Bleeding

WHEN TO SEE YOUR DOCTOR

* You bleed heavily and persistently when you get a cut or wound.

* If blood is spurting, go to an emergency room.

What Your Symptom Is Telling You

Your stir-fry dinner was turned into a bedtime snack while you waited for your finger to stop bleeding after you cut it instead of the onion. And yesterday, you nearly missed your bus because a shaving mishap took a half-hour (and half a roll of toilet paper) before the blood was stanched.

Few of us escape our "slice of life"—whether it's from the knife in the kitchen, the razor in the bathroom or the blade in the workshop. But a lot of blood doesn't always mean a lot of damage.

"The face and scalp are heavily lined with small blood vessels and a shaving nick or a slight cut on the scalp can bleed profusely," says Kurt Kleinschmidt, M.D., director of the Emergency Medicine Program at Darnall Army Hospital in Fort Hood, Texas.

Normally, blood oozing from a minor cut soon stops by itself or with simple control measures. If bleeding seems to continue longer than usual, it may be because you've recently taken aspirin, a painkiller that also delays clotting. In fact, many stroke-prone people take aspirin to prevent abnormal clotting and to keep their blood thin and flowing. The downside is that it also keeps blood flowing from minor injuries. "Taking a single aspirin can interfere with clotting for up to two weeks," says Dr. Kleinschmidt.

You may also bleed excessively when you get a cut or wound if you're taking warfarin (an anti-clotting drug prescribed for heart problems) or vitamin E.

Other factors linked to abnormal or profuse bleeding include hormonal disorders and damage to internal blood vessels caused by an infection, an ulcer or gastritis.

Symptom Relief

Your doctor should evaluate any heavy or persistent bleeding so he can find the cause, says Dr. Kleinschmidt. This will also help prevent iron-deficiency anemia, which can result from heavy blood loss.

For the run-of-the-mill cut or nick, here's what you can do.

Press firmly. For any bleeding, press firmly and directly over the wound, using a clean cloth. "Pressure seals off ruptured blood vessels and allows natural clots to form faster," says Dr. Kleinschmidt. But don't lift the cloth for any reason—moving it will disturb the clotting mechanism. If blood seeps through the cloth, simply place another cloth on top of the soaked one and continue to apply pressure.

Once the bleeding has stopped for ten minutes, remove the cloth, cleanse the wound with soap and water, apply a dab of antibiotic cream and cover the wound with an airtight, adhesive bandage.

Take a deep breath. "The sight of blood—especially if there is lots of it—presses the panic button in some people," says Clorinda Margolis, Ph.D., clinical professor of psychology and human behavior at Jefferson Medical College of Thomas Jefferson University in Philadelphia. Taking several slow, deep breaths can reduce your panic and may even help wounds clot quicker, she says.

Avoid aspirin before surgery. "We advise people not to take aspirin for eight to ten days before surgery or a trip to the dentist," says Robert E. Clark, M.D., Ph.D., director of the Dermatologic Surgery and Cutaneous Oncology Unit at Duke University Medical Center in Durham, North Carolina. The same holds for vitamin E and other anti-coagulants. If you need to take a pain reliever, try acetamin-ophen. It doesn't block clotting.

Stock up on styptic pencils. Some people—such as those at risk for stroke—must take an anti-clotting medicine. For them, a shaving nick or nosebleed can turn into an endless leak. Styptic pencils can help save the day, says Dr. Clark. The active ingredients in these little white wands narrow blood vessels, tighten the skin and help speed the clotting of minor cuts.

Handle sharp objects with care. If you take an anti-coagulant, always keep first-aid kits or adhesive bandages wherever you use sharp utensils or tools. For prevention, wear protective gloves when using sharp objects such as hedge trimmers. "Wearing Playtex gloves may even be prudent when slicing vegetables," says Dr. Clark. And whatever you do, when you handle something sharp, don't rush. For example, take your time shaving your face or legs, especially when the razor rounds the jawbone or ankle bone, where nicks are more likely.