Haemorrhage

Key takeaways

• Heavy, persistent or unexplained bleeding needs assessment of the source, blood loss and any clotting problem.
• Direct pressure can help an external wound, but suspected internal bleeding requires emergency care.
• Blood thinners, pregnancy, recent surgery, trauma and inherited bleeding disorders change both urgency and treatment.

The catalogue is not a care pathway for active haemorrhage; a medicine is used only when the bleeding type and contraindications have been established.

What determines how bleeding is stopped?

Treatment may involve pressure, endoscopy, surgery, transfusion, reversal of an anticoagulant or correction of a clotting disorder. Tranexamic acid slows clot breakdown and has defined uses, including selected heavy menstrual, surgical and trauma-related bleeding; it is not appropriate for every cause.

What information helps clinicians?

Record where bleeding is seen, how quickly dressings are soaked, recent procedures and all medicines. Heavy menstrual bleeding needs evaluation for pregnancy-related, structural and clotting causes; women’s health provides related context.

When to seek urgent care

Call emergency services for bleeding that will not stop with firm pressure, vomiting or coughing blood, black or heavily blood-stained stool, heavy bleeding in pregnancy, severe pain after trauma, fainting, confusion, cold clammy skin or breathing difficulty.