Haemorrhage and its management

Haemorrhage means escape of blood from an artery, vein or capillary to extravascular space, its management is very essentials as it leads the Hypovolemic shock to the animals.

The complete loss of blood is referred to as exsanguination.

Classification of Haemorrhage-

1. External haemorrhage
2. Internal haemorrhage
3. Depending on the time of occurrence
4. Depending on the source of haemorrhage

1. External haemorrhage-

External haemorrhage occurs from open wounds or cut wounds that is visible on the outside of the body. Examples are-

• Epistaxis– bleeding from nose
• Haematuria- Blood in urine
• Haematemesis- vomiting fresh blood
• Haemoptysis– coughing up blood from the lungs
• Melena- presence of blood in faeces

2. Internal haemorrhage-

is bleeding occurring inside the body. It may be caused by high blood pressure (by causing blood vessel rupture) or other forms of injury, especially high speed deceleration occurring during an automobile accident, which can cause organ rupture. When blood is collected in a newly formed cavity called as Haematoma.

Examples of Internal Haemorrhage are-

• Haemometra – haemorrhage into uterus
• Haemopleura – haemorrhage into pleural cavity
• Haemoperitoneum – haemorrhage into peritoneal cavity
• Haematocele – haemorrhage in to tunica vaginalis
• Haemarthrosis – haemorrhage into a joint
• Haematomyelia – haemorrhage into spinal cord
• Petechiae – Pinpoint haemorrhages on skin and subcuts
• Ecchymosis – haemorrhagic spots on skin and subcuts.

3. Depending on the time of occurrence-

Primary haemorrhage

Primary haemorrhage occurs immediately after injury.

Reactionary haemorrhage

Reactionary haemorrhage occurs within 24hours after the primary bleeding has been arrested due to mechanical disturbance of clot in vessel or due to slipping of the ligature.

Secondary haemorrhage

Secondary haemorrhage occurs after about a week or more due to septic disintegration of clot or due to sloughing of portion of vessel because of a septic or gangrenous lesion.

4. Depending on the source of haemorrhage-

Depending on the source of haemorrhage, it is Arterial, Venous and Capillary types.

Characteristics	Arterial	Venous	Capillary
Color	Bright red	Dark red	Red
Flow	Jets (Jerks) Spurting / pulsating	Continuous flows freely	slow and steady oozing
Of force	cardiac side	peripheral side(distal )	wound

Etiology of Haemorrhage-

• Trauma – blunt trauma (e.g. fall, motor vehicle accident), laceration, or penetrating trauma (e.g. knife or gun).
• Necrosis and ulcerations of blood vessel wall
• Infection and subsequent release of toxins of microorganism
• Aneurysm ( weaknesses in blood vessels )
• Increased blood pressure
• Lack of oxygen and nutrition.
• Anaphylactic shock
• Deficiencies of coagulation factors.
• Deficiency diseases (Haemophilia, Thrombocytopenia, Deficiency of vitamin C, vitamin K, Plant toxins (sweat Clover)

Symptoms of Haemorrhage-

• Bleeding from injured blood vessel
• Skin and mucous membrane become pale, cold and moist
• Patient feels thirsty
• Air hunger
• Thready pulse
• Hypotension
• Low hemoglobin and red blood cells
• Severe bleeding leads to shock

Treatment of Haemorrhage-

For treatment of Haemorrhage, various Haemostatic Techniques are used.