TranslatePublished: 27 Oct 2026
Publication Date: Jan 2026
Review Date: Jan 2028
This leaflet has been given to you as your team is worried that you or your loved one may be at risk of suffering a major bleed.
Your care team will talk to you about the risk of bleeding and provide a suggested care plan, but you may find this leaflet helpful.
If a major bleed happens there is a possibility that you or your loved one might die. If this is the case, our aim is to minimise distress and provide comfort and support.
You may be offered an emergency anti-anxiety medication called Midazolam. Midazolam should be safely stored in a secure, cool, and dark place that is easily accessible.
There are 2 different ways Midazolam can be given; either by oral preparation or by a subcutaneous injection by the nurse. This will be discussed with you and your loved ones in advance, they will be shown how to use it.
Living with the risk of bleeding and caring for a loved one who is at risk of bleeding can be frightening. It can be useful to have some equipment easily accessible in the event of bleeding, including:
You may be offered an emergency anti-anxiety medication called Midazolam. Midazolam should be safely stored in a secure, cool, and dark place that is easily accessible.
There are 2 different ways Midazolam can be given; either by oral preparation or by a subcutaneous injection by the nurse.
This will be discussed with you and your loved ones in advance, they will be shown how to use it.
Midazolam is an anti-anxiety medication, which is given to lessen distress and awareness of bleeding and works in around 15-20 minutes.
The usual does is 10mg via an injection given by a healthcare professional or orally by carers or loved ones. Further 10mg doses can be given after 10 minutes depending on your care plan and needs.
Midazolam cannot stop the bleeding but should help manage distress and anxiety symptoms. The aim is to provide comfort during a difficult time. The main side effect of Midazolam is drowsiness, sedation, and rarely it can
slow down breathing. You may become drowsier or lose consciousness after Midazolam has been given. Please do not worry if this happens. Doses are prescribed at a therapeutic range.
You can follow the ABCDE acronym:
A: Assurance - If a large bleed occurs, it is important for family and carers to remain calm and provide reassurance that the bleed was anticipated and prepared for.
B: Be there - The most important care you can offer is to stay by your relative’s side all the time. Please try to avoid leaving them alone.
C: Comfort and Calm - Large bleeds rarely cause pain, but they can cause distress. Continue to comfort your relative and try to keep them calm. If available, dark towels and repositioning can make bleeding less apparent. Blankets can be used to keep someone warm.
D: Dial for Help - Call for help using your emergency contacts. District nurses will aim to arrive as soon as possible to provide support and help to keep your relative comfortable. In some cases, bleeding can happen very quickly and sometimes people can lose consciousness within minutes before help arrives.
E: Extras - In the event of a large bleed, loved ones may be able to give oral Midazolam if available. This will be discussed with you in advance.
www.mariecurie.org.uk
www.macmillan.org.uk
www.nhs.uk
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