Exsanguination (also known colloquially as bleeding out) is the fatal process of hypovolemia (blood loss), to a degree sufficient to cause death. One does not have to lose literally all of one's blood to cause death. Depending upon the age, health, and fitness level of the individual, people can die from losing half or two-thirds of their blood; a loss of roughly one-third of the blood volume is considered very serious- even a single deep cut can warrant suturing and hospitalization, especially if trauma, a vein or artery, or another co-morbidity is involved. It is most commonly known as "bleeding to death". The word itself originated from Latin: ex ("out of") and sanguis ("blood").
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Exsanguination is used as a method of slaughter where, before the incision is made, the animal, depending on species, is rendered insensible to pain by various methods, including captive bolt, electricity or chemical. Without prior sedation, stunning or anesthetic, this method of slaughter causes a high degree of anxiety and should not be used alone.[1] The captive bolt is placed against the skull of the animal, and penetrates to cause tissue destruction in the brain, incapacitating the animal so that the procedure may take place. Electricity is used mostly in porcine, poultry and domestic sheep, whereas chemical is used in injured livestock.
While the animal is incapacitated, a pointed knife is fully inserted through the skin just behind the point of the jaw and below the neck bones. From this position, the knife is drawn forward severing the jugular vein, carotid artery, and trachea. Properly performed, blood should flow freely with death occurring within a few minutes. Sometimes the same procedure is repeated on the other side of the neck, severing vein and artery on the other side.
Beyond the initial cost of purchasing a captive bolt, continued usage of the method is very inexpensive. The animal is incapacitated for the duration of the procedure, so it is one of the safest methods for the slaughterer.
Slaughter by exsanguination is mandated by Judaic kashrut (kosher) and Islamic halal dietary laws. The double edged pointed knife is prohibited. Instead, a long knife with a squared off end is used that in Jewish law must be at least twice the width of the animal's neck. The operation of sticking or exsanguination is executed faster than when using the pointed knife, as four large blood vessels in the neck are severed simultaneously.
A 1978 study at the University of Veterinary Medicine Hanover indicates that these traditional methods, when executed as prescribed by the religious authorities, gave comparable results as animals stunned with a captive bolt pistol.[2]
In Islamic and Jewish law, captive bolts and other methods of pre-slaughter paralysis are generally not permissible, as consumption of animals found dead are regarded as carrion and stunned animals that are later killed will come into this category.
Various halal food authorities have more recently permitted the use of a recently developed fail-safe system of head-only stunning using a mushroom shaped hammer head that delivers a blow that is not fatal, proved by it being possible to reverse the procedure and revive the animal after the shock.[3]
Exsanguination is a relatively uncommon and dramatic cause of death in humans.
Traumatic injury can cause exsanguination if bleeding is not stymied. It is the most common cause of death on the battlefield. Non-battlefield causes can include murder by shooting or stabbing; motor vehicle accidents; suicide by cutting arteries, typically those in the wrists; and partial or complete amputation of limbs with circular saws and chain saws.
Patients can also develop catastrophic internal hemorrhages, such as from a bleeding peptic ulcer or splenic hemorrhage, which can cause exsanguination even without any external bleeding. Another cause of exsanguination in the medical field is that of aneurysms. If a dissecting aortic aneurysm ruptures through the adventitia, this can result in massive hemorrhage and exsanguination in a matter of minutes. It is a relatively common cause of unexpected, sudden death in patients who seemed previously well. Blunt force trauma to the liver, kidneys, and spleen can cause severe internal bleeding as well, though the abdominal cavity usually becomes visibly darkened as if bruised. Similarly, trauma to the lungs can cause bleeding out, though without medical attention blood can fill the lungs causing drowning, or in the pleura causing suffocation, well before exsanguination would occur. In addition, serious trauma can cause tearing of major blood vessels without external trauma indicative of the damage.
Alcoholics and others with liver disease can also suffer from exsanguination. Thin-walled, normally low pressure dilated veins just below the lower esophageal mucosa called esophageal varices may ulcerate or be torn ("Mallory-Weiss syndrome") during the violent vomiting of the alcohol leading to massive bleeding and sometimes exsanguination. The impaired liver function also reduces the availability of clotting factors (many of which are made in the liver), making any rupture in vessels more likely to cause a fatal loss of blood.