Abstract
The management of terminal catastrophic haemorrhage is a rare clinical palliative emergency for which the management is based largely on anecdotal and experiential guidelines, with no high grade evidence but rather robust contention and controversy. Whilst often rapid and deadly, inevitably dramatic and devastating for the treating health professionals and family, the key management areas include risk identification, supportive practices, the use of sedative medication and the ethical issues faced in the management of terminal haemorrhage.