What to know about different types of bleeding

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Arterial bleeding is the most severe and urgent type of bleeding. It can result from a penetrating injury, blunt trauma, or damage to organs or blood vessels.

Because the blood comes from the arteries, it is distinctive from the other types of bleeding. For example, the blood is bright red due to it containing oxygen. It also comes out in spurts and pulses, which correlate to the beats of the heart.

This type of bleeding can be hard to control because the pressure from the beating heart means that it will not clot or stop as easily.

Treatment may involve the following:

1. The initial step is to put pressure over the wound causing the bleeding with a latex-gloved hand and sterile gauze. It is also important to contact an emergency number to get medical help.
2. If this stops the bleeding, the next step is to cover the wound with a sterile gauze dressing and bandage to continue to exert pressure on the wound.
3. When the bleeding comes from an artery in the arm or leg, it may help to elevate the body part above the level of the heart.
4. If all efforts to stop the bleeding fail, the last resort involves applying a tourniquet above the bleeding wound.

Learn how to apply a tourniquet here.

Venous bleeding is less severe than arterial bleeding, but it can still be life threatening. For this reason, it requires immediate medical attention.

As the blood is coming from a vein, it is dark red. This is because it does not contain as much oxygen. Also, because veins are not under direct pressure, the blood flows steadily but comes out less forcefully than it does with arterial bleeding.

Treating venous bleeding involves the same procedures as treating arterial bleeding.

Capillary bleeding typically happens due to injury to the skin, and it is much more common than the other types. Instead of spurting out, as in arterial bleeding, or flowing out, as in venous bleeding, it oozes from the damaged body part.

Not only is capillary bleeding the least severe, but it is also the easiest to control because it comes from blood vessels on the surface rather than from deep inside the body.

Treatment typically involves the following:

1. The initial step is to cleanse the wound with soap and water or a cleanser that is nontoxic to the cells.
2. The wound may need irrigation under pressure to remove contaminants, which will help prevent infections.
3. The final step is to apply pressure with a latex-gloved hand and sterile dressing. Typically, pressure is sufficient to control the bleeding, and the additional steps that a doctor may use to stop arterial or venous bleeding are not necessary.

External bleeding refers to bleeding that flows out of the body. Examples include nosebleeds and bleeding from a minor skin cut.

Internal bleeding refers to bleeding that occurs inside the body. This can happen following damage to an organ or an internal body part.

Sites where internal bleeding commonly occurs include the hip, knee, elbow, and ankle joints. Internal bleeding may also occur in the brain, large muscles, intestinal tract, or space surrounding the lungs.

Minor internal bleeding is common and may only produce small, red specks on the skin or minor bruising.

However, severe internal bleeding can be life threatening. This is typically due to a person losing a significant volume of blood and experiencing hypovolemic shock, or, specifically, hemorrhagic shock.

Symptoms of internal bleeding can vary depending on the location of the bleeding and may include the following.

Intracranial bleeding

This occurs when a blood vessel inside the cranium, or skull, ruptures and bleeds around or into the brain. It usually is due to long-term high blood pressure, which causes weakening of the arterial walls.

Symptoms can include:

• weakness on one side of the body
• nausea
• vomiting
• headache
• a change in mental status

Pleural cavity bleeding

The pleural cavity is the space surrounding the lungs. When bleeding occurs here, it interferes with normal lung expansion, which can affect the transfer of oxygen and carbon dioxide between the lungs and the blood.

Symptoms can include:

• chest pain
• shortness of breath
• dizziness

Abdominal bleeding

This refers to bleeding in the large cavity of the torso, which contains organs such as the stomach, liver, and kidneys.

Some common causes of bleeding inside the abdomen may include:

• damage to the liver, kidneys, or spleen
• damage to a blood vessel in the abdomen
• rupture of a cyst

Signs and symptoms may include:

• low blood pressure
• abdominal pain
• vomiting blood
• fainting
• blood in the urine
• abdominal bruising

Bleeding from bone fractures

Bones feature an extensive network of blood vessels. This means that sustaining a bone fracture can result in life threatening bleeding — particularly if the fracture occurs in a long bone, such as the humerus, radius, ulna, femur, fibula, or pelvis.

Bleeding from the gastrointestinal tract

Bleeding from the gastrointestinal tract has many possible causes, such as a tumor or inflammation of the colon, stomach, or esophagus.

Symptoms may include:

• stomach cramps
• black, tarry stools
• vomit that looks like coffee grounds
• bright red vomit
• feeling faint
• shortness of breath

The American College of Surgeons (ACS) states that uncontrolled bleeding is the top cause of preventable death following an injury.

The ACS provides the below first aid recommendations for treating bleeding from an injury:

• Call 911 or another emergency number.
• Remove the person’s clothing to find the source of the life threatening bleeding.
• If someone does not have a first aid kit, cover the wound with a cloth and apply pressure with both hands. The cloth could come from a bystander’s shirt.
• If a first aid kit is available and an arm or leg is bleeding heavily, apply a tourniquet.
• If a tourniquet is not available — or if the bleeding is coming from the groin, neck, or shoulder — pack the wound with a cloth and apply steady pressure.

If a person is experiencing severe external bleeding, it is important to apply first aid and seek immediate medical help.

If a person suspects internal bleeding, they should also seek medical help to prevent shock or death.

Regardless of the type of bleeding or injury someone has, if the bleeding is severe, a person should contact emergency services or go to an emergency room.

There are three main types of bleeding: arterial, venous, and capillary bleeding. These get their names from the blood vessel that the blood comes from.

Additionally, bleeding can be either external, such as what comes from a minor skin scrape, or internal, such as what comes from an injury to an organ or bone.

Heavy bleeding is a life threatening emergency that can cause shock and death. If a person experiences a severe external bleed or suspects internal bleeding, it is vital that they receive immediate medical treatment. First aid can help slow the bleeding and prevent severe complications and death.