4 Critical Steps to Take If You Suspect a Post-Accident Internal Injury

What Is Internal Bleeding?

Internal bleeding is blood that is being released from your organs or veins under the surface of your skin. Internal bleeding can be difficult to diagnose and hard for normal people to recognize. When you have internal bleeding, your blood is pooling in different body cavities, including the brain, the abdomen, and the chest cavity. The severity of your internal bleeding will depend on the type of injury, the location, and how long the bleed has been left undiagnosed.

Internal bleeding occurs when blood leaks from a damaged blood vessel or injured organ inside the body. The amount of blood loss, the location of the bleeding, and the effect on blood flow all influence how serious the injury becomes. Severe bleeding can lower blood pressure and prevent red blood cells from carrying enough oxygen to vital tissues.

4 Critical Steps to Take If You Suspect Internal Bleeding

1. Check for warning signs. After a crash, fall, or blunt force trauma, watch for dizziness, weakness, confusion, fainting, loss of consciousness, shortness of breath, chest pain, abdominal pain, severe abdominal pain, nausea, vomiting, unusual bruising, vomiting blood, coughing up blood, rectal bleeding, or blood in your stool.
2. Seek immediate medical attention. Internal bleeding can be life threatening. Seek medical attention right away after a car accident, slip fall, or other trauma if symptoms appear or worsen.
3. Ask about diagnostic testing. A doctor may check blood pressure, heart rate, breathing, bruising, abdominal tenderness, and other signs of internal injury. A CT scan is commonly used to check for internal bleeding in the head, chest, abdomen, or pelvis after trauma.
4. Monitor your symptoms after leaving the accident scene. Some injuries do not show up right away. Watch for low blood pressure, rapid heart rate, worsening pain, weakness, pale or clammy skin, confusion, shortness of breath, vomiting blood, black tarry stool, or bright red blood in the stool.

Causes of Internal Bleeding

The most common cause of internal bleeding due to an accident is blunt trauma. This is caused by an impact of some force on the body. In most cases, the cause of internal bleeding after trauma is due to broken bones. The different types of trauma include:

Common causes of internal bleeding after an accident may include car accidents, violent falls, slip and fall accidents, workplace accidents, sports injuries, broken bones, blunt force trauma, and penetrating trauma.

Blunt Trauma

• Blunt trauma often occurs when the body collides with another object with excessive force. In the case of a car accident, your body may hit the front dash in a collision. During a crash or blunt trauma, your blood vessels may become torn or crushed, resulting in internal bleeding.
• Blunt trauma is also called blunt force trauma. In a collision, the chest or abdomen may strike the steering wheel, dashboard, seat belt, airbag, ground, or another hard surface. This type of force trauma can cause a blood vessel to tear or crush, leading to bleeding inside the body.

Penetrating Trauma

• When a foreign object is forced into the body, causing damage to the blood vessels. This can happen in a car accident if a piece of metal were to puncture the body or during a fall.
• Penetrating trauma can damage tissue, blood vessels, or internal organs. It may cause internal bleeding, external bleeding, or both, and should be treated as a serious injury.

Other Possible Causes of Internal Bleeding

• This article focuses on post-accident internal injuries, but internal bleeding can also have non-trauma causes. Possible causes may include gastrointestinal bleeding, bleeding disorders, inflammatory bowel disease, Crohn disease, ectopic pregnancy, or use of nonsteroidal anti-inflammatory drugs. A doctor can help determine whether symptoms are related to trauma or another medical condition.

Common Symptoms of Internal Bleeding

Internal bleeding injuries can be anywhere from a minor incursion that will heal itself to a life-threatening condition. It’s important to be aware of any physical changes that you experience following an accident. The symptoms that you will experience when you have internal bleeding depend on where the injury is located. Let’s examine the symptoms according to their placement:

Common internal bleeding symptoms and internal bleeding signs can include:

• Dizziness, weakness, fainting, or loss of consciousness
• Rapid heart rate or a heart rate that feels unusually fast
• Low blood pressure, pale skin, sweating, or clammy skin
• Chest pain, shortness of breath, rapid breathing, or coughing up blood
• Abdominal pain, severe abdominal pain, swelling, or deep bruising
• Nausea, vomiting, or vomiting blood
• Blood in the stool, bright red blood, rectal bleeding, or black tarry stool
• Confusion, vision changes, severe headache, seizures, or weakness on one side of the body

Head Injuries

• If your brain is bleeding, it will often cause severe headaches, dizziness, vomiting, and nausea. Experiencing weakness on one side of the body is also common. Stay aware of vision changes that can indicate internal brain bleeding. If the bleeding is allowed to get worse, you may experience confusion, seizures, and loss of consciousness.
• Bleeding in the brain can become life threatening. Seek immediate medical care for severe headache, confusion, seizures, vision changes, weakness on one side of the body, or loss of consciousness after trauma.

Chest Injuries

• If you have injured your chest, blood can gather in the chest cavity, putting stress on your vital organs, including your heart. Internal bleeding in the chest can cause shortness of breath, pain, a gasping cough, and spitting up blood. If you are coughing up blood, you need to see an emergency doctor immediately. A small amount of blood, less than a teaspoon, is considered an emergency. Any more blood than a teaspoon that is coughed up could be a fatal injury.
• Bleeding around the heart can be fatal if not treated quickly. The additional pressure on the heart muscle can restrict it from beating normally. This condition, known as cardiac tamponade, can be fatal.
• Lung injuries include punctures and collapses; there is often excessive external bruising on the chest and the neck. The skin of the upper neck and abdomen may feel crinkly as it collects the oxygen that is meant for the lungs.
• Internal bleeding in the chest may cause chest pain, shortness of breath, rapid breathing, a gasping cough, or coughing up blood. These symptoms may indicate a life threatening condition and require emergency medical help.

Abdominal Injuries

• Internal bleeding in the abdomen can cause pain, bruising, and pain. Bruising along the flank may also indicate internal bleeding in the abdomen.
• When a doctor listens to the abdomen with a stethoscope and cannot hear bowel sounds, it is a good indicator of internal bleeding.
• Bleeding in the abdomen can result in blood in the esophagus and intestines, which can cause vomiting of blood or blood in the stool respectively.
• Internal bleeding in the abdomen can cause abdominal pain, severe abdominal pain, swelling, tenderness, deep bruising, or bruising along the flank. Bleeding in the abdominal cavity can involve internal organs such as the liver, spleen, stomach, or intestines.

Stomach, Digestive Tract, and GI Bleeding Symptoms

• Bleeding in the stomach or digestive tract is also called gastrointestinal bleeding or GI bleeding. Gastrointestinal GI bleeding may cause vomiting blood, blood in the stool, bright red blood from the rectum, rectal bleeding, black tarry stool, or symptoms that feel like internal bleeding in the stomach. Acute GI bleeding or upper GI bleeding can be serious and should be evaluated by a medical professional.

Bones and Joint Injuries

• Breaking a bone can result in internal bleeding. The most obvious sign is excessive bruising around the fracture. In some cases, the skin surrounding the fracture could turn pale and tight with a condition called compartment syndrome.
• Broken bones can damage nearby blood vessels and cause internal bleeding. Severe fractures may lead to swelling, bruising, pale skin, tight skin, or worsening pain, and should receive prompt medical attention.

Complications of Internal Bleeding

The loss of blood when there is internal bleeding can be anywhere from minor to fatal. In some cases, a minor case of bleeding will eventually stop and heal on its own. However, more serious cases can lead to serious conditions. Let’s take a look at some of the complications of internal bleeding.
Untreated internal bleeding is serious because ongoing blood loss can reduce blood flow, lower blood pressure, and deprive vital organs of oxygen. Severe internal bleeding may lead to shock, organ failure, or death if not treated quickly.

Shock

• When your body goes into shock, it is experiencing a lack of blood and oxygen to the vital tissues. When shock is caused by a loss of blood volume due to an internal injury it is referred to as hypovolemic shock. 
• Signs of shock include rapid heartbeat, sweating, and shallow breathing.
• Symptoms of shock may also include low blood pressure, pale or clammy skin, weakness, confusion, fainting, and a rapid heart rate. A heart rate that rises suddenly or stays unusually high in beats per minute after an accident can be a warning sign.

Organ Failure

• Vital organs like the liver and heart are more susceptible to a lack of blood. The tissues can quickly die when there is not enough blood flow and can cause organ failure.
• The heart, brain, liver, kidneys, and lungs depend on steady blood flow. When internal bleeding causes major blood loss, these organs may not receive enough oxygen, which can result in organ failure.

How Doctors Diagnose Internal Bleeding

• If a doctor suspects internal bleeding, they may begin by checking vital signs such as blood pressure, heart rate, breathing rate, and oxygen level. A physical exam may include checking the chest, abdomen, head, joints, bruising, and areas of pain. The doctor may also ask about the accident, the force of impact, your symptoms, and whether symptoms have changed over time.
• Diagnostic testing may include a CT scan, ultrasound, X-ray, blood tests, or other imaging. A CT scan can help identify bleeding in the brain, chest, abdomen, or pelvis. Blood tests may show signs of blood loss or changes in red blood cells. The exact tests depend on the injury, symptoms, and medical judgment of the treating provider.

Treatment for Internal Bleeding

• Treatment for internal bleeding depends on the cause, location, and severity of the bleeding. Minor bleeding may be monitored, while severe internal bleeding may require emergency treatment, medication, blood transfusion, a procedure to stop bleeding, or surgery. Doctors may also treat related injuries such as broken bones, organ damage, or chest and abdominal trauma.
• Do not try to treat suspected internal bleeding at home. Direct pressure may help stop external bleeding from an open wound, but it does not stop bleeding inside the body. If you suspect internal bleeding, seek medical care right away.

When to See a Doctor

If you are involved in an accident, it is crucial to allow yourself to be examined by on-site medical professionals. They will help you determine the severity of any injuries you may have, including the chance that you may have internal injuries. 

If you notice any of the signs that you have internal injuries discussed in this article, including pain, shortness of breath, dizziness, pain, and bruising, you should see a doctor as soon as possible.

Different types of trauma can cause internal injuries to the body. If you are involved in a car accident or violent fall, you may have hidden injuries that don’t show up right away. See your doctor if you suspect that you may have a post-accident internal injury.

Seek immediate medical attention if you notice signs of internal bleeding after an accident, including chest pain, shortness of breath, dizziness, severe headache, confusion, vomiting blood, blood in the stool, abdominal pain, severe abdominal pain, deep bruising, fainting, or symptoms of shock. If symptoms are severe or life threatening, call emergency medical services instead of driving yourself.

If new symptoms occur or existing symptoms get worse after you leave the accident scene, seek medical help immediately. Internal bleeding can occur even when there is no obvious external wound, and early treatment can help prevent serious complications.