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 : Eritropoesis Rubrisit 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 : good 2. 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 lose Class I II blood lose good with fluids treatment Class II III blood lose Good, blood transfustion + fluids treatment -- bad, if abondoned -- can cause a mortality