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Haemorrhage
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Haemorrhage is defined as the blood coming out of the vessels or rupturing out of the blood vessels.

Types of Haemorrhage

(A) Haemorrhage is classified into two types, that is External and Internal .

i.) External haemorrhage: It is the one that is revealed outside or seen externally.

ii) Internally haemorrhage: It is the one that is not seen from outside or it is concealed haemorrhage.

(B) Haemorrhage may be:

i) Arterial haemorrhage: When haemorrhage comes from an artery, it is termed as an arterial haemorrhage. It is bright red in colour.

ii) Venous haemorrhage: It is the one which comes from a vein. It is dark red in colour and it flows out slowly.

iii) Capillary haemorrhage: It is the one in which haemorrhage comes from capillaries. In this case, the blood is bright red and oozes rather then flow out.

(c) According to the time of appearance haemorrhage is of three types:

i) Primary haemorrhage: It is the one which occurs at the time of injury or operation.

ii) Reactionary haemorrhage: It is the one which occurs within 24 hours of injury or operation.

iii) Secondary Haemorrhage: This occurs usually after 7 to 14 days of injury or operation. This type of haemorrhage mainly occurs due to infection.

Symptoms of Haemorrhage

Few signs and symptoms that usually accompanying haemorrhage are heavy blood loss, be it internal or external. Increased pulse rate, low blood pressure, increasing pallor, restlessness and deep sighing respiration (air hanger) are the typical features of acute extremities, empty veins are also characteristically seen when the bleeding is continuing.

Pulse rate and blood pressure should be measured ¼th or ½ hourly intervals when the patient is losing blood. Often the blood pressure is maintained at normal level by peripheral vaso constriction due to adrenergic releasing. Suddenly the blood pressure may fall abruptly with collapse and even death of the patient. Moreover, when the blood loss has been excessive It pulse becomes of low volume, which is classically known as ‘Thready Pulse’.

Treatment of Haemorrhage

It consists of two parts.

(A) To stop blood loss

(B) To restore blood volume by blood transfusion, infusion of crystalloid solution and infusion of plasma or plasma substitutes.

(A) Blood loss is stopped mainly by three methods: (1) Rest (2) Pressure and packing from outside (3) By operative methods.

(1) Rest : Absolute reset is necessary because restlessness causes more blood loss. Some sedatives and analgesics are presecribed to provide rest to the patients. Morphine is commonly use.

(2) Pressure and Packing from outside: This is mainly a first aid treatment. Sterile pieces of gauze and bandage may be used as pressure bandage to reduce bleeding from external wound. If sterile gauzes and bandages are not available, then clean linen cloth may be used as bandage to reduce bleeding from the wound.

(3) By operative Methods: During operation haemorrhage is usually stopped by artery forceps (haemostats and vessels. Then the bleeding vessel is either ligated with catgut or silk according to the size of the vessel. When haemorrhage is in the form of oozing then gelatin spange may be used to stop such bleeding.

Subconjuntival Haemorrahge

It is a haemorrhage, commonly seen in the region of eye. It is commonly seen during facture of facial region. It comes under Lefort’s classification of fracture may occur due to trauma. Along with subconjunctival haemorrhage these may be pain and oedema also noted in some cases. There may be also discolouration around the eye region. Bluish coloured ey may be noted. Patient may not be able to open the eye for few days. But in due course of time it gets healed. As eye, is important organ of body, so special attention should be given and it should be protected from any sort of infection.



 

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