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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Palliative care advice lines

24 hour Advice Line Michael Sobell Hospice
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24 hour Advice Line Michael Sobell Hospice

T. 0203 824 1268

Offers support and advice on palliative care issues to GPs, Care Homes, District Nurses and hospital doctors.

It is also an Advice Line for patients and families who live in Hillingdon and need advice on any aspect of palliative care. 

The Advice Line is answered by hospice nurses in the Inpatient Unit and queries are escalated to the on-call palliative medical team if needed.

24/7 Your Life Line 24/7 Hillingdon (YLL)
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24/7 Your Life Line 24/7 Hillingdon (YLL)

T. 0800 328 5697

W. https://www.cnwl.nhs.uk/services/community-services/your-life-line-team-hillingdon

The team is made up of clinical nurse specialists and health care assistants (HCA) who can support patients with complex needs at home in the last weeks and months of their life (with any diagnosis). 

The service is open 24 hours a day, 365 days a year, and can offer advice.

 Urgent night visits  are available to patients already referred to the service.

If you have already been referred to this service, you will have been given a direct contact number.

Speak to your GP or district nurse to be referred to the service.

District Nurses

District Nurses Hillingdon
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District Nurses Hillingdon

T. 01895 486 127/ 01895 234001

W. https://www.cnwl.nhs.uk/services/community-services/hillingdon-district-nursing-service

Hillingdon District Nurses support adult patients who are housebound and need nursing care in their own homes and/ or community settings and who live in Hillingdon or are registered with a Hillingdon GP.

 

 

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