Patient Education Blog

Being on Blood Thinners: How Do I Know I am Bleeding?

Emily Hawes, UNC School of Pharmacy, writes… 

Patients on blood thinners are at increased risk for bleeding.  This can be easy to recognize external bleeding (bruising, bleeding from a cut, nosebleeds, etc.) or more occult internal bleeding.  Patients need to know how to recognize abnormal bleeding.  If any of the below signs of abnormal bleeding occur patients need to respond immediately and contact their physician, to avoid a delay in diagnosis.

These are the signs and symptoms patients should look out for:

  1. You may experience a very severe headache – the worst headache ever.  This may indicate a bleed into the head (around or into the brain).
  2. You may also have confusion, weakness, slurred speech, loss of vision, i.e. symptoms of a stroke.  This may also indicate a bleed into the head/brain.
  3. You may have heavy nosebleeds.
  4. You may vomit bright red blood or something that looks like coffee grounds.  This may come from a bleed in the food tube (esophagus) or stomach.
  5. You may have bowel movements that contain bright red blood or look dark, black, and tarry.
  6. You may have blood in your urine.
  7. You may have unusually heavy, frequent or long vaginal / menstrual bleeding
  8. You may have bleeding from your skin that does not stop after applying significant pressure or have abnormal bruising that does not improve over several days or continues to worsen.
  9. You may experience significant weakness, dizziness, shortness of breath, and low blood pressure.  This may indicate anemia, i.e. low blood counts due to significant blood loss.
  10. You may crave ice or want to eat chalk or clay.  This may reflect iron deficiency from chronic blood loss and anemia.

Last updated: Aug 17th, 2011

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