Haemorrhage Nursing Management

 HAEMORRHAGE

It is an escape of blood from its vessels.

1. Primary haemorrhage It occurs at the time of operation or injury.

2. Secondary haemorrhage It occurs sometime after the operation as a result of slipping of a ligature because of infection, insecure tying or erosion of a vessel.

Other classification depending on the kind of vessel that is bleeding:

1. Capillary haemorrhage-is characterized by a slow general ooze.

2. Venous haemorrhage - It is bubbles out quickly and is dark in colour.

3. Arterial haemorrhage Bleeding from an artery. It is bright red in colour and appears in spurts with each heart beat.

Clinical Manifestations

It depends on the amount of blood loss and the rapidity of its escape. The patient is apprehensive, restless, thirsty, skin is cold, moist and pale. The pulse rate increases. The temperature falls and respiration are rapid-deep. Patient may have air hunger. As haemorrhage progresses, cardiac, output decreases, arterial and venous BP and Hb of the blood falls rapidly.

Nursing Management

1. Apply firm manual pressure over the wound or artery involved. Do not constrict circulation.

2. Immobility of injured extremity to control blood loss.

3. Elevate the affected part.

4. If the patient is haemorrhaging internally whole blood or plasma expanders are given at the rate of blood loss. The patient who is bleeding internally requires surgery.

5. Apply a tourniquet just above the wound, only as a last resort, when the haemorrhage cannot be controlled by any other method.

Bleeding conditions

Epistaxis Bleeding from the nose.

Haemoptysis is the expectoration of blood from the respiratory tract.

Coughing up of blood.

Haematemesis vomiting of blood.

Bleeding Disorders

Purpura-refers to escape of blood into the skin and mucous membranes.

Thrombocytopenia is a subnormal number of blood platelets. It is a common cause of abnormal bleeding.