Exsanguination

Exsanguination (also known colloquially as bleeding out) is the fatal process of total hypovolemia (blood loss). It is most commonly known as "bleeding to death". The word itself originated from Latin: ex ("out of") and sanguis ("blood").

Slaughter of animals in meat industry
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. 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.

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 method prescribed generally calls for cutting the throat and allowing the blood to drain from the head before the rest of the body. A 1978 study at the University of Veterinary Medicine Hanover indicates that these traditional methods, when executed as prescribed by the religious authorities, do not cause suffering to the slaughtered animal.

In Islamic and Jewish law, captive bolts and other methods of pre-slaughter paralysis are generally not permissible, due to it being forbidden for an animal to be killed prior to slaughter. Various halal food authorities have more recently permitted the use of a recently developed fail-safe system of head-only stunning where the shock is less painful and non-fatal, and where it is possible to reverse the procedure and revive the animal after the shock.

Cause of human death
Exsanguination is a relatively uncommon and dramatic cause of death in humans. Exsanguination is a possible suicide method caused by cutting of arteries.

Trauma (injury) can cause exsanguination if bleeding is not stymied. It is the most common cause of death on the battlefield (though the most common cause of death from battle is infection). Non-battlefield causes can include partial or complete amputation from use of circular saws (e.g., hand-held circular saw, radial arm saw, table saw).

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. 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, 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.

In Pop Culture

 * In Season 2 Episode 16 of the tv series NCIS, 'Pop Life', Ducky tells Gibbs how much he loves the word Exsanguination. Ducky is the shows medical examiner.