Exsanguination

of blood (enough for one blood transfusion). If an average adult loses 5 to 8 times this much blood, they could die from exsanguination.]]

**Exsanguination** is losing enough blood to cause death. A person does not have to lose all of their blood to **exsanguinate**. People can die from losing half to two-thirds of their blood.

## Overview
The average adult has about 4 to 6 liters of blood (9 to 12 US pints) in their body. The average man has more blood than the average woman (who has 4 to 5 liters), and people who weigh more or are taller than others have more blood.

Babies (have about one cup of blood) and children have much less blood than adults, and can exsanguinate much easier by losing less blood than adults. The liver can and does store up to one pint of blood. Exsanguination is often called **bleeding to death** or **bleeding out**. It is a medical emergency.

## Definition
Doctors define exsanguination this way:

* The patient is still losing blood
* The bleeding is so bad that if it is not stopped quickly, the patient will die
* The patient has lost over 40% of their blood (2 to 2.4 liters in an average adult)

## Types
Bleeding can be *external* or *internal*. Up to half of these people (33-56%) die before they even get to the hospital. It is usually caused by gunshot wounds, motor vehicle accidents, or explosions. which is commonly caused by Von Willebrand disease

## Effects
. Figures B and C show aneurysms in parts of the aorta. When an aneurysm breaks, a person can exsanguinate within minutes.]]

If a person is losing blood very quickly, they will only be conscious for 20 seconds to a few minutes. If blood loss is slower, and the person does not get medical treatment, they may be conscious for a few hours. However, they will get more and more confused and tired as they lose more blood. Eventually the person will go into a coma because there is not enough blood left in their body to bring oxygen to their brain. Finally their heart will stop and they will die.

#### Hypothermia
Blood helps keep us warm. Because of this, losing a lot of blood causes hypothermia. When a person loses blood, they also lose the platelets and blood-clotting proteins the blood carried. These platelets and proteins make the blood clot. If a person loses a lot of blood, there will not be enough oxygen in the blood that is left to make energy this way. The body switches to anaerobic respiration and makes energy out of glucose without needing oxygen. However, this creates many acidic waste products (chemicals that the body does not need, which are left over after the body does chemical reactions).

* Calling 9-1-1 (in the US), 9-9-9 (in the UK), or another local emergency telephone number immediately
* Trying stopping the bleeding by:
** Pressing against the place that is bleeding
** If the person is bleeding from an arm or leg, lifting the arm or leg above the level of the person's heart
** Making a tourniquet and wrapping it tightly above where the person is bleeding
* Keeping the person warm
* Trying to help the person stay calm
* Laying the person down and raising their legs, if possible
* If the person is coughing or vomiting blood, turning them on their side so they do not choke

If possible, a person giving first aid should wear gloves any time they touch another person's blood. The sick or injured person may have an infection that can be spread through blood, such as HIV or hepatitis. Wearing gloves protects the person giving first aid from getting these infections. The three people who died in the bombings died right away.
* Advanced cancer Of everyone who has advanced cancer and is not getting treated for their cancer, up to one in 10 people have dangerous bleeding This makes alcoholics more likely to bleed dangerously if they get hurt. Liver damage can also lead to a problem called esophageal varices, which can cause a person to exsanguinate by throwing up blood.

* They are elderly
* They do not get into surgery quickly enough
* They have hypothermia, with a temperature under 34° C
* Their blood is more acidic because of acidosis
* They have lower numbers of platelets when they first get to the hospital
* They needed to be given more than 4 liters of blood, or over 10 liters of fluids, to replace the blood they lost
* They lost more than 15 mL of blood per minute (losing blood this fast, the person would exsanguinate in less than 30–40 minutes)

## Related pages
* Tourniquet 
* NSAID

## References