🔅 HAEMORRHAGE

– Haemorrhage is the medical term for abnormal bleeding from a blood vessel. It can be internal or external, and it can vary in severity and location. Haemorrhage can cause blood loss, shock, organ damage, and death if not treated promptly.

Some of the common causes of haemorrhage are:

• Traumatic injuries, such as cuts, punctures, fractures, or gunshot wounds

• Medical conditions, such as hemophilia, leukemia, liver disease, or placenta accreta

• Medications, such as blood thinners, antibiotics, or aspirin

• Complications from medical procedures, such as surgery, childbirth, or endoscopy.

SYMPTOMS OF HAEMORRHAGE

– Some of the common symptoms of haemorrhage are:

• Bleeding from a wound, natural opening, or internal organ

• Pain, swelling, or bruising at the site of bleeding

• Dizziness, nausea, vomiting, or fainting

• Pale, cold, clammy, or sweaty skin

• Rapid pulse, low blood pressure, or shortness of breath

• Confusion, seizures, coma, or death.

DIAGNOSIS OF HAEMORRHAGE

The diagnosis of haemorrhage depends on the location and severity of the bleeding. Some of the tests that may be used are:

• Physical examination and medical history.

• Blood tests, such as complete blood count, coagulation tests, or blood type and crossmatch.

• Imaging tests, such as ultrasound, X-ray, computed tomography (CT), or magnetic resonance imaging (MRI)

• Endoscopy, colonoscopy, or angiography, to visualize the bleeding source

• Lumbar puncture, to detect bleeding in the brain or spinal cord.

PROGNOSIS OF HAEMORRHAGE

– The prognosis of haemorrhage depends on the amount of blood loss, the speed of treatment, and the underlying cause of bleeding. Some of the factors that may affect the outcome are:

• Age, health status, and comorbidities of the patient

• Location, size, and type of the blood vessel involved

• Availability and accessibility of medical resources and personnel.

• Effectiveness and timeliness of interventions and transfusions

PREVENTION OF HAEMORRHAGE

– The prevention of haemorrhage may involve:

• Identifying and managing risk factors, such as hypertension, diabetes, or smoking.

• Avoiding or limiting the use of medications that increase bleeding risk, such as blood thinners, antibiotics, or aspirin.

• Using protective equipment and following safety measures to prevent injuries.

• Seeking prenatal care and following obstetric guidelines to prevent complications during pregnancy and childbirth.

• Practicing active management of the third stage of labor, such as using oxytocin or uterine massage, to prevent postpartum haemorrhage.

– The treatment of haemorrhage may involve:

• Applying pressure, elevation, or tourniquet to stop external bleeding.

• Administering fluids, blood products, or medications to restore blood volume, clotting, and hemostasis

• Performing surgery, embolization, or tamponade to repair or occlude the bleeding vessel or organ.

• Providing supportive care, such as oxygen, ventilation, or antibiotics, to prevent or treat complications.

RELATED MEDICAL CONDITIONS

– Some of the related medical conditions to haemorrhage are:

1). Anemia, a condition in which the blood has a low level of red blood cells or hemoglobin

2). Shock, a condition in which the blood pressure drops and the organs do not receive enough oxygen and nutrients.

3). Disseminated intravascular coagulation, a condition in which the blood clots abnormally throughout the body

4). Hemorrhagic stroke, a condition in which a blood vessel in the brain ruptures or leaks.

5). Hematoma, a collection of blood outside a blood vessel, such as in the brain, skin, or muscle.

RECENT STUDIES ON HAEMORRHAGE

– Some of the recent studies on haemorrhage are:

• A 2021 study in Sweden found that a possible cause of spontaneous brain haemorrhage could be transmitted via blood transfusion.

• A 2020 review article summarized the novel concepts and improvisations for treating postpartum haemorrhage, such as new devices, techniques, and strategies.

• A 2020 study in the United States found that tranexamic acid given within the first three hours after birth reduced mortality due to bleeding in women with postpartum haemorrhage.

• A 2019 review article discussed the updated strategies in the management of acute variceal haemorrhage, such as early transjugular intrahepatic portosystemic shunt and endovascular balloon occlusion of the aorta.

PREVENTING POSTOPERATIVE BLEEDING

– Provided below are some general information and tips on how to prevent postoperative bleeding. However, you should always follow the specific instructions given by your surgeon and healthcare team, as they may vary depending on your individual situation and type of surgery.

– Postoperative bleeding is bleeding that occurs after surgery, either from the incision site or from inside the body. It can be caused by various factors, such as: surgical complications, medical conditions, medications, or supplements that affect blood clotting. Postoperative bleeding can be serious and life-threatening if not treated promptly.

Here are some common ways to prevent postoperative bleeding:

i). Before surgery, inform your surgeon and healthcare team about any health conditions, medications, or supplements that you have or take, especially those that may increase your bleeding risk, such as blood thinners, antibiotics, aspirin, vitamin E, ginkgo, ginseng, or feverfew. They may advise you to stop or adjust some of them before surgery.

ii). Follow the preoperative instructions given by your surgeon and healthcare team, such as fasting, avoiding alcohol, and stopping smoking. These may help reduce the risk of bleeding and other complications during and after surgery.

iii). After surgery, keep the bandage covering your incision clean and dry, and change it as directed by your surgeon and healthcare team. Do not remove or disturb any stitches, staples, or drains unless instructed to do so.

iv). Avoid any activities that may increase the pressure or strain on your incision or surgery area, such as lifting, bending, coughing, sneezing, or straining during bowel movements. Use a pillow or your hands to support your incision when you need to do these activities.

v). Drink plenty of fluids and eat a balanced diet that includes foods rich in iron, vitamin C, and protein. These may help your body heal faster and prevent anemia, which can worsen bleeding.

vi). Monitor your incision and surgery area for any signs of bleeding, such as blood soaking through the bandage, swelling, bruising, pain, or redness. Also, watch for any signs of shock, such as dizziness, nausea, vomiting, fainting, pale or cold skin, rapid pulse, low blood pressure, or shortness of breath. If you notice any of these signs, seek immediate medical attention.

COMMON CAUSES OF POSTOPERATIVE BLEEDING

– Since postoperative bleeding is bleeding that occurs after surgery, either from the incision site or from inside the body it can be caused by various factors, such as:

• Surgical problems, such as blood vessels not secured or stitches that came apart.

• Injury to other organs during surgery.

• Health conditions, such as liver or kidney disease, or a bleeding disorder, such as hemophilia.

• Medicines, such as blood thinners, antibiotics, or aspirin.

• Vitamin or herbal supplements that affect blood clotting, such as vitamin E, ginkgo, ginseng, or feverfew

– Postoperative bleeding can be serious and life-threatening if not treated promptly. Some of the signs and symptoms of postoperative bleeding are:

i). Blood that soaks through the bandage covering your incision.

ii). Anxiety or confusion.

iii). Faster heart rate than normal for you.

iv). Faster breathing than normal for you, or shortness of breath.

v). Urinating less than usual, or not at all

If you notice any of these signs, seek immediate medical attention.

TREATING POSTOPERATIVE BLEEDING

– Postoperative bleeding can be serious and life-threatening if not treated promptly.

Some of the common ways to treat postoperative bleeding are

• A blood transfusion may be done to give you donated blood through an IV. Blood components may be given during a transfusion to help stop your bleeding. Blood components are the parts of blood that help it to clot. Examples are clotting factors, platelets, and plasma.

• Antifibrinolytic medicines may slow or stop your bleeding. These are medicines that prevent the breakdown of blood clots. Examples are tranexamic acid and aminocaproic acid.

• Surgery may be done to fix the blood vessel or area that is bleeding. This may involve repairing or tying off the bleeding vessel, removing the bleeding organ, or applying pressure or a sealant to the bleeding site.

• Procedures such as endoscopy and angiography may be used to find the source of your bleeding, or to control it. An endoscope is a long, bendable tube with a light on the end of it. It can be inserted through a natural opening, such as the mouth or anus, to see inside your body. An angiogram is a picture of your arteries. A dye is injected into your blood to make them visible on an X-ray. A catheter can be inserted through an artery to reach the bleeding site and deliver a substance that blocks the blood flow.