Prophylaxis involves preventive care from injuries and diseases. This is contrary to curative or palliative care that is taken after a disease is contracted. Prophylaxis also encompasses inoculations, vaccinations and procedures followed to prevent disease, such as flossing teeth to prevent plaque. These preventive methods can be taken at individual or public health level.
Bleeding in general is an alarming sign to the body. Comprehensive analysis is taken into consideration in evaluating the appropriate cause of the bleeding. This enables a prophylaxis approach and also categorizes the type of bleeding into internal or external. Internal bleeding is associated with many pre-existing conditions. In many cases internal bleeding may occur because of a trauma caused in a particular region affecting a vital organ of the body.
Clinical signs and evaluations of internal bleeding
External bleeding has causes such as wounds, laceration or an injury. Internal bleeding is difficult to identify. It is necessary to identify the exact location and damage of the blood vessel be it an artery or a vein. The body's only responses to such damages are clot formation through platelet aggregation and also thrombus. This immediate response of the body is to prevent hemorrhage and hypoxia in the organ systems.
Many clinical parameters are evaluated in the emergency room to understand and identify the exact cause of the bleeding inside the body. In case of internal bleeding, patients are immobilized to avoid further damage. Underlying fractures and bone disruptions are evaluated in case of internal fractures. Body orifices should be administered with dressings to prevent blood loss and infection. Vital parameters such as oxygen saturation, blood pressure, and pupil analysis are done to evaluate hypoxia and heart rate in case of trauma. Neurological, cardiovascular, respiratory and musculoskeletal systems are examined for blood vessel damage and associated prominent complaints of pain.
After thorough examination of the patient and recording the history, radiological investigations are required to detect vital organ damage. Surgical interventions are required in case of fracture, brain hemorrhage and other adverse organ damage. In patients who are on anticoagulants and blood thinning medications, internal bleeding is imminent in case of trauma.
In case of internal bleeding associated organ damage, the predominant reason is the damage of blood vessels in the organ due to compression. Most common examples are abdominal injuries caused during sports such as football and wrestling. Head injuries are more common in sports associated with more physical contact such as martial arts and boxing. Other important reasons are shift in internal organs in case of trauma. Internal bleeding is directly associated with long term alcohol consumption as it affects the blood vessels of the hepatic portal system. The complications associated with internal bleeding are severe as they may lead to death of the patient. This happens when transfusion doesn't happen on time.
Splenectomy or spleen removal surgery is resorted only when there is no other choice but to remove the infected or damaged spleen. Splenectomy is also resorted to in case of cancers involving the spleen such as leukemia or Hodgin lymphoma, severe lupus or blood disorders such as sickle cell disease or thalassemia. Idiopathic thrombocytopenic purpura is a blood disorder that often necessitates spleen removal. Splenectomy can be done in traditional open style or by laparoscopic method. The spleen functions include making antibodies and removing antibody-coated blood cells. So a Splenectomy leaves a person with a compromised immune system. Post spleen removal, patients are at higher risk for infections and blood vessel complications. Antibiotic prophylaxis and yearly vaccines are prescribed.
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Bibliography / Reference
Collection of Pages - Last revised Date: June 20, 2019