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"How would you know if you have internal bleeding?"

ZocdocAnswersHow would you know if you have internal bleeding?


I was running the other day and slipped and fell really hard. I don?t think anything is wrong other than some bruising and soreness, but my sister says I could have internal bleeding and not know it and die. How would I know if I have internal bleeding?


Bleeding from falls can be very serious, sometimes fatal. But this often does not take days or weeks. If you fell and have sustained serious internal injuries, serious bleeding can cause hemorrhagic shock and possible death in a matter of hours if not properly treated. It is especially true for patients who are on multiple medications including anti-platelets (Aspirin and Plavix) or anti-coagulation (Coumadin). You can not tell how much blood loss there is simply by examination alone unless it is in the extremities. Thus, a significant amount of blood loss can be hidden in different areas of the body (thighs, pelvis, abdomen, chest). Except for the thighs, it is necessary to get a CT scan or an ultrasound in order to diagnose bleeding in your body cavities. But often you may not even need all of these fancy work up if you do not have bleeding risks. A visit to the local emergency department is often sufficient for evaluation (vital signs and blood count) and monitoring. If your blood counts or your heart rate/blood pressure are of concern, then additional work up may be necessary to make sure you did not have serious internal bleeding. Blood can often cause pain in the abdomen but it is not always a reliable clue. Now this is all about significant blood loss causing shock. But even small amount of bleeding in the brain (so common with falls in patients on blood thinners) can be deadly, and those at risks should always seek medical attention for head injuries. I would recommend a consultation with a primary care doctor if you have any concerns.

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