It's easy to diagnose and treat bleeding you can see. But what do you do about bleeding you can't see? Though medical attention is usually required in this circumstance, even a lay person can assess immediate signs of internal hemorrhaging (bleeding) in a patient, perhaps helping to stave off problems on the way to the hospital or while waiting for the ambulance to arrive. It seems obvious, but someone who is suffering from internal hemorrhaging from an injured organ will often have pain in their abdomen. Sometimes this pain seems to move to their sides or back. Another sign is something called "referred pain," which means internal hemorrhaging in the abdomen may (oddly enough) cause severe pain in the shoulder or jaw. If you touch the abdomen of someone with internal hemorrhaging, they will often report that the pain increases. Sometimes the pain is only in one certain part of the abdomen. Other times the pain covers the entire area. Their stomach may feel hard or stiff, and the patient may flinch. A common sign in women who are suffering from internal hemorrhaging is vaginal bleeding. In younger women, this is often caused by ectopic pregnancy or other pregnancy-related complications. Another sign of internal hemorrhaging is a pulsating mass in the abdomen. This may be felt by the lay person if the patient is suffering from something called an abdominal aortic aneurysm. This is an extremely critical condition that requires immediate emergency care. Not all internal hemorrhaging is found in the abdominal area. When larger bones are broken, such as the upper arm or upper leg, patients can suffer internal hemorrhaging in the area of the broken bone. Broken ribs can also puncture organs and lungs, causing internal bleeding into the chest area. If you have a blood pressure cuff and a stethoscope, and you know how to use them, you can assess vital signs as a possible indicator of internal hemorrhaging. Someone who is bleeding internally will often have a lower blood pressure, and a higher pulse rate, than normal. Even people who don't have special equipment can check the pulse rate at the wrist or the neck of a person with internal hemorrhaging. Source
