Internal Bleeding

Is bleeding which occurs inside the body. Sometimes the blood will leak from inside the body through natural openings. Other times the blood stays inside the body, causing pain and shock, even though you cannot see the blood loss.


Internal bleeding can be caused numerous ways. Any time someone could have internal bleeding, you will do no harm by treating them for internal bleeding, but not treating the victim could lead to death.

Some causes include:

  • Falls
  • Car Accidents
  • Motorcycle Accidents
  • Pedestrians Struck by a Vehicle
  • Gun Shot Wounds
  • Injuries from Explosions
  • Impaled Objects
  • Stab Wounds
  • Surgery


A person may be bleeding internally if one of these things happens:

  • Blood comes out of the nose or mouth (occurs from severe head trauma)
  • Blood or clear fluid comes out of the ear (occurs from severe head trauma)
  • Blood is in the stool
  • Blood is in the urine
  • Bright red blood, or blood like ‘coffee-grounds’, is in the vomit
  • Bruising over the abdominal or chest area
  • Pain over vital organs
  • Fractured femur

But remember, a person may be bleeding inside the body, even though you cannot see the bleeding. If you see the signs of shock and no apparent injuries, always suspect internal bleeding. Check the skin color changes. In cases of internal bleeding the skin may become pale and cold, and cyanosis may be present.


As with any victim, before treating, put on disposable gloves if possible and take other necessary body substance isolation precautions.

  • Call 911
    • If the victim has ABC complications, treat those first – CPR always has priority.
  • Check the victim’s vital signs
  • Administer CPR if necessary
  • Treat for shock
    • Assist the victim into the most comfortable position
  • Monitor ABCs and vitals until the ambulance arrives
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