Blood-thinning medications, which include anticoagulants and antiplatelets, are a necessary therapy for millions of people at risk of dangerous blood clots. These drugs function by interfering with the body’s natural coagulation process, significantly impairing the body’s ability to stop bleeding. This means even minor injuries can turn into potentially serious events. Managing bleeding in a person taking these medications requires specific, urgent, and prolonged first aid attention. This information is intended solely as a guide for immediate first aid and is not a substitute for professional medical advice; always call 911 or your local emergency number for severe or uncontrolled bleeding.
Immediate Steps for External Wounds
When an external injury occurs, the immediate priority is to control the blood loss from the visible wound. Begin by gently cleaning the wound area with water or an antiseptic wipe only if the bleeding is minor and easily controlled. For any wound that is actively bleeding, immediately cover the area with a clean cloth, sterile gauze, or a thick bandage.
The most effective technique for controlling external bleeding is the continuous application of direct pressure. Use the palm of your hand to press down firmly and evenly on the material covering the wound. Individuals on blood thinners require a much longer period of uninterrupted pressure than standard first aid to allow the altered clotting factors time to work.
Maintain this firm, continuous pressure for a minimum of 15 to 20 minutes without lifting the material to check the wound. If blood soaks through the initial material, do not remove it, as this can disrupt any nascent clot formation. Instead, apply additional layers of cloth or gauze directly over the existing ones and continue pressing firmly.
If the injury is to an arm or leg, elevate the limb above the level of the person’s heart while maintaining the direct pressure. Raising the wound helps to reduce the blood pressure in the injured area, which slows the rate of blood loss. After the initial 15 to 20 minutes, if the bleeding has slowed but not stopped, you may consider using a pressure dressing to maintain compression.
A pressure dressing involves wrapping a bandage tightly over the gauze or cloth to secure it in place. If the wound is gushing blood, is very deep or dirty, or if the bleeding cannot be stopped after 20 to 30 minutes of continuous pressure, seek emergency medical attention immediately. These criteria indicate that the wound requires professional closure and potentially the temporary reversal of the anticoagulant effect.
Recognizing and Responding to Internal Bleeding
Internal bleeding is a distinct and often more dangerous risk for people on blood thinners, as it may not present with obvious external signs. A head injury, even a minor bump or fall, is particularly concerning due to the risk of intracranial bleeding. Symptoms may include a severe or persistent headache, unusual confusion, difficulty speaking, severe dizziness, or nausea and vomiting after the incident.
Bleeding in the gastrointestinal tract can also be silent but is often indicated by changes in bowel movements or vomit. Look for black, tarry-looking stools, which suggest digested blood from the upper GI tract, or bright red blood in the stool. Vomit that resembles coffee grounds, or is bright red, is a sign of acute stomach or esophageal bleeding.
General signs of internal blood loss, regardless of location, are the body’s response to a sudden drop in blood volume. The injured person may experience unexplained severe pain in the abdomen, joints, or back. Other indicators include pale or clammy skin, a rapid or weak pulse, and general weakness or dizziness.
Any suspicion of internal bleeding, such as a severe fall, a significant blow to the torso, or the onset of any of the above symptoms, requires an immediate emergency response. Call 911 or proceed directly to the nearest emergency department. Do not wait for symptoms to worsen, as rapid medical evaluation is necessary to locate the source of the bleeding and, if necessary, administer medications to temporarily reverse the effects of the blood thinner.
Post-Injury Care and Monitoring
Once the immediate bleeding has been controlled or emergency care has been sought, ongoing monitoring and follow-up are necessary. While minor bruising is a common side effect of blood thinners, a rapidly expanding bruise or one that is unusually large, known as a hematoma, should be watched closely. Contact a healthcare provider if a bruise appears suddenly, causes significant pain, or seems to be growing quickly in size.
It is important to inform the prescribing physician or the anticoagulation clinic about the injury, even if it seemed minor. The doctor may need to review and temporarily adjust the blood thinner dosage or schedule, especially after a significant injury like head trauma. In cases of serious internal bleeding, physicians must carefully weigh the risk of further bleeding against the risk of forming a life-threatening blood clot if the medication is stopped.
For external wounds that were successfully managed at home, ensure the area is kept clean and dry to prevent infection. Any signs of infection, such as increased redness, swelling, warmth, or pus, warrant a call to the primary care physician. Close follow-up ensures that the balance between preventing clots and minimizing bleeding risk is maintained during the recovery period.