<P> Some protocols call for the use of clotting accelerating agents, which can be either externally applied as a powder or gel, or pre-dosed in a dressing or as an intravenous injection . These may be particularly useful in situations where the wound is not clotting, which can be due to external factors, such as size of wound, or medical factors such as haemophilia . </P> <P> Recombinant factor VIIa (rFVIIa) is not, as of 2012, supported by the evidence for most cases of major bleeding . Its use brings a significant risk of arterial thrombosis, and therefore it should only be used in clinical trials or with patients with factor VIIe deficiency . </P> <P> Internal wounds (usually to the torso) are harder to deal with than external wounds, although they often have an external cause . The key dangers of internal bleeding include hypovolaemic shock (leading to exsanguination), causing a tamponade on the heart or a haemothorax on the lung . The aortic aneurysm is a special case where the aorta, the body's main blood vessel, becomes ruptured through an inherent weakness, although exertion, raised blood pressure or sudden movements could cause a sudden catastrophic failure . This is one of the most serious medical emergencies a patient can face, as the only treatment is rapid surgery . </P> <P> In the event of bleeding caused by an external source (trauma, penetrating wound), the patient is usually inclined to the injured side, so that the' good' side can continue to function properly, without interference from the blood inside the body cavity . </P>

Management of simple injuries and emergencies during bleeding