Internal Bleeding (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Internal bleeding facts
- What is internal bleeding?
- What causes internal bleeding?
- What are the signs and symptoms of internal bleeding?
- How is internal bleeding diagnosed?
- How is internal bleeding treated?
- What are the complications of internal bleeding?
How is internal bleeding treated?
The initial treatment plan of any patient with internal bleeding begins with assessing the patient's stability and making certain the ABCs are well maintained. This includes making certain the patient's:
- Airway is open,
- that the patient is Breathing, and
- there is adequate Circulation, meaning stable pulse rate and blood pressure.
The definitive treatment of internal bleeding depends upon where the bleeding located, the individual situation, and the stability of the patient. The basic goals include identifying and stopping the source of bleeding and repairing any damage that the bleeding may have caused.
In patients who take anti-coagulation medications and have significant bleeding, medication reversal of the anti-coagulation may need to occur.
What are the complications of internal bleeding?
Depending upon where it occurs, if not recognized, internal bleeding may cause organ failure, shock, and death. For example:
- If there is uncontrolled bleeding in the chest or abdomen, the body may lose enough circulating red blood cells to compromise oxygen delivery to cells in the body. Cells shift from aerobic metabolism using oxygen to anaerobic metabolism. This is only a temporary fix and if allowed to continue, the acid-base balance of the body is adversely affected. If enough cells stop working, the body's organs will also begin to fail. This situation is called shock. If the bleeding is not stopped and if fluid resuscitation and perhaps blood transfusion are not provided, the patient may die.
- Internal bleeding in the brain may cause minimal damage or it may lead to stroke-like symptoms, coma, and death. Symptoms depend upon the location of the bleeding, the amount of bleeding, and whether the bleeding causes increased pressure within the skull, further affecting brain function.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
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