Your patient is vomiting bright red blood. What does this indicate?

• A. Severe dehydration
• B. Active internal bleeding
• C. External bleeding
• D. Mouth ulcers

Answer: (B)

Vomiting bright red blood means there is active bleeding inside the upper gastrointestinal tract, such as the esophagus, stomach, or the beginning of the small intestine. The blood is bright red because it’s fresh and is being expelled quickly, indicating ongoing hemorrhage. This is different from a scenario caused by dehydration or mouth ulcers, which wouldn’t produce a continuous stream of bright red emesis. It’s also not about external bleeding, since the blood is coming from inside the body and being vomited rather than seen on the skin or from an external wound. In the field, treat this as a potentially serious condition: monitor the patient closely, assess for signs of shock, manage the airway if needed, keep them as safe and comfortable as possible, and transport promptly for medical care.