Hemorrhage
From Anvita Health Wiki
Contents |
More Specific Terms
- adrenal hemorrhage
- alveolar hemorrhage
- apoplexy
- Duret hemorrhage
- dysfunctional uterine bleeding (DUB)
- gastrointestinal hemorrhage
- intracranial hemorrhage
- ocular hemorrhage (hemophthalmos)
- ovarian hemorrhage
- retinal hemorrhage (RHe)
- retroperitoneal hemorrhage; retroperitoneal hematoma
Introduction
- Bleeding from the rupture of a blood vessel.
Etiology
- frequency, severity & type of bleeding are clues to etiology.
- hemostatic plug disorder
- cutaneous bleeding
- mucous membrane bleeding
- epistaxis
- oropharyngeal bleeding
- menorrhagia
- deep hematomas
- hemarthrosis
- delayed bleeding after surgery or trauma
Pathology
- breakdown in the control of bleeding through interplay of vasoconstriction, platelet aggregation, & coagulation
Laboratory
- complete blood count ( CBC)
- prothrombin time (PT) & aPTT
- additional testing as indicated
- bleeding time
- von Willebrand factor ( vWF)
- specific assays for coagulation factor VIII or factor IX
- dilute whole blood clot lysis
- euglobulin clot lysis time
- dilute thrombin time
- serum fibrinogen
- qualitative factor XIII assay
Management
- pressure over bleeding vessels
- monitor: blood pressure, heart rate
- correct underlying bleeding diathesis
- correct hypovolemia
- normal saline or lactated Ringers
- blood transfusion if indicated
- UrgentQR applied directory to wound may be of value
More General Terms
Additional Terms
- ecchymosis
- epistaxis (nose bleed)
- hematoma
- hemoptysis
- menorrhagia
- petechia
- purpura
- vaginal bleeding (including uterine bleeding)
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
