First Aid/Internal Bleeding

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Internal bleeding is bleeding which occurs inside the body. Sometimes the blood will leak from inside the body through natural openings. Other times the blood stays inside the body, causing pain and shock, even though you cannot see the blood loss.


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Internal bleeding can be caused numerous ways. Any time someone could have internal bleeding, you will do no harm by treating them for internal bleeding, but not treating the victim could lead to death.

Some causes include:

  • Falls
  • Car Accidents
  • Motorcycle Accidents
  • Pedestrians Struck by a Vehicle
  • Gun Shot Wounds
  • Injuries from Explosions
  • Impaled Objects
  • Stab Wounds
  • Surgery


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A person may be bleeding internally if one of these things happens:

  • Blood comes out of the nose or mouth (occurs from severe head trauma)
  • Blood or clear fluid comes out of the ear (occurs from severe head trauma)
  • Blood is in the stool
  • Blood is in the urine
  • Bright red blood, or blood like 'coffee-grounds', is in the vomit
  • Blood comes from a woman's vagina (birth canal) after an injury or during pregnancy
  • Bruising over the abdominal or chest area
  • Pain over vital organs
  • Fractured femur

But remember, a person may be bleeding inside the body, even though you cannot see the bleeding. If you see the signs of shock and no apparent injuries, always suspect internal bleeding. Check the skin color changes. In cases of internal bleeding the skin may become pale and cold, and cyanosis may be present.


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Best Practice
Any time there is the possibility of internal bleeding, it is crucial to treat as if there is internal bleeding. Not treating may result in death, but treating when there is no injury will not result in harm.

As with any victim, before treating, put on disposable gloves and take other necessary body substance isolation precautions.

  • Check the victim's ABCs.
    • If the victim has ABC complications, treat those first - ABCs always take priority.
  • Call an ambulance.
  • Treat for shock.
    • Assist the victim into the most comfortable position.
  • Monitor ABCs and vitals until the ambulance arrives.

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