Haemorhage Anemia

“ Decreased count of eritrosit ( Hb ) that cause of bleeding “

Diagnosis :1. Bleeding : - Inner : Mucosal bleeding, (

hematemesis, melena, hemaptisis, hematuria)

- Outer :Types of wound

2. Hemoglobin : Decreased,,, ( mild – severe )3. Peripheral blood smears :

#Acute --- Normochrom Normositer#Chronic – Hipochrom Mikrositer

4. Bone marrow smear : EritropoesisRubrisit Domination

5. Sign & Simptomps :– Dizzy, fatigue, lethargie, dispnoe, tachicardi– Syok hipovolemik, collapse

• Therapy : ( * BVE : 80 ml / Kg body weight ) Depens on the haemorhage degree ( ATLS )1. Class I : Blood loss : 0 – 15 % BVE ( Blood

volume Estimation ). Vital sign : good2. Class II : Blood Loss : 15 – 30 % BVE

treatment : - Tranfusion is not necessary - Kristaloid ( NaCl 0,9% or R.L )

3. Class III : Blood Loss : 30 – 40%treatment : - Cristaloid fluid resusitation

- Blood transfusion

4. Class IV : Blood Loss : > 40%treatment : - agresife resusitation --- Prevent

death

Complication :a) Effects arising immendiately

Cardiovascular reflex Arteriol constriction decreased blood flow to less vital organ. ( except : brain and heart )The symptomps depends on speed and numbers of blood lose.

b) Chronic affects ( after several hours )Movement fluids, from interstitial to intravascular

Hemodilusi --- * Leucositosis * Hb, Ht, Eritrosit * bone marrow hyperactive * cerebral disorders, miocard infarc

Prognosis :Depends on degree of speed and amout blood loseClass I – II blood lose – good with fluids treatmentClass II – III blood lose – Good, blood transfustion +

fluids treatment-- bad, if abondoned-- can cause a mortality