Internal Bleeding: Why You Should NOT Give Water & What to Do Instead

❌ Do NOT Give Water or Anything by Mouth

Giving fluids to someone with suspected internal bleeding is dangerous and contraindicated.

Why It’s Harmful

• Aspiration risk: Altered mental status from shock/blood loss → cannot protect airway.
• Surgical delay: Full stomach complicates emergency anesthesia (aspiration pneumonia risk).
• No benefit: Oral fluids do not replace intravascular volume; IV fluids/blood products are needed.
• May worsen bleeding: Theoretical concern—gastric distension could increase intra-abdominal pressure.

Recognize Internal Bleeding

Suspect if trauma (car crash, fall, assault) + any of:

• Abdominal pain, rigidity, distension, bruising (Cullen’s sign, Grey Turner’s sign).
• Vomiting blood (hematemesis) or coffee-ground emesis.
• Black, tarry stools (melena) or bright red blood per rectum.
• Vaginal bleeding (pregnant/postpartum).
• Signs of shock: pale/cool/clammy skin, rapid weak pulse, low BP, confusion, thirst, rapid shallow breathing.

Immediate Actions

1. Call 911 / Activate EMS.
2. Lay person flat (supine). Elevate legs 12 inches unless head/neck/spine injury or breathing difficulty.
3. Keep warm (blanket) to prevent hypothermia.
4. Monitor ABCs: Airway, Breathing, Circulation. Be ready for CPR.
5. Do NOT give anything by mouth.
6. Do NOT move unless scene is unsafe.

What EMS/Hospital Will Do

• Large-bore IV access ×2 → crystalloid bolus → blood products (PRBCs, plasma, platelets).
• FAST ultrasound / CT scan to locate bleed.
• Emergency surgery/interventional radiology (embolization) to stop hemorrhage.

Bottom Line

Internal bleeding is a time-critical surgical emergency. Your only job: call 911, keep them still and warm, nothing by mouth.