Internal bleeding (also called internal haemorrhage) is a loss of blood that occurs from the vascular system into a body cavity or space. It is a serious medical emergency and the extent of severity depends on:

  • Bleeding rate (hypovolaemic shock)
  • Location of the bleeding (damage to organs, even with relatively limited amounts: see specific chapters)

Severe bleeding in a body cavity/space is an emergency condition with unstable vital signs (e.g., ruptured spleen,
ruptured tubal pregnancy)


  • Invasive surgical intervention to control bleeding is life saving
  • Do not delay operation in attempt to stabilise the patient as this may not be achieved
  • Prompt resuscitation
  • Establish IV line and give fluids rapidly
  • Draw blood for grouping and cross matching for volume replacement after surgical haemostasis
  • Surgical intervention
    • Rapid sequence induction of general anaesthesia
    • Use drugs with minimal or no cardiac depression
    • Laparotomy to achieve surgical haemostasis