Exsanguination · What Is It, Causes, Treatment, and More

Published: Nov 21, 2025
Author: Ali Syed, PharmD•
Editor: Alyssa Haag, MD•
Editor: Ian Mannarino MD, MBA
Illustrator: Jessica Reynolds, MS
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What is exsanguination?

Exsanguination is the fatal loss of blood, which may also colloquially be called bleeding out” or “bleeding to death.” An individual may not need to lose all their blood for exsanguination, as it most commonly occurs after losing half to two-thirds of their blood volume.  

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What causes exsanguination?

Several factors and mechanisms may cause exsanguination. Exsanguination most commonly results after severe internal and external injuries from direct trauma to a major artery or vein (e.g., the internal and external carotid arteries and internal and external jugular veins). Internal and external injuries may result from puncture wounds, crush injuries, deep lacerations, and blunt force trauma. Exsanguination may also be caused by medical conditions, including malignancy and a ruptured aortic aneurysm. Certain medications like anticoagulants (e.g., warfarin and clopidogrel), may contribute to the process of exsanguination. Iatrogenic causes of exsanguination may include invasive surgeries such as a cardiac valve replacement or invasive procedures such as a bronchoscopy.  

How is exsanguination treated?

Treatments for exsanguination vary depending on the underlying cause and severity of blood loss. Initial conservative approaches may involve traditional compression methods such as manual compression; or compression devices such as compression balloons or arterial compressors (i.e., tourniquets), which use mechanical pressure to compress bleeding sites. Other conservative approaches involve discontinuing any offending medications, including anticoagulants (such as warfarin) and antiplatelet therapies (such as clopidogrel); resuscitation with intravenous fluids; transfusing red blood cells or platelets; reversing anticoagulant factors with therapies such as vitamin K or fresh frozen plasma; and giving tranexamic acid to control bleeding. If indicated, surgical repair of the bleeding site may be necessary.  

References

Asensio JA, Petrone P, O'Shanahan G, Kuncir EJ. Managing exsanguination: what we know about damage control/bailout is not enough. Baylor Univ Med Cent Proc. 2003;16(3):294-296.


Bilku DK, Downing ND. A simple technique for exsanguination of the hand. Surgeon. 2009;7(6):379-380.



Chen HZ, Liang WS, Yao WF, Liu TX. Compression methods after femoral artery puncture: a protocol for systematic review and network meta-analysis. Medicine (Baltimore). 2021;100(4):e23909.


Fraser Health. Exsanguination. Hospice Palliative Care Program; 2006.