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Internal Bleeding Symptoms

What are the Symptoms of Internal Bleeding?

Internal bleeding refers to blood loss occurring within a patient’s body. Because this happens inside the body (rather than on the outside), internal bleeds may go unnoticed for a period of time. If the bleeding is rapid, enough blood may accumulate to press on internal structures, or to form a bulge or discolored spot underneath the skin. Severe internal bleeding events can cause shock, loss of consciousness, and even death.

Symptoms of Internal bleeding may include:

  • Unexpected bleeding or unusually long lasting bleeding
  • Severe or uncontrollable bleeding
  • Pink or brown urine
  • Red or black stools
  • Bruises with unknown cause
  • Blood clots and coughing up blood
  • Blood in vomit or vomit with “coffee grounds” consistency
  • Unexpected pain, swelling, joint pain, headaches, dizziness, weakness

How is Internal Bleeding Treated?

Internal bleeding occurs when a patient suffers a rupture of an artery, vein or capillary. In some cases the bleeding is visible, other times it is not. Concealed bleeding is harder to diagnose than visible bleeding; therefore, if you are unsure, it is better to treat the patient as if they are losing blood internally. These signs may indicate internal blood loss and a shock response:

  • Skin appearance
  • Conscious state
  • Pulse
  • Respiration


If you are unsure as to the type of injury the patient has sustained, assume the worst and treat them for internal bleeding. Unfortunately, untrained medical personnel can not stop internal blood loss on their own; therefore, the goal of management is to slow down blood loss so the chance of survival is increased:

  • Call 9-1-1 immediately. Don’t wait to see if the person improves on their own
  • Check the patient’s airway, breathing and circulation. Begin CPR if necessary
  • If unconscious and breathing, place the patient in the recovery position with legs elevated above the heart
  • If the patient is conscious, lie them down and raise their legs if injuries permit
  • Keep the person warm. This may help prevent shock by minimizing heat loss
  • Reassure and stay calm. This helps provide a sense of security for the patient
  • Check pulse and breathing
  • Treat other injuries as needed

Do not give the person anything to eat or drink, as they may need surgery to stop the bleeding