Hemorrhage Types and Treatment

Technically, hemorrhage (or haemorrhage) means bleeding, of any amount.

In the medical community, the term is reserved for significant or severe bleeding, which may be life-threatening. Bleeding can occur from any body orifice, such as the mouth, ears, or anus, but can also occur from trauma such as a deep cut. Taking blood thinning medications, such as coumadin or heparin, can increase the risk of bleeding significantly, making it difficult to control bleeding if the wound or problem is significant.

Categories and Severity

In medicine, hemorrhage is categorized by how severe it is. For comparison purposes, donating blood typically means a loss of 5-10% of total blood volume, which the body can typically handle without difficulty.

Category 1: Up to 15% of total blood has been lost. No treatment is typically needed. Minor bleeding, such as an easily controlled nosebleed, cut or other types of injury.

Category 2: 15-30% blood loss. Typically requires IV fluid, and may produce fatigue, lightheadedness, and paleness. A more serious injury or disease process is usually responsible for this type of blood loss, but it may happen with minor injuries when the bleeding is difficult to stop.

Category 3: 30-40% blood loss. Requires medical attention and may require fluids and transfusion with donated blood. The patient may become combative, irritable, confused, weak, fatigued, tired, and pale.

Category 4: More than 40% blood loss. Requires aggressive emergency medical treatment with both blood replacement and fluids given IV. A life-threatening condition, medical attention must be sought immediately and blood loss must be stopped for the patient to survive.

An individual who is a Category 1 may eventually become a Category 4 Hemorrhage if medical attention is not sought. It is important to seek treatment for bleeding quickly, rather than waiting for bleeding to stop. Even bleeding as minor as a nosebleed can become very serious if the bleeding continues for longer than 20-30 minutes.

Patients who are on a blood thinner should be aware that bleeding can be very challenging to stop at home and be prepared to seek treatment if they sustain a wound, even if the wound seems minor. As a general rule, bleeding that cannot be stopped, even minor bleeding, should result in medical attention. 

Patients Who Do Not Accept Blood Products

Some religions prohibit transfusions, for those individuals, other methods may be used to control bleeding and support the body while more blood is slowly made. For individuals who are planning surgery but cannot have a transfusion from another person, blood may be banked in preparation for the possibility of bleeding. This is often referred to as "bloodless surgery."