Bleeding: why does it occur and what types do we know? + First aid

Bleeding as a state of blood loss from the body, organs and structures of the body accompanies a number of conditions that can include injuries and diseases. It is a common phenomenon in our environment and we encounter it since childhood. But it is not always just a harmless process. It can indicate something serious.

Blood is characteristically coloured. When skin, tissues, mucous membranes or blood vessels are disturbed, bleeding occurs. This is a symptom not only of injury but also of many diseases.

You are often interested in:
What types/types of bleeding do we know?
How to stop bleeding and what to do in first aid?
When is it necessary to seek professional help?
Information is given in the article.

Bleeding can be external or internal.

External bleeding is visible and occurs when the structure of blood vessels or veins is disrupted. Blood flows out of the body. It is most often the result of wounds (lacerations, cuts, cuts, stabbings, gunshot wounds).

Internal bleeding is dangerous in that it is not externally visible. Blood enters the body from veins, vessels or arteries into the body cavities, hollow organs and the environment between them. It is the result of blunt trauma, but also of trauma penetrating the body.

Bleeding can also be a consequence of various diseases.

The type of bleeding also determines whether it is traumatic or non-traumatic bleeding.
This information is significant and important in the search for the source.

Lower bleeding intensity

Bleeding from small capillaries and veins is the least dangerous. These are the thinnest and most delicate blood vessels in the body. Bleeding is usually only mild and not serious. It occurs with abrasions and minor superficial injuries.

Bleeding from small veins is also not serious. The blood is usually darker in colour and flows freely. However, the orientation of bleeding by colour is not always indicative. Several factors influence the colour of the blood.

Higher bleeding intensity

The worst bleeding is from arteries and tangles of larger veins. Arteries are thick blood vessels, blood circulates in them under higher pressure. It is usually lighter in colour (due to higher saturation, saturation of haemoglobin with oxygen). Blood flows out intensely, it may even spurt.

When bleeding from larger veins and their tangles, the intensity of bleeding is also higher. The blood in the veins does not pulse and the pressure is lower, but this does not prevent the higher intensity. There is no splashing. The blood may be darker (due to the lower oxygen saturation of the blood).

Colour and shade of blood

Bleeding is also professionally called hemorrhage.

As already written, blood can be of different shades and colours. Determining whether it is bleeding from an artery or a vein may not be clear-cut on the basis of shade.

Arterial or venous bleeding may not be easy to distinguish.

However, it depends on several factors. These include:

• the association with respiratory and circulatory impairment
• when bleeding into and from the upper parts of the digestive tract, it is darker to black, which is due to its staining (technically melena)
• black is present in the stool 12-72 hours after the start of bleeding
• bleeding from the lower parts of the colon or rectum is red (enterorrhagia and is paler, brighter)
• when returning blood from the stomach, its colour is rusty brown
• when bleeding from larger vessels it is homogeneous, uniform (subsequently clots form)
• foamy when bleeding into the lungs; foamy blood is also present in pulmonary oedema
  • in the case of blood from the respiratory tract or lungs, the blood may be pale red or pink and foamy, also dark and with coagulae (blood clots) present
• in dehydration, the blood itself is thick and dark

External haemorrhage is visible immediately or within a short period of time after soaking through the clothing. This recognition element is absent in internal haemorrhage. Often its first manifestation is shock.

More in the article Shock: What is the medical term shock, what are its causes, types and stages?

Bleeding in injuries and diseases

In some diseases, such as inflammatory diseases of the sinuses or the upper respiratory tract, bleeding from the mouth or nosebleeds also occur. With bleeding, a tumor can also be thought of.

Bleeding from natural orifices such as the mouth, nose, vagina, rectum, urethra.

External bleeding is also dangerous for people with a bleeding disorder, or with impaired platelet function to heal a wound. It is therefore, for example, haemophilia. Haemophilia is a bleeding disorder that is also manifested by increased bleeding.

Traumatic bleeding

Occurs from a variety of traumatic causes. It can be minor but also risky and health and life threatening.

Traumatic (accident) bleeding and types of wounds:

• simple - abrasions such as various superficial scratches
• complicated - when deep structures are affected, for example blunt abdominal trauma, head and brain injuries, etc.
• penetrating - penetrating the body, its structures and cavities
• haematomas, i.e. bruises from blows which do not break the skin but blood accumulates under the skin
• wounds by mechanism
  • lacerations (vulnus lacerum) - when the skin is pulled and broken at the same time
  • incisional (vulnus scissum)
  • puncture (vulnus punctum)
  • incisional (vulnus sectum)
  • gunshot (vulnus sclopetarium)
  • bite (vulnus morsum)
  • contusions (vulnus contusum), due to crushing mechanism
  • for example, a minor prick with a needle, a knife, a blow on a table corner, etc.
• subsequently classified according to whether the wounds are clean, mechanically soiled, aseptic (biologically clean), septic (infected) or poisoned, for example by poisons

How to stop bleeding and proceed with first aid?

1. Apply pressure to the bleeding site and apply pressure
   • a sterile cloth is ideal
   • of course, if you don't have one handy, another clean cloth - dry
   • if you don't have any cloth, you can use your hands - ideally with a glove, a barrier device
     • but beware - risk of infection/infection in a stranger or known person with a blood borne disease (HIV, Hepatitis C virus, etc.)
   • pressure is not applied to the wounded eyes, no direct pressure is applied to the foreign object in the wound, treat around it
2. remove clothing or surface debris from around the wound
3. if there is a foreign object directly in the wound, this is not removed, bleeding could increase
4. keep the wound closed until treatment
5. if possible, a bandage should be used and the wound dressed
6. if the covering leaks, do not take it off but add another/new layer
7. the bleeding person should be at rest so as not to increase the work of the heart, which could also increase bleeding
8. place the casualty in a supine position to avoid fainting
9. the upper limb should be held above the level of the heart, with the leg raised higher off the mat
10. immobilise the injured part of the body, for example the upper or lower limb with a splint (even improvised)
11. WARNING, once the bleeding has stopped, do not remove the covering until professional treatment
12. it is advisable to cool the wound through the dressing (cold wrap - dry)
13. cover the person and prevent heat loss
14. apply the tourniquet only as a last resort (for a maximum of 10 minutes, then release if the bleeding has stopped and monitor the condition) - it is important to note the location of the tourniquet and the time it was applied
15. in case of serious injury, call the emergency services (fall from a great height, unconsciousness, other serious mechanisms)

+ The purpose of first aid for a bleeding wound is to stop the bleeding - not to clean and sterilize the wound.
Use protective equipment if possible...

Blood and the digestive tract

Blood may be present in some diseases of the digestive tract. In ulcer disease, in inflammation, diverticulitis. Also in cancer. Blood is present in vomit, stool. Massive vomiting of blood may occur.

Also massive bleeding from the rectum.

In the rectal area, it occurs, for example, in hemorrhoids. There is a rupture of painful nodes where blood has accumulated. The clotted blood, which could not leave the veins in the rectal area, has accumulated there. With increased pressure on these vessels, the node simply bursts.

The hidden form of bleeding is common in a variety of minor and serious diseases. Therefore, the presence of a hidden (professionally called occult) bleeding is investigated.

Even in the case of Crohn's disease or ulcerative colitis, these conditions occur.

People with celiac disease also have excessive bleeding because they also have bleeding disorders. These also occur in liver disease. Bleeding can occur in other parts of the body.

In women, not only during menstruation

Abnormal menstrual bleeding can occur in women. A more serious form is bleeding during ectopic pregnancy or miscarriage. Inflammatory diseases of the female reproductive system can also manifest themselves in this way.

Bleeding also accompanies the rupture of a cyst.

Pregnant women are afraid of bleeding, which is natural, but bleeding during pregnancy does not always mean a miscarriage. A gynaecological examination is necessary. Bleeding is a frequent sign of the beginning of labour, so it is not possible to rely solely on the outflow of amniotic fluid. Even in this case, an examination is advisable.

Intrapartum haemorrhage

In hemorrhagic stroke, bleeding into the brain is present. In addition, it is usually a consequence of head trauma. This condition is dangerous mainly because of the oppression of the brain in the skull. The blood has no way to drain and increases the intracranial pressure.

Bleeding after medication

Caution is advisable with acetylsalicylic acid derivatives or non-steroidal antirheumatic drugs. Stomach bleeding can be triggered after just one tablet. People with stomach problems should beware of this.

Another group are drugs whose main role is just to prevent blood clotting.

They are used in various cardiovascular diseases. With the wrong setting of these drugs or with an overdose, bleeding occurs.

In other inflammations or autoimmune diseases, blood vessels burst. Subsequently, bleeding into the surrounding space and tissue occurs. Bleeding conditions after injuries or illness are life-threatening. Professional treatment should be sought immediately.

Read also the article: nosebleeds. What are the most common causes and how to stop it?

When is professional help needed?

You ask:

When should professional treatment/examination be considered?

1. In shock, unconsciousness or impaired consciousness, disorientation, if the person does not remember the circumstances
2. if the person has fever and associated symptoms, pallor, weakness, dizziness, collapse
3. if the bleeding cannot be stopped by pressure
4. if the wound requires a tourniquet
5. in the case of a serious mechanism of injury and in the case of serious injuries
6. internal bleeding
7. if the wound needs to be treated with sutures, stitches, if it is larger in extent, length, depth
8. if there are foreign objects in the wound
9. infected wounds, including bite wounds, wounds with oozing pus and non-healing wounds
10. greater blood loss, especially if the person has associated cardiovascular diseases, blood disorders, anaemia, clotting disorders or is taking anti-clotting drugs
11. when more serious problems are associated