|Bleeding from bodily orifices includes nosebleeds, bleeding from the ear, mouth, vagina, anus, and urethra. It may be an indication of a serious disorder.
Nosebleeds are very common and often the cause is unknown. For general treatment of uncomplicated nosebleed, see How to Treat Nosebleeds, page 89, and Controlling bleeding from the Mouth and Nose. If a bleeding follows heavy impact to the nose, then assume that there may be a broken nose or cheekbone.
If there is blood loss from the ear, keep the victim as still as possible and rest the head with the injured side down, with a clean pad held over the ear into which blood can drain.
BLEEDING FROM THE EAR
If the blood from the ear is thin and watery then it is likely that there has been some damage to the skull, and possibly the brain, since the blood is mixing with the fluid that cushions the brain. This is a very serious injury and 911 should be called as soon as possible. Keep the victim as still as you can and gently rest the head, injured ear down, with a clean pad held over the ear for the blood to drain into. Do not tie this pad in place. Keep a check on the victim’s airway and breathing and be prepared to resuscitate if necessary.
If the blood is bright red and is accompanied by earache, deafness, a sudden change in pressure, or an expulsion then it is likely to be burst eardrum. Again, keep the injured ear downward, hold a clean pad in place, and seek medical attention.
BLEEDING FROM THE MOUTH
If the bleeding from the mouth follows a direct impact to the face it is likely the bleeding has been caused by damage to the teeth, gums, or tongue. There may also be damage to the jaw and cheekbones. Bright red and frothy bleeding from the mouth may be a sign of damage to the lungs.
Dark red blooding being coughed up from the mouth may be a sign of a burst stomach ulcer. Seek urgent medical attention.
BLEEDING FROM THE VAGINA
The most likely reason for vaginal bleeding is menstruation (a Period). If it is the case and the bleed is accompanied by cramps then woman may wish to take her normal analgesics.
A woman complaining of vaginal bleeding not related to her periods should be given privacy and sensitive handling, with gentle questioning to determine the cause. For all vaginal bleeding, provide sanitary pads or a clean towel where possible. Where the bleeding is potentially pregnancy-related, do not dispose of old pads of any blood loss. Instead, move these discreetly away from the woman to be checked by medical staff.
Bleeding in an early pregnancy may be an indication of a miscarriage, but there are number of other potential causes. Make the woman comfortable and seek advice from her midwife or doctor. If the bleeding is severe and/or she is displaying signs of shock call 911.
In later pregnancy a bright red, painless bleed may indicate a serious problem with the placenta. Make the woman comfortable, call 911 and treat for shock.
If the bleeding is as result of an accident or recent assault, call 911 and treat for shock.
A woman with vaginal bleeding needs to be treated sensitively. Provide clean towels or sanitary pads, and keep these for medical staff to check if you suspect a miscarriage.
HOW TO TREAT NOSEBLEEDS IN ADULTS
1. Lean forward and split blood into a handkerchief or some other receptacle.
2. Pinch the nose just below the bone and apply firm pressure for 10 minutes (this is the amount of time it takes for a clot to form). If the bleeding has not stooped after 10 minutes, apply pressure for two further periods of 10 minutes. If it still bleeding then either take or send the victim to hospital.
Once the bleeding has stopped, advise the victim not to scratch, pick, or blow his nose, not to drink hot liquid, and not to exert himself, as all these activities can dislodge the clot and cause the bleeding to start again.
BLEEDING FROM THE ANUS
Bleeding from the anus may be bright red and fresh looking. If it follows a recent accident, this may indicate injury to the anus or lower bowel. Treat for shock as appropriate and seek medical help.
Black, tarry blood has been partially digested and indicates a potential injury to the upper bowel. Again, treat for shock as appropriate and seek medical help.
BLEEDING FROM THE URETHRA
Blood in the urine, particularly following an accident, may indicate injury to the bladder, kidneys, or other internal organs. It may also accompany a broken pelvis where the bone has damaged the bladder. Treat for shock as appropriate and seek medical help as quickly as possible. There is no way of determining the seriousness of the situation until it is in expert hands.