3. • Haemorrhage is treated by arresting
the bleeding, and not by fluid
resuscitation or blood transfusion
• Although necessary as supportive
measures to maintain organ
perfusion, attempting to resuscitate
patients who have on-going
haemorrhage will lead to
physiological exhaustion
10. • (immediately) as a result of an
injury (or surgery).
Primary hemorrhage
11. Reactionary hemorrhage
• (within 24 hours) usually caused by
dislodgement of clot by resuscitation,
normalization of blood pressure and
vasodilatation. Reactionary haemorrhage
may also result from technical failure such
as slippage of a ligature
12. Secondary hemorrhage
• (within 7–14 days) is caused by
sloughing of the wall of a vessel. It
usually occurs 7–14 days after injury
and is precipitated by factors such as
infection, pressure necrosis (such as
from a drain) or malignancy
13. The adult human has
approximately 5 liters of blood
(70 ml kg–1children and adults)
(80 ml kg–1 neonates).
.
15. Management of haemorrhage
1. Identify hemorrhage
External hemorrhage may be obvious but
the diagnosis of concealed hemorrhage
may be more difficult
• cavity hemorrhage must be excluded with
rapid investigations (chest and pelvic
radiography, abdominal ultrasound or
diagnostic peritoneal aspiration).
16. Control of haemorrhage
1. Pressure and packing
- Pressure dressing
- Digital pressure
- Balloon
- Tourniquet