Bleeding – Overview, classification, types and dangers

Imagine what happens when a pipe is broken and begins to leak; the result is that the water will eventually not get to its destination but will leak out and gather around a particular spot unless something is done to the pipe or the source of supply is cut off totally. This is exactly what happens when a haemorrhage occurs in the body.

Bleeding, an Overview

Haemorrhage is also referred to as bleeding and it occurs when there is an injury to a blood vessel causing blood to glow ‘out of circuit’. Similar to the description above, blood as a liquid is transported in closed vessels to organs around the body.

These vessels are arteries and veins; arteries taking away from the heart and to the different parts of the body, and veins returning blood to the heart for movement to the lungs and oxygenation.

Arteries are usually under higher pressures because of their function in blood circulation, as compared to veins which are under less pressure; this implies that injury to an artery will be more dangerous and cause more blood to leak out than a similar injury to a vein.

Classification of bleeding

Bleeding can be broadly grouped into two types

• Physiological bleeding.
  This is a type of bleeding that occurs under normal conditions even in the absence of any disease. The major type of physiological bleeding that occurs is the monthly menstrual flow in females that have attained puberty. Physiological bleeding may also occur during delivery due to the rupture of membranes.
• Pathological bleeding.
  This type of haemorrhage occurs as a result of a disease or an illness going on and affecting the body. Some vaginal bleeds may be pathological as well, probably due to growths in the vagina or in the uterus.
  Examples of ailments that can lead to pathological bleeding include Haemophilia (lack of anti-clotting factor), leukaemia, vitamin K deficiency, Menorrhagia, vaginal tumours, bleeding due to trauma, bleeding due to ectopic pregnancy, etc.

Types of Bleeding

Based on severity, haemorrhage can be acute or chronic.

Acute haemorrhage occurs when there is a little injury to the skin or any part of the body. A scratch on the skin and a little knife cut are examples of acute haemorrhage, so-called because most times with little or no intervention, the site of bleeding heals quickly.

Most acute haemorrhage occurs externally.

Chronic haemorrhage is bleeding that occurs uncontrollably and in most cases doesn’t stop until there is an intervention. Although acute bleeding majorly occurs externally, bleeding may be severe when there is serious trauma to the surface of the skin; such as that which sometimes occur in accidents.

In most cases, internal bleeding can also be chronic, especially because it is difficult to identify, and will not usually stop until there is an intervention. Internal bleeding will not cause blood to come out on the surface, but may lead to swelling of the region caused by hematoma (accumulation of blood).

How does the body stop haemorrhage?

Blood has three type of cells: Red blood cells or erythrocytes, white blood cells or leukocytes, and blood platelets or thrombocytes. While red blood cells are responsible for the transportation of nutrients, white blood cells for immunity, blood platelets are responsible for blood clotting and prevention of further bleeding.

The following steps take place when a blood vessel is injured

• Upon exposure to air, a series of reaction is triggered, the first being the constriction of the blood vessel to prevent further loss of blood.
• A series of reaction occurs and platelets aggregate at the site of the injury forming a temporary platelet plug.
• The coagulation cascade which involves clotting factors is activated.
• The final clot is formed and the blood vessel is sealed.

This process only takes place efficiently when the bleeding is acute.

Dangers of prolonged haemorrhage

When bleeding occurs for a long time, it leads to haemorrhagic anaemia usually characterized by weakness, and pale looks. It is easier to prevent external bleeding from getting severe if the patient is taken to the hospital immediately.

If bleeding gets worse, it could lead to shock due to an insufficient supply of blood to the brain, coma, and even death.
Hence, it is advisable to treat cases of prolonged or incessant bleeding as urgent and see a doctor.