Haemorrhage refers to prolonged or uncontrolled bleeding. It can be classified based on the source (external vs internal), nature of the bleeding vessels (arterial, venous, or capillary), or time of occurrence (primary, reactionary, or secondary). Causes include trauma, infections, surgery, systemic diseases, or abnormalities in clotting factors or platelets. Symptoms include pallor, thirst, tachycardia, hypotension, and signs of shock from blood loss. General measures to manage haemorrhage involve applying direct pressure, dressings, elevation, and monitoring for signs of shock. More specific methods to achieve hemostasis include mechanical techniques, sutures, cautery, topical

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