haemorrhage.pptx. .

Pathophysiology. .

1. HAEMORRHAGE

2. INTRODUCTION Haemorrhage is defined as an acute loss of blood from a damaged blood vessel. The bleeding can be minor such as when the superficial vessels in the skin are damaged. It can also be significant bleeding leading to compromised vital signs and altered mental status. Haemorrhage can be either ext ernal or internal .

3. CLASSIFICATION OF H A EMORRHAGES 1. Nature of haemorrhage Concealed Revealed 2. Time occurance of haemorrhage Primary Reactional Secondary 3. Intervention of haemorrhage Surgical Non surgical 4. Blood source of haemorrhage Arterial Venous Capillary 5. Duration of haemorrhage Chronic Acute 6. Traumatic haemorrhage 7. Non traumatic haemorrhage 8. Profuse haemorrhage

4. ETIOLOGICAL FACTORS There are various causes of haemorrhage, these include: Trauma Blood clotting disorders Hypertension Vascular abnormalities Medications such as anticoagulants Infections like as viral haemorrhegic fevers for example Ebola GIT conditions for example peptic ulcers Cancer Liver diseases Autoimmune diseases like thrombocytopenia purpura

5. CHARACTERISTICS OF HAEMORRHAGE Severity of haemorrhage is divided into a class system organized by percent of volume loss . CLASS 1 HAEMORRHAGE Up to 15% blood volume loss. Patient is generally asymptomatic. CLASS 2 HAEMORRHAGE From 15% to 30% . Manifestations include nausea, and fatigue. Pallor and cooling of extremities is realised. Tachycardia is first vital sign followed by increased respiratory rate. CLASS 3 HAEMORRHAGE From 30% to 40% blood volume loss. There is delayed capillary refill and changes in mental status. There is drastic blood pressure deviations . CLASS 4 HAEMORRHAGE From 40% going upwards of blood loss. There is lack of urine output, absent peripheral pulse and further deviation in vital signs. Severe haemorrhage can lead to shock and worsened mental state

6. DIAGNOSIS OF HAEMORRHAGE Diagnosis typically involves a physical examination , medical history taking and aspiration I maging tests like CT scans ， Xrays ， Ultrasounds and Radiography to locate source of bleeding.

7. Lab investigations Partial thromboplastin time Prothrombin time Platlet count Fbc Electrolytes Urea Creatinine Bleeding and clothing time

8. CLINICAL MANIFESTATIONS Clinical manifestations depend on several factors which include cause, severity, duration and type. General signs and symptoms include ; Coldness( temperature subnormal) Feeling faint Rapid thread y pulse , hypotension Pallor T hirst C yanosis Shock ( hypovolumeric ) Restlessness and anxiety Air hunger Haematoma Ecc h ymosis (bruising)

9. MANAGEMENT OF HAEMORRHAGE Assess , identify the source and severity of bleeding. Apply firm, direct pressure to the bleeding site with a clean cloth or bandage If possible, raise bleeding area above heart level to reduce blood flow Apply sterile dressing and secure with bandage or adhesive tape In severe bleeding , use haemostatic agents or dressings that promote clotting. Move patient to emergency room for severe haemorrhage. In cases of significant blood loss, administer intravenous fluids or blood transfusions in a medical setting . Treatment and control depends on severity and cause of haemorrhage

10. Drug Treatment Birth control pills Antifibrinolytic agents Desmopressin (DDAVP) Immunosuppressive medicines e.g prednisone Vitamin K supplements Monoclonal antibodies

11. CONCLUSION H aemorrhage is basically the escape of blood outside the vessel containing it . Blood loss results in fluid volume deficit and decreased cardiac output. It further results in reduction of circulating blood volume which is a primary cause of shock. Fluid replacement is imperative to maintain circulation therefore haemorrhage requires medical attention and can be deadly. It is important to correctly identify the type of haemorrhage and apply the proper method of arresting the haemorrhages.

12. REFERENCES Jun Teruya , Management of Bleeding Patients, 2 nd edition 2021 Edition Springer AB Johnson, National Institute of Health, 2022 Textbook of Stroke Medicine, 2 nd Edition , ed Michael Brainin and Wolf –Dieter Heisser