SHORT DESCRIPTION ABOUT HAEMORRHAGE BY DR. ANAND SINGH BHADORIYA (MBBS)

1. Haemorrhage and it’s
management
PRESENTATION BY
DR. ANAND SINGH BHADORIYA
MBBS (GRMC, GWALIOR)

2. What is haemorrhage?
• Prolonged or uncontrolled bleeding is often referred to as haemorrhage.
• Blood carries oxygen and nutrients to the tissues and is vital for body
functions.
• Any damage to the vasculature leads to the outflow
• Escape of blood from blood vessels.

3. Classification of haemorrhage
• 1. Depending on the source of bleeding
• i ) External haemorrhage- When the bleeding is revealed and seen
outside. Eg-: Epistaxis
• ii ) Internal haemorrhage- Bleeding is concealed and not seen
outside. Eg-: Intracranial haemorrhage.
• 2. Depending on the nature of bleeding vessels
• i ) Arterial Haemorrhage- Bright red in colour. Blood emitted as a jet
with each heartbeat.
• ii ) Venous Haemorrhage- Dark red in colour . Blood flow is steady.

4. • iii ) Capillary Haemorrhage: Bright red in colour. Generalised ooze of blood
instead of blood flow.
• 3. Depending upon time of haemorrhage.
• i ) Primary Haemorrhage: Occurs at the time of trauma or surgery.
• ii ) Reactionary Haemorrhage: Occurs within 24 hours of trauma or surgery.
• iii ) Secondary Haemorrhage: Occurs after 7-14 days of trauma or surgery.
• Depending upon Volume of blood loss.
• i ) Mild: Blood loss < 500 ml
• ii) Moderate : Blood loss 500-1000 ml
• iii ) Severe : Blood loss > 1 L.

6. ETIOLOGY
• Trauma
• Infections
• Surgical
• Due to systemic diseases
• Abnormalities in clotting factors
• Abnormalities in platelets

7. Clinical Features
• Pallor, thirsty, cyanosis
• Tachycardia ,tachypnea.
• Cold clammy skin due to vasoconstriction.
• Dry face, dry mouth and goose skin appearance.
• Rapid threads pulse , hypotension
• Oliguria

8. GENERAL MEASURES
• Apply direct pressure - This is to try and stop the flow of blood and
encourage a clot to form
• Apply a dressing - Applying a sterile non- fluffy dressing covers the
wound protecting it and preventing the spread of infection.
• Elevation - Elevate the bleeding limb or area above’s heart . This will
reduce the amount of blood flow to the wound
• Monitor - Periodically monitor the individual as they may go into shock
due to blood loss.

9. Methods of Achieving Hemostasis
• Mechanical methods .
• Haemostat
• Application of haemostat at the bleeding point helps in direct occlusion
of the bleeding vessel.
• Sutures And Ligation
• Gelatin Sponge or Gelfoam or Surgifoam
• Fibrin glue
• Natural collagen sponge

10. Adrenaline Tranexamic acid
Thermal Agents - Cautery

11. SYSTEMIC AGENTS
• WHOLE BLOOD
• PLATELET RICH PLASMA
• FRESH FROZEN PLASMA
• CRYOPRECIPITATE

12. Thank you