Exsanguination: How a Minor Accident Injury Could Lead to a Fatality

There are many reports about people who were walking and talking one minute after a car accident to suddenly losing consciousness and dying. People on the scene are caught off guard, perhaps including medics, because the victim did not complain about feeling severe pain but succumbed anyway. Alternatively, the patient could be so concerned about an excruciatingly painful wound like a broken bone and not realize something else is happening because all signs point to one particular injury upon which the patient and medical personnel must focus. Then, suddenly, the patient slips away seemingly without explanation and despite receiving appropriate medical care.

Car accidents, work-related accidents, and even falls can cause internal bleeding. One of the common internal injury mechanisms in car accident victims is internal bleeding from a ruptured blood vessel. A blood vessel can rupture from the violent restraint of a seatbelt locking or striking the torso on a hard object like the steering column. In those instances, the accident victim might tell someone that their chest hurts and that the pain is consistent with the seatbelt stopping the body. The patient might dismiss the pain by saying that he or she suffered a bruised sternum in the crash. While he or she might have correctly assessed his or her pain, under the contusion, a blood vessel tore open and is now leaking blood into the chest cavity.

“Exsanguination” is the medical term for dying from a catastrophic loss of blood. The volume of blood in our bodies depends on many factors, including gender, age, weight, and health. Generally, the volume of blood in our bodies is equal to seven percent of our body weight.

The body can lose nearly half of its blood supply, and the person could survive; however, once the blood loss reaches about fifteen percent of blood loss, the body will start to divert blood from the body’s extremities and pull it into the organs essential for survival. The process of diverting blood from outer or distal areas of the body to the more critical body parts is called hemorrhagic shock. Blood loss can occur quickly, and death can happen in a mere matter of minutes, especially if a large blood vessel ruptured.

Degrees of hemorrhagic shock fall into four categories, designated by the Roman numerals I through IV. Class I hemorrhagic shock will force a victim to feel slightly anxious. Class I hemorrhagic shock comes on with 15% blood loss. The patient will not necessarily act any differently than they usually would. A patient in Class II hemorrhagic shock will experience an increase in anxiety because the person’s blood pressure will decrease, the patient’s respiratory rate will increase, and the patient’s pulse will quicken.

Once the patient reaches Class III hemorrhagic shock, the patient is in grave medical danger. The onset of Class III hemorrhagic shock occurs when the patient’s blood loss reaches between 30 and 40 percent or 1,500 to 2,000 milliliters. The patient’s pulse will increase to a rapid pace of nearly 130 beats per minute while the person’s blood pressure decreases. At this time, anxiety increases, and the person begins to feel confused. With over 40 percent blood loss, the patient will start to be lethargic and feel cold because the body is pulling the blood into the center of the body. The victim’s pulse will exceed 140 beats per minute at this juncture.  Any blood loss up to and beyond 50 percent is fatal.

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Sources:https://www.symptoma.com/en/info/exsanguination#pathophysiology and https://www.healthline.com/health/how-much-blood-in-human-body#howmuch-blood-can-you-lose