While the general public understands that internal bleeding means bleeding that can't be seen on the outside of the body, medical personnel tend to use terms that describe more precisely where inside the body the bleeding is found. The internal bleeding may occur within tissues, organs, or in cavities of the body including the head, chest, and abdomen. Examples of other potential sites of bleeding include the eye and within tissues that line the heart, muscles, and joints.
Internal bleeding can be difficult to identify. It may not be evident for many hours after it begins, and symptoms may only occur when there is significant blood loss or if a blood clot is large enough to compress an organ and prevent it from functioning properly.
Internal bleeding occurs when damage to an artery or vein allows blood to escape the circulatory system and collect inside the body. The amount of bleeding depends upon the amount of damage to an organ, the blood vessels that supply it, and the body's ability to repair breaks in the walls of the blood vessels. The repair mechanisms available include both the blood clotting system and the ability of blood vessels to go into spasm to decrease blood flow to an injured area.
Internal bleeding can be caused by blunt trauma, deceleration trauma, fractures, pregnancy, medications or alcohol abuse.
The symptoms of internal bleeding depend upon where the bleeding is located, how much bleeding has occurred, and what structures and functions in the body are affected.
- Intracranial bleeding from trauma often causes pain. Symptoms of stroke, including weakness, slurred speech, and loss of vision, may also be associated with intracranial bleeding. The signs and symptoms depend upon where and how much blood there is in the brain. If the bleeding continues, symptoms become progressive and easier to recognize.
- Intra-abdominal bleeding may be hidden and present only with pain, but if there is enough blood loss, the patient may complain of weakness, lightheadedness, shortness of breath, and other symptoms of shock and decreased blood pressure. Once again, the symptoms depend upon where in the abdomen the bleeding occurs.
- Bleeding may also occur into joints, causing significant pain and loss of range of motion.
The initial treatment plan of any patient with internal bleeding begins with assessing the patient's stability and making certain the ABCs are well maintained. This includes making certain the patient's:
- Airway is open,
- that the patient is Breathing, and
- That there is adequate Circulation, meaning stable pulse rate and blood pressure.
The basic goals include identifying and stopping the source of bleeding and repairing any damage that the bleeding may have caused.
Depending upon where it occurs, if not recognized, internal bleeding may cause organ failure, shock, and death. It is essential to get treatment right away if suffer from internal bleeding.