Bleeding

Bleeding, or haemorrhage, is the loss of blood from the vascular system. It can occur externally, through wounds or body openings, or internally, where blood collects within the body. Bleeding can be acute, arising suddenly, or chronic, persisting over time.

Bleeding is commonly classified by the type of vessel involved. Arterial bleeding is typically bright red and may spurts with every heartbeat. Venous bleeding tends to be darker and flows steadily. Capillary bleeding is usually slower and oozing. Causes include injury to vessels from trauma, surgical procedures, or medical interventions; diseases such as ulcers, aneurysms, or cancer; and disorders of hemostasis, including platelet or coagulation factor deficiencies, or the effects of anticoagulant medications.

Normal hemostasis involves vasoconstriction, platelet plug formation, and the coagulation cascade that leads to clot formation, followed by clot resolution as healing progresses. Disruptions in these processes can cause either excessive bleeding or inadequate hemostasis.

Diagnosis relies on clinical assessment and, when indicated, laboratory tests and imaging. Laboratory evaluations may include a complete blood count and coagulation studies such as PT/INR and aPTT to assess blood cell counts and clotting function. Imaging, including ultrasound or CT, may be used to evaluate internal bleeding.

Management focuses on stopping the bleed and treating the underlying cause. Minor external bleeding is often addressed with wound care and pressure. More significant bleeding may require fluid resuscitation, blood transfusion, reversal of anticoagulants, and procedural interventions such as endoscopy, surgery, or radiological treatments. In any case of severe or internal bleeding, seek emergency medical care.