Haemorrhage from malignant wounds

A malignant wound (e.g. a neck mass/lymph node) may erode into a major blood vessel and cause severe bleeding 

If a patient has a deep wound near a major blood vessel it is essential to have emergency injections (e.g. morphine and midazolam) available to calm the patient and stabilise the situation. 

It is good practice to gently explore this with the patient and carer. They can be reassured that major bleeding is very rare.

For superficial wound bleeds

  • Tranexamic acid 500mg/5ml Ampule for injection should be soaked into gauze and applied with pressure for 10 mins
  • Adrenaline 1:1000 soaked on gauze to be used in the same way
  • Kaltostat wound dressing is the best option for an oozing wound

Having dark coloured towels available to mop up bleeding can reduce distress.

Haemostatic sprays and Celox hamostatic granules are proving very effective for constantly bleeding wounds which do not respond to the above treatments. 

Recommended Resources

West Midlands Palliative Care: Major Haemorrhage

Published 1st January 2025

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Related Services

Community Wound Care Team: Essex Partnership University Trust
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Community Wound Care Team: Essex Partnership University Trust

The team works with healthcare staff in all aspects of the prevention and management of acute and chronic wounds, with specific focus on those patients with hard to heal, complex and/or problematic wound care.

The Tissue Viability and Complex Leg Ulcer Services are part of the community service provided by this team.

Please compete the SystmOne referral form if available.

Referral form for clinician use only.

EPUT Community Wound Care Referral form (DOCX)

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