Internal bleeding is fairly common after traumatic injury. Even relatively minor incidents where people have been struck by cars can cause internal bleeding.
Minor internal bleeding may stop by itself as the body's own defense system kicks in and clotting agents begin to work. However, even in cases where the actual injury is minor, every victim should be seen by a medical professional as soon as possible. Indeed, internal bleeding can often go unnoticed for hours or even days before more severe symptoms are noticed. By that time it may be too late for easy treatments to be effective. Surgery may be the only option left.
No two pedestrian accidents are the same and every victim should be treated as an individual. Indeed, the injuries you suffer after being hit by a car may be extremely different based on your personal history, medical records, physique, and body composition. That's why it's always imperative that every victim hit by a car seek medical attention immediately.
However, there are some common types of injuries EMTs and ER docs see after patients have been hit by a car and internal bleeding is one of them.
Internal bleeding occurs when tissue, an organ (or organs), or blood vessels are ruptured during impact. These ruptures may cause relatively minor bleeding or they may cause severe bleeding depending on the location and extent of the rupture.
Because the abdomen is where many of the vital organs reside, and because it's relatively unprotected by the musculoskeletal system, abdominal bleeding is common after pedestrian injuries. However, internal bleeding can occur anywhere in the body including:
There are two types of trauma that can create internal bleeding after being hit by a car:
These two types of physical trauma may create very different types of injuries that range in severity.
Blunt trauma occurs when the victim comes into contact with an object (a car's bumper, windshield, pavement, or roadside obstacle) which does not penetrate the skin. This impact puts tremendous pressure on the body and can cause significant deformities—like squeezing a rubber ball.
While many of the tissues inside your body are elastic (to some extent) this blunt force trauma often exceeds your body's natural ability to put itself back in order. This can result in internal tears of sensitive, blood-filled tissue. These tears can lead to either minor or significant internal bleeding after being hit by a car.
Often this type of injury either doesn't exhibit external symptoms at all or may exhibit symptoms the victim may mistake as unrelated to internal bleeding such as bruising, swelling, or unusual localized warmth.
Blunt trauma internal bleeding can often be difficult to repair because the wounds created aren't clean cuts, they're tears. This may result in severe organ damage, ragged internal wounds, and the inability of surgeons to pinpoint exact locations when it comes to bleeding.
Penetrating trauma occurs when a foreign object actually pokes through the skin. These types of injuries often occur during car accidents when sharp edges are present. These edges can be glass fragments, bent metal from the vehicle, or even roadside hazards like guard rails, tree limbs, and road signs.
These foreign objects can pierce or slice delicate internal tissues including organs and major blood vessels creating internal bleeding.
While these types of injuries are often easier to pinpoint, they may be extremely difficult to treat and often result in severe trauma and extensive blood loss.
It's important to look for the symptoms of internal bleeding after you've been hit by a car even if you've been seen by an ER doctor and are no longer in hospital. Due to the nature of internal bleeding, it may take hours or even days for these symptoms to arise. And any of these symptoms should be treated seriously, warranting another visit to the doctor.
These symptoms can range in severity from mild to severe but each should be treated with caution. If you’re a pedestrian who has been hit by a car, internal bleeding can be fatal.
While many people think that blood loss is the major risk factor due to internal bleeding, pressure build-up can cause serious injuries and death as well. Indeed, when blood is leaking into any body cavity (the chest, skull, or abdomen) the volume of liquid in that void will begin to press on tissue, organs, and blood vessels in that area as well. This increased pressure can be severe and even fatal—especially if it affects the brain, heart, or lungs.
This internal pressure is often called a silent killer because many victims don't even realize they're at risk. Sometimes symptoms of this internal pressure are noticed and mistaken for mild annoyances (such as headache or indigestion) instead of being treated as a potential warning sign.
Victims often choose to treat these symptoms themselves at home with pain medication (which could actually increase internal bleeding) and rest and only realize the danger they're in after it's too late.
In addition, if a person who has been hit by a car is suffering from internal bleeding, the total volume of blood they have available in their circulatory system may be significantly reduced. This can lead to serious even fatal hypotension.
Symptoms of seriously low blood pressure include:
If the internal blood loss continues, the blood pressure may drop to the point where the heart simply cannot pump enough to organs and the body will begin to shut down. If not corrected, this can lead to cardiac arrest, brain damage, and organ failure.
If you've been hit by a car and may be experiencing internal bleeding, your doctor can order an ultrasound or a CT scan. This can help them visualize the internal bleeding, hopefully, pinpoint the source, and plot a course of treatment.
Sometimes, when the bleeding isn't severe and doctors suspect that the body's natural healing process may be able to cope with it, they may simply hold patients for observation and treat them for hypotension (increasing fluids, monitoring heart rate, etc.).
However, if the bleeding is severe or is creating related problems (such as internal pressure) an active approach including surgery is the most common treatment.
The goal of these procedures is twofold: to stop the bleeding, and to reduce the pressure.
Sometimes this necessitates temporarily removing pieces of bone, opening the membranes that surround muscles (fasciotomy), and even exploratory surgeries.
If you've been hit by a car, internal bleeding can dramatically increase the overall cost associated with your recovery. While ER visits are costly, inpatient treatment, surgical procedures, and extended recovery can easily max out personal health insurance policies and leave victims wondering how they will ever pay their medical bills.
For example, many insurance policies have a co-pay for ER visits (around $100 on average). But that visit actually costs about $1,200 to $2,000 depending on the services needed. If victims with minor internal bleeding are admitted to the hospital for simple observation, an overnight stay in California can cost $2,600 or much more per night. If surgery is required, patients are looking at multiple charges from multiple service providers (including anesthesiologists, surgeons, etc.) and could be looking at well over $10,000-20,000.
Thankfully, California traffic law makes drivers legally responsible (thus financially liable) for the damages they cause through negligence or recklessness. That means that victims suffering from internal bleeding after being hit by a car can often seek compensation from the at-fault driver's insurance policy as well as their own. This allows injured individuals to worry less about finances and concentrate more on their physical recovery.
Regardless of the cost or the hassle, or the inconvenience you may associate with an ER visit, never neglect the signs of internal bleeding. While it's true that minor internal bleeding may heal itself, the risk of developing significant even fatal complications is extremely high. Always act on the side of caution and seek medical attention immediately.