How do you know if you have a haemorrhage?

September 23, 2025 •

4 min read

While the signs of external bleeding are often obvious, internal haemorrhages can be harder to detect, making a timely diagnosis critical for survival. Knowing the specific symptoms associated with different types of haemorrhages is essential for recognizing a medical emergency and seeking immediate help.

Quick Summary

Recognizing a haemorrhage, or bleeding, depends on whether it is internal or external, with symptoms ranging from visible blood loss to more subtle indicators like dizziness, rapid heart rate, or unexplained bruising, which all warrant medical attention. The specific location, such as the brain or abdomen, will produce different signs, making a proper diagnosis crucial for effective treatment.

Key Points

Internal vs. External Bleeding: Haemorrhages can be internal (bleeding inside the body) or external (bleeding from a visible wound or orifice), and symptoms differ significantly depending on the location.
Hidden Dangers of Internal Haemorrhage: Internal bleeding can be subtle, with signs like unexplained bruising, dizziness, confusion, or a rapid heart rate, which may signal a medical emergency.
Critical Signs of Brain Bleed: A sudden, severe headache is a hallmark sign of a subarachnoid haemorrhage and requires immediate medical attention.
First Aid for External Haemorrhage: For severe external bleeding, apply direct, firm pressure to the wound with a clean cloth while seeking emergency help.
Hemorrhagic Shock Awareness: The loss of significant blood volume, either internally or externally, can lead to shock, characterized by a rapid pulse, low blood pressure, and clammy skin.
Professional Diagnosis is Essential: Imaging tests like CT scans or MRIs are often necessary to diagnose internal bleeding accurately and determine the cause.
When in Doubt, Seek Help: Since internal bleeding can be life-threatening, it is always best to seek professional medical attention if a haemorrhage is suspected, rather than waiting for symptoms to worsen.

Understanding Haemorrhages: A Critical Health Issue

Haemorrhage is the medical term for bleeding, which can occur either internally or externally, and can range from minor to life-threatening. Identifying a haemorrhage requires paying close attention to your body’s signals, as the symptoms differ greatly depending on the location and severity of the bleed. While external bleeds from visible cuts are usually easy to spot, internal bleeding can be much more insidious, with symptoms developing gradually and sometimes pointing to a severe underlying issue. Recognizing these warning signs quickly is paramount for a positive health outcome.

Symptoms of External Haemorrhages

External haemorrhages occur when blood flows out of the body through a break in the skin or a natural body opening. The severity can vary, but key indicators make it easier to identify. Visible bleeding is the most obvious sign, but you must also consider the volume and rate of blood loss. Arterial bleeding, for example, is bright red and spurts in time with the heartbeat, indicating rapid, significant blood loss. In contrast, venous bleeding is a steady flow of darker red blood, and capillary bleeding is a slow ooze.

Visible Blood Loss: This can be from a wound, or from natural orifices like the nose (epistaxis), mouth, rectum, or vagina.
Blood that Won’t Clot: If you apply pressure to a wound and the bleeding does not slow or stop, it may indicate a more severe issue.
Foreign Object: If an object is embedded in a wound, it can be a sign of significant trauma and bleeding.
Significant Bruising or Haematoma: A large, visible bruise, or haematoma (a swelling of clotted blood within the tissues), indicates a haemorrhage under the skin.

Recognizing Internal Haemorrhages

Detecting internal bleeding is often more challenging because the blood is not visible and the symptoms can be vague or mimic other conditions. The signs depend heavily on where the bleeding is occurring. In severe cases, significant blood loss can lead to hemorrhagic shock, a life-threatening condition.

Internal bleeding in specific areas of the body presents with distinct symptoms:

In the Head (Intracranial Haemorrhage): A sudden, severe headache—often described as the "worst headache of your life"—is a primary warning sign. Other symptoms can include confusion, dizziness, nausea, vomiting, seizures, or weakness/numbness on one side of the body.
In the Chest (Hemothorax): Difficulty breathing, chest pain, and coughing up blood can point to bleeding in the chest cavity.
In the Abdomen (Hemoperitoneum): A swollen, tight, or tender abdomen, unexplained bruising around the abdomen, and blood in the vomit, urine, or stool are key indicators. The stool may appear black and tarry, indicating upper gastrointestinal bleeding.
In the Joints and Muscles: Swelling, pain, and extensive bruising can occur from internal bleeding in these areas, often following an injury.
General Signs of Shock: As blood volume decreases, the body may go into shock. This can be indicated by rapid heart rate, low blood pressure, pale and clammy skin, confusion, and dizziness.

Diagnosis and Medical Intervention

Diagnosing a haemorrhage, especially an internal one, requires professional medical evaluation. Healthcare providers rely on a combination of physical exams, patient history, and diagnostic tests to confirm a haemorrhage and determine its cause and location.

Initial Assessment: A doctor will review your symptoms, vital signs, and recent medical history, especially any recent injuries or use of blood-thinning medications.
Imaging Tests: To locate internal bleeding, doctors may use computed tomography (CT) scans, magnetic resonance imaging (MRI), or ultrasounds. For example, a CT scan is highly effective at detecting bleeding in the brain.
Blood Tests: Laboratory tests can check for low blood cell counts or other clotting abnormalities that may indicate internal bleeding.
Other Procedures: In some cases, a cerebral angiogram may be used to visualize blood vessels in the brain, or a spinal tap (lumbar puncture) may be necessary to check for blood in the spinal fluid.

Comparison of Internal vs. External Haemorrhage Indicators


Indicator	External Haemorrhage	Internal Haemorrhage
Visible Signs	Bleeding from an open wound or orifice (nose, mouth, rectum).	Bruising, swelling, or blood in vomit/stool.
Primary Location	Outside the body, from a wound or opening.	Inside body cavities or tissues (e.g., abdomen, brain, chest).
Level of Obviousness	High, often immediately apparent.	Can be low, developing gradually over time.
Associated Pain	Can be localized to the wound site.	Can be widespread, severe, and may worsen.
Signs of Shock	Can be present with significant blood loss, alongside visible bleeding.	Often one of the first and most critical signs, as blood loss is not immediately apparent.
Emergency Urgency	Varies, but severe bleeding requires immediate attention.	Always requires immediate medical attention due to hidden nature.

When to Seek Emergency Medical Attention

Any suspected haemorrhage, especially an internal one, should be treated as a medical emergency. Delaying treatment can have fatal consequences. If you notice any of the severe or general signs mentioned above, particularly following an injury, it's critical to act fast. For minor external bleeding, first aid steps like applying direct pressure and elevating the affected area are appropriate, but major, uncontrolled bleeding requires professional intervention. Always consult a healthcare professional if you are unsure about the nature or severity of bleeding. Further information on emergency first aid for severe bleeding can be found on authoritative sites like The American College of Surgeons' Committee on Trauma.

Conclusion

Knowing how to recognize a haemorrhage is a crucial health skill that could save a life. While external bleeding is often straightforward to identify, internal bleeding requires careful observation of more subtle and widespread symptoms. From the sudden, severe headache of a brain bleed to the rapid pulse and clammy skin indicating shock, awareness of these signs is the first step toward receiving timely medical care. Always prioritize immediate medical help for any suspected severe haemorrhage to ensure the best possible outcome.

Frequently Asked Questions

A haemorrhage can feel very different depending on its location and severity. External bleeding is visible, while internal bleeding might cause pain at the site of the injury, abdominal swelling, dizziness, headache, or confusion.

Signs of internal bleeding are not always obvious but can include fatigue, dizziness, weakness, nausea, abdominal pain, a swollen abdomen, or the presence of blood in your urine, stool, or vomit. These symptoms, especially after a trauma, should prompt an immediate medical evaluation.

A subarachnoid haemorrhage, or bleeding around the brain, is known for causing a sudden, severe headache that people often describe as the "worst headache of their life." This is a critical medical emergency.

A haemorrhage is the general term for bleeding from a damaged blood vessel. A haematoma is a specific type of haemorrhage where blood has clotted and pooled within the tissues, creating a noticeable lump or swelling.

Yes, medications like anticoagulants and antiplatelets can increase your risk of bleeding and can lead to a haemorrhage. It is important to inform your doctor about all medications you are taking, especially before any surgery.

Doctors diagnose a haemorrhage by assessing your symptoms and conducting tests. For internal bleeding, they often use imaging techniques like CT scans or MRIs. They may also order blood tests to check for specific markers.

Minor external bleeding may stop with first aid, but for severe external bleeding or any suspected internal bleeding, you should seek emergency medical attention immediately. Waiting could lead to life-threatening complications.