, yes, it can be. Approximately 31 percent of people involved in trauma die of blood loss. (14)
What can treat hemorrhage? Internal bleeding as a result of infection, immune inadequacies or disease require treatment from a medical professional. However when accidents happen you can help by using first aid until medical help is obtained. Pressure can be applied with a clean dressing to stop bleeding. Be careful if there are foreign objects in the wound not to apply pressure to them. Try and keep the wound clean and reassure the injured person. If possible, raise the injury above the heart to slow down bleeding. (15)
Hemorrhage describes bleeding from blood vessels which are damaged and can occur internally or externally. The loss of blood is usually profuse and rapid and may need immediate medical care.
External hemorrhage is usually obvious and provided it is dealt with swiftly to prevent blood loss, can be treated successfully.
Internal bleeding is indicated by blood appearing from body openings like the nose, mouth, ears, anus or vagina. This should be investigated by a medical professional to obtain diagnosis and treatment.