Internal Bleeding
Internal bleeding is classified as either visible, in that the bleeding can be seen, or concealed, where no direct evidence of bleeding is obvious.
Always consider internal bleeding after injury, understanding it cannot be controlled by the first aider.
In most instances, obtaining an adequate history of the incident or illness will give the first aid provider the necessary clue as to whether internal bleeding may be present.
Remember that current signs and symptoms, or the lack of them, do not necessarily indicate the casualty’s condition.
Certain critical signs and symptoms may not appear until well after the incident due to the stealth of the bleed, and may only be detected by the fact that the casualty’s observations worsen despite there being no visible cause.
Visible Internal Bleeding Visible internal bleeding is referred to this way because the results can be seen in bleeding from:
Remember to look at the important observations that may indicate internal bleeding, which include:
Internal bleeding is classified as either visible, in that the bleeding can be seen, or concealed, where no direct evidence of bleeding is obvious.
Always consider internal bleeding after injury, understanding it cannot be controlled by the first aider.
In most instances, obtaining an adequate history of the incident or illness will give the first aid provider the necessary clue as to whether internal bleeding may be present.
Remember that current signs and symptoms, or the lack of them, do not necessarily indicate the casualty’s condition.
Certain critical signs and symptoms may not appear until well after the incident due to the stealth of the bleed, and may only be detected by the fact that the casualty’s observations worsen despite there being no visible cause.
Visible Internal Bleeding Visible internal bleeding is referred to this way because the results can be seen in bleeding from:
- Anus or vagina – usually red blood mixed with mucus
- Ears – bright, sticky blood or blood mixed with clear fluid
- Lungs – frothy, bright red blood coughed up by the casualty
- Stomach, bowel or intestines – bright, dark or tarry blood
- Under the skin (bruising) – the tissues look dark due to the blood under the skin
- Urinary tract – dark or red coloured urine
Remember to look at the important observations that may indicate internal bleeding, which include:
- Skin appearance
- Conscious state
- Pulse
- Respiration
- pale, cool, clammy skin
- thirst
- rapid, weak pulse
- rapid, shallow breathing
- ‘guarding’ of the abdomen, with foetal position if lying down
- pain or discomfort
- nausea and/or vomiting
- visible swelling of the abdomen
- gradually lapsing into shock
- call ‘000’ for an ambulance
- put on disposable gloves if available
- if conscious – lie the casualty down with legs elevated and bent at the knees
- if unconscious – recovery position and elevate the legs if possible
- reassurance
- treat any injuries
- give nothing by mouth
