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Bleeding & Bruising Safety

Bleeding Red-Flag Card — for Chemotherapy

Bruises appearing without any injury, or bleeding that is hard to stop, can mean your platelet count is low. This card tells you which signs need emergency care right now and which need a call to your team today.

Medically reviewed by Dr. N. Kiranmayee, Medical Oncologist · Last reviewed September 2026

  • Six signs to act on immediately — Go straight to emergency for any of these — do not wait for a callback.
  • One call to make first — For smaller worries, your oncology helpline is the right first contact.
  • No anti-inflammatory painkillers — Aspirin, ibuprofen, and diclofenac increase bleeding risk. Ask your team what is safe for pain.
  • Pin it on the fridge — Your family needs to know these signs too, in case you are too unwell to call yourself.
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During chemotherapy, low platelets can make even minor injuries bleed seriously. Signs that need emergency care include bleeding that will not stop, blood in your urine or stool, vomiting blood, and a sudden severe headache. Call your oncology helpline first. Go straight to the emergency department if bleeding is heavy or you cannot reach your team.

If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.

When should you call your oncology team instead of going straight to emergency?

Call your oncology helpline the same day if you notice new bruises with no obvious cause, bleeding gums, or a nosebleed that stops on its own.

These signs tell your team your platelet count may be falling — and that can change what they plan for your next cycle.

If you cannot reach your team and you are worried, go to emergency and tell them you are on chemotherapy. Bring your medicines list.

If you are worried right now, call

Our helpline is answered by clinical staff. If a symptom is on the list above, do not wait for a callback — call, or go to your nearest emergency department.

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Dr. Naresh Gundu

MBBS, DNB (Internal Medicine), DM (Medical Oncology)

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MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)

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Dr. Bharati Devi Gorantla

MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)

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Medical Oncologist

Dr. Owais Mohammed

MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)

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Dr. T. Raghavender Reddy
Medical Oncologist

Dr. T. Raghavender Reddy

MBBS, DM (Medical Oncology), MD (Radiation Oncology)

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Medical Oncologist

Dr. N. Kiranmayee

MBBS, DM (Medical Oncology), MD (Internal Medicine)

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Dr. Muralidhar Muddusetty

MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)

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Dr. Raghavendra Naik

MBBS, MS (General Surgery), M.Ch (Surgical Oncology)

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Surgical Oncologist

Dr. Mohammed Imaduddin

M.B.B.S, MS (General Surgery), M.Ch (Surgical Oncology)

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Dr. Vinay Mamidala

MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)

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Dr. Paila Gowri Naidu

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Dr. Venkata Sushma P

MBBS, MD (Radiation Oncology)

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Dr. Kirti Ranjan Mohanty

MBBS, MD (Radiation Oncology)

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Dr. Vajja Sandeep Kumar

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Not sure whether this counts as an emergency?

Call the helpline. It is always better to check than to wait.

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Is this bruise normal, or a low-platelet warning?

FeatureProbably normalLow-platelet warning — call today
CauseA knock or bump you rememberNo obvious cause
SizeSmall, stays the sameLarger than a palm, or still spreading
Other bleedingNoneGum bleed, nosebleed, or blood in urine too
How you feelFine otherwiseUnusually tired, dizzy, or short of breath
Typically startsAfter a visible knockOvernight or without any injury — often noticed in the morning

What goes on my fridge card?

  • Emergency department — for any of the six red-flag signs above
  • Oncology helpline — for new bruising, gum bleed, or a brief nosebleed
  • Tell emergency staff you are on chemotherapy and bring your medicines list
  • Do not take aspirin, ibuprofen, or diclofenac for pain — ask your team first
  • Do not wait overnight if a red-flag sign appears
  • Your family should know these signs — you may not be able to call yourself

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Still not sure what applies to you?

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Common questions

Frequently asked questions

Is a nosebleed during chemotherapy an emergency?

Not always — it depends on whether it stops. Sit upright, lean forward slightly, and pinch the soft part of your nose for ten uninterrupted minutes. If it stops, call your oncology team the same day to report it. If it has not stopped after ten minutes, or if you are also bleeding somewhere else, go to the emergency department.

Can I take a painkiller for bruise pain?

Aspirin, ibuprofen, and diclofenac make bleeding more likely by interfering with platelet function and should not be taken during chemotherapy unless your oncologist has specifically said so. Paracetamol is generally considered safer for pain, but check with your team before taking anything — some chemotherapy regimens can interact with it too.

What does a low platelet count feel like?

Many people notice nothing until a blood test reveals it. When platelets fall further, you may see bruises without any obvious cause, small flat red dots under the skin called petechiae, bleeding gums when brushing, or an unusually heavy period. Any of these is worth reporting at your next contact point with your oncology team.

What should I say when I call or arrive at emergency?

Say four things: you are on chemotherapy, the name of the drug or drugs if you know them, what you are seeing and when it started, and whether you take any blood-thinning medicines. Bring your medicines list or treatment summary card if you have one. This helps staff prioritise you correctly and speeds up the assessment.

Full index

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Blood Counts, Infection, Fever & Emergencies73

Anaemia & Low Haemoglobin

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Chemotherapy and Supportive Medicines by Name75

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