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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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District Nurses

Camden Integrated Community Healthcare (CICH)
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Camden Integrated Community Healthcare (CICH)

T. 020 3317 3400

W. https://www.cnwl.nhs.uk/services/community-services/camden-integrated-primary-care-service

The service provides high-quality care to support GPs in managing often complex housebound adults in Camden.

CICH is made up of five neighbourhood teams:

  • Central Camden Integrated Community Healthcare
  • East Camden Integrated Community Healthcare
  • West Camden Integrated Community Healthcare
  • North Camden Integrated Community Healthcare
  • South Camden Integrated Community Healthcare
District Nursing CNWL Camden
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District Nursing CNWL Camden

Please contact the Clinician of the Day (COD) for patients who are under the care of the district nursing service.

Clinician of The Day (COD) day teams are available 7 days a week 8.30am to 5.00pm.

Central and South Neighbourhood 020 3317 2137 / 07718 271 672 cnwl.central.camdencommunityhealth@nhs.net cnwl.south.camdencommunityhealth@nhs.net 
East Neighbourhood 020 3317 3357 / 07483 353 675 cnwl.east.camdencommunityhealth@nhs.net 
West Neighbourhood 020 3317 5705 / 07718 271 673 cnwl.west.camdencommunityhealth@nhs.net 
North Neighbourhood 020 3317 5915 / 07718 271 675 cnwl.north.camdencommunityhealth@nhs.net 
Twighlight: 5.00 to 10.00pm 07711 015 850  Availability 24/7  
Overnight 9.00pm to 7.30am 07711 389 089 Availability 24/7  

 

Palliative care advice lines

NCL Palliative Advice Team
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NCL Palliative Advice Team

T. 020 8152 3252

W. https://northlondonhospice.org/get-support/out-of-hours-telephone-advice

The North Central London Palliative Advice Team is a telephone service providing palliative care patients, families, carers, and healthcare professionals (in NCL ICS boroughs) with out of hours advice and support.

The telephone service is available 8.00pm to 8.00am, seven days a week.

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