Initial assessment of acute haemorrhage

The assessment of the patient with acute blood loss may be conveniently divided into three phases. The first involves the recognition that acute blood loss has occurred. Further assessment of the site and magnitude of the blood loss will continue in parallel with resuscitation. The second phase of the assessment is the localising of the source or sources of bleeding to allow for control of continuing loss and to plan definitive therapy for the control of ongoing haemorrhage if necessary. The third phase of assessment is to estimate the quantity of blood and fluid loss to allow for the rational planning of resuscitation. The third phase is divided into two sections: the first is the initial assessment of the magnitude of the loss, the second the ongoing assessment of the patient's status as resuscitation proceeds. Successful resuscitation depends on repeated assessment of the patient while treatment proceeds.