Internal Bleeding and Abdominal Injuries

A closed wound normally occurs when a blunt object forcefully hits a part of the body but is unable to break through the skin’s surface results in tissue and blood vessels rupturing which can cause massive internal bleeding or hemorrhage.

In most cases, internal bleeding can be readily distinguished by bruise on the affected part of the injury. In rare cases, deep internal bleeding involving rupture organs may be difficult to identify because bruising might not be apparent. Nonetheless serious internal bleeding can be life threatening if not identified and cared for.

Recognizing Internal Bleeding

The signs of internal bleeding may appear immediately or might take several days to manifest. Common recognizable indications include:

• Bruising of injured area.
• Painful and tenderness of affected area.
• Vomiting or coughing of blood.
• Stool that can be either black or streaks of bright red blood.
• For massive internal bleeding the victim’s blood pressure will drop followed by shock if not properly diagnosed and cared for.

Care for Internal Bleeding

For minor internal bleeding such as a bruise on an extremity, follow the basic home remedy as follows:

1. Follow the R-I-C-E method (rest, ice pack, compress and elevate).
2. Apply ice or cold pack on the injured area for 15-20 minutes.
3. Compress the injured area by applying an elastic bandage for 3-4 hours a day.
4. Elevate the injured extremity if not fractured or within tolerated range of motion.
5. For suspected hemorrhaging, rush victim to a medical service provider for proper diagnostic procedure and management. 
   

Abdominal Injuries

Abdominal injuries can be classified as either open or closed. Closed abdominal injuries normally occur when the abdominal region is subjected to heavy blows such as a punch or kick or any form or assault. Open abdominal injuries include penetrating sounds, protruding organs and impaled objects wherein there is a break in the abdominal wall which holds various abdominal organs.

The risk of infection is often very high in open abdominal injuries mainly because of the possibility of a break in the intestinal mucosa which is full of bacteria that when introduced to the abdominal cavity could possibly result in systemic infection.

Recognizing closed abdominal injury

The common universal sign of this injury include bruises, pain, tenderness and muscle tightness of the abdomen.

Care for close abdominal injury

To care for close abdominal injury:

1. Place the victim in a comfortable position with the legs pulled up towards the abdomen.
2. If vomiting occurs place in the recovery position.
3. Care for shock. Initiate CPR in necessary.
4. Contact emergency care services or paramedics.
   

Recognizing a protruding organ

A protruding organ refers to a severe life threatening injury affecting the abdomen in which the contents of the abdomen escape and protrude from the wound. This form of injury is very dangerous and must be cared for immediately.

Care for a protruding organ

To care for protruding abdominal contents:

1. Place the victim in a comfortable position with the knees bent and the legs pulled towards the abdomen to help stabilize the abdominal pressure.
2. Cover the protruding organs loosely with a moist clean (preferably sterile dressing).
3. Initiate basic care for shock and active bleeding. Never apply direct pressure over the open wound.
4. Immediately call for emergency medical services for proper management and possible surgery.

Reference:

Alton, T. et al (2012). First Aid, CPR and AED Standard 6^th Ed. Jones & Bartlett Learning