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Internal bleeding (also called internal haemorrhage) is a loss of blood from a blood vessel that collects inside the body, and is not usually visible from the outside. [1] It can be a serious medical emergency but the extent of severity depends on bleeding rate and location of the bleeding (e.g. head, torso, extremities).
The severity of hemorrhagic shock can be graded on a 1–4 scale on the physical signs. The shock index (heart rate divided by systolic blood pressure) is a stronger predictor of the impact of blood loss than heart rate and blood pressure alone. [11] This relationship has not been well established in pregnancy-related bleeding. [12]
The annual incidence of shock of any etiology is 0.3 to 0.7 per 1000, with hemorrhagic shock being most common in the intensive care unit. Hypovolemic shock is the most common type of shock in children, most commonly due to diarrheal illness in the developing world. [4]
Exsanguination, hypovolemic shock, coma, shock Bleeding , hemorrhage , haemorrhage or blood loss is blood escaping from the circulatory system from damaged blood vessels . [ 1 ] Bleeding can occur internally , or externally either through a natural opening such as the mouth , nose , ear , urethra , vagina or anus , or through a puncture in the ...
Clinical [ edit ] Gastric aspiration and or lavage , where a tube is inserted into the stomach via the nose in an attempt to determine if there is blood in the stomach, if negative does not rule out an upper GI bleed [ 20 ] but if positive is useful for ruling one in. [ 14 ] Clots in the stool indicate a lower GI source while melana stools an ...
Bilateral adrenal gland hemorrhaging is more common. It is characterized by overwhelming bacterial infection meningococcemia leading to massive blood invasion, organ failure, coma, low blood pressure and shock, disseminated intravascular coagulation (DIC) with widespread purpura, rapidly developing adrenocortical insufficiency and death.
Other signs may be seen depending on the underlying cause. For example, jugular venous distension is a significant finding in evaluating shock. This occurs in cardiogenic and obstructive shock. This is not observed in the other two types of shock, hypovolemic and distributive. [3] Some particular clinical findings are described below.
The scoring system uses clinical criteria (increasing age, co-morbidity, shock) as well as endoscopic finding (diagnosis, stigmata of acute bleeding). It is named for Professor Tim Rockall, who was the main investigator and first author of the studies that led to its formulation.