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Haemorrhage: Causes, Symptoms, & Treatment

Haemorrhage occurs when a damaged blood vessel starts to bleed, causing various conditions that affect the body internally and externally. The types of haemorrhage range anywhere from minor to major injuries to bleeding in the brain. Internal bleeding occurs when the blood leaks through a damaged organ or vessel, whereas external bleeding occurs when the bleeding is due to a cut or injury on the skin. 

What are the different types of haemorrage?

Haemorrage can be categorized into four categories, based on the severity of bleeding – 

Category 1 – This category comprises of bleeding that’s less than 15% of the total blood lost. Usually, such cases of bleeding do not require medical interventions and examples of this category include nosebleeds, or small cuts to the skin.

Category 2 – This category refers to any incidents of bleeding that causes bleeding that leads to 15-30% of blood loss. This type of bleeding can be caused by internal medical conditions like stroke, or due to external physical trauma. 

Category 3 – This category refers to 30-40% blood loss. To treat this category of hemorrhage, patients may require blood transfusions with donated blood

Category 4 – This category refers to the severe of bleeding that causes more than 40% blood loss. Patients suffering from this intensity of bleeding will require immediate medical condition, and if left untreated, this type of bleeding leads to fatalities. 

What are the symptoms of haemorrage?

Haemorrage can occur in different parts of the body, but there are a few signs and symptoms that are common for all types of haemorrage. These include the following:

  • Unstoppable bleeding, even after applying pressure
  • Swelling and the secretion of yellow or brown pus
  • A state of shock or experiencing high fever

If a patient suffers from these symptoms, they should be administered emergency medical help and taken to a hospital as fast as possible, as excessive blood loss can lead to fatalities.

What causes a haemorrhage?  

There are a variety of conditions that causes bleeding, including the following: 

Traumatic bleeding  

Any external or internal injury can cause traumatic bleeding depending on its severity. Some common types of traumatic injuries are:  

  • Scrapes or abrasions that penetrate deep into the skin  
  • Cuts or lacerations  
  • Wounds from needles, nails or knives  
  • A gunshot wound  
  • Crushing injury  

Medical conditions  

Certain medical conditions can also cause bleeding or Haemorrhage but are less common when compared with traumatic bleeding. The conditions that cause this type of bleeding includes: 

  • Leukemia  
  • Haemophilia  and other blood clotting disorders 
  • Liver disease  
  • Vitamin K deficiency  
  • Brain trauma  
  • Thrombocytopenia or low blood platelet count  
  • Menorrhagia – prolonged menstrual bleeding  
  • Acute bronchitis  
  • Cancers 
  • Complications from medical procedures, such as childbirth or surgery
  • Damage to an internal organ
  • Viruses that attack the blood vessels like viral hemorrhagic fever or dengue hemorrhagic fever 


The chances of bleeding or Hemorrhage may increase due to the intake of certain medicines and treatments. The doctor will warn the patients regarding this during the prescription of the therapy and advise on how to handle the situation when bleeding occurs. Medications that can lead to bleeding includes: 

Depending on the location or cause, a haemorrhage may be called:

  • Hematoma (a predominantly bad bruise) or bruise.  Both include bleeding just under the skin
  • Hemothorax, blood collecting between chest wall and the lungs
  • Nosebleed 
  • Intracranial hemorrhage, bleeding in the brain
  • Postpartum hemorrhage, more bleeding than normal after childbirth
  • Petechiae: tiny spots on skin that may be red, brown or purple 
  • Subarachnoid hemorrhage (a kind of stroke caused by head trauma)
  • Subdural hematoma: blood leaking into the dura mater (membrane between brain and skull) 
  • Subconjunctival hemorrhage, broken blood vessels in the eye.

Is a haemorrhage sign of an emergency?  

Internal or external bleeding, bleeding disorders or blood thinners leading to bleeding are all emergencies that require immediate attention. 

The following are a few situations that should be taken care of on an immediate basis: 

  • The patient has severe fever along with bleeding or has gone into shock  
  • Uncontrolled bleeding despite applying pressure  
  • Wound requiring a tourniquet  
  • Bleeding caused by serious injury  
  • The wound requires stitches to stop bleeding  
  • Foreign objects  are stuck in the wound  
  • The wound is infected – with swelling or leaking of pus  
  • Injury due to a bite from an animal or human  

What are the treatment options for haemorrhage?  

Before emergency services arrive, passers-by must try to save the life of the person experiencing excessive bleeding. Below are some of the methods or treatment options that can be used to control bleeding:  

First AID for Traumatic Bleeding  

Call the hospital if the person is exhibiting any emergency indicators described above or requires urgent assistance to stop the bleeding. To keep the heart rate and blood pressure under control, the individual who is bleeding should remain calm as the bleeding will be accelerated if the heart rate or blood pressure is excessively high.   

To lessen the danger of fainting, lay the individual down as soon as possible and elevate the bleeding location. Clear the wound of any loose debris or foreign objects. Removing objects such as knives, arrows and weapons can end up causing more damage and will lead to increased bleeding. In this circumstance, use bandages and pads to retain the object in place and absorb the bleeding till the hospital is reached.  

To put pressure on the wound, one can use the following to maintain medium pressure till the bleeding slows down and stops:  

  • Clean cloth  
  • Bandages  
  • Clean hands 

Things Not To Do in Haemorrhage

  • When the bleeding stops, do not remove the cloth from its place or use adhesive tape to hold it in place.  
  • Do not open the wound regularly to see if the bleeding has stopped, as this will cause disturbance to the wound and may lead to continued bleeding. 
  • Do not apply pressure when the person has an injury in the eye.  

How to use a tourniquet for bleeding?  

Tourniquets should only be used as a last resort by an experienced person. These steps can be followed to apply a tourniquet:  

  • Identify the best location for the tourniquet. It should be applied to a limb between the heart and the bleeding.  
  • If possible, make the tourniquet with bandages by tying a half knot around the limb. Make sure there’s enough room on the loose ends to tie another knot.  
  • Place a stick between the knots.  
  • Tighten the bandage by twisting the stick  
  • Secure the tourniquet place with the help of a tape or cloth  
  • At least every 10 minutes, check the tourniquet. Release the tourniquet and apply direct pressure if the bleeding has slowed down enough.  

Key takeaways  

During a haemorrhage, the patient should seek urgent medical assistance. Constant support and reassurance can help the patient stay calm and composed. Be it internal or external bleeding, ensure to contact the doctor immediately and seek medical attention.   

Verified By Dr Ramakrishna Janapati
DM(Cardiology), MD(General Medicine), MBBS, Consultant Cardiologist, Apollo Hospitals, Jubilee Hills, Hyderabad
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