Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
!
Escalate
Active bleeding from a varicose vein needs immediate elevation and firm direct pressure, urgent medical assessment and referral to a vascular service; haemodynamic compromise requires emergency resuscitation.
Synopsis
Recognise venous hypertension complications, refer according to NICE criteria and sequence duplex-guided intervention correctly.
Varicose veins are dilated tortuous superficial veins caused by venous reflux; chronic venous insufficiency describes the oedema, skin change and ulceration produced by sustained venous hypertension.
Refer immediately for bleeding varicose veins.
Refer symptomatic primary or recurrent varicose veins, venous skin changes, superficial vein thrombosis with suspected incompetence, a venous ulcer unhealed after 2 weeks or a healed venous ulcer.
Key red flags
Bleeding varicosity
External bleeding can be brisk from a small skin breach, especially with dependency; elevate, apply firm direct pressure and refer immediately.
Investigation priorities
01
Lower-limb venous duplex ultrasoundFirst step
Confirm diagnosis, define truncal reflux and plan intervention.
Management branches
bleedingBleeding varicose vein
Active or recent spontaneous bleeding from a varicosity.
First: lie the patient down, elevate the limb above heart level and apply firm direct pressure with a pad until bleeding stops.
Next: assess haemodynamics, haemoglobin and anticoagulant use; resuscitate and transfer urgently if bleeding is ongoing or significant.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.