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Emergency Medical Technician > Bleeding > Flashcards

Bleeding Flashcards

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Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

As blood flows out of the heart, it passes into the ___

A

Aorta

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2
Q

The largest artery in the body

A

Aorta

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3
Q

The smaller blood vessels that connect the arteries and capillaries

A

Arterioles

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4
Q

Small tubes, with the diameter of a single red blood cell, that pass among all the cells in the body

A

Capillaries

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5
Q

The capillaries link the ___

A

Arterioles and venules

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6
Q

Blood leaving the distal side of the capillaries flows into the ___

A

Venules

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7
Q

These small, thin-walled vessels empty into the veins

A

Venules

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8
Q

The veins empty into the ___

A

Inferior and superior venae cavae

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9
Q

Blood contains ___

A
  1. Red cells
  2. White cells
  3. Platelets
  4. Plasma
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10
Q

Key to the formation of blood clots

A

Platelets

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11
Q

Blood clot formation depends on several factors

A
  1. Blood stasis
  2. Changes in the blood vessel wall
  3. Blood’s ability to clot
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12
Q

Monitors the body’s needs and adjusts the blood flow by constricting or dilating blood vessels as required

A

Autonomic nervous system

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13
Q

The cardiovascular system adapts to changing conditions in the body to maintain ___

A

Homeostasis and perfusion

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14
Q

If blood volume is significantly diminished and the system fails to provide sufficient circulation for every body part to perform its function, then ___ results

A

Hypoperfusion or shock

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15
Q

The circulation of blood within an organ or tissue to allow it to meet the cells’ current needs for oxygen, nutrients, and waste removal

A

Perfusion

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16
Q

Cells in the brain and spinal cord will start to die after ___ minutes without adequate perfusion

A

4 to 6

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17
Q

The lungs can survive only ___ minutes without adequate perfusion

A

15 to 20

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18
Q

Kidneys can be damaged after ___ minutes without adequate perfusion

A

45

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19
Q

Skeletal muscle demonstrates evidence of injury after ___ hours of inadequate perfusion

A

2 to 3

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20
Q

An organ that is kept at a considerably lower temperature may be better able to ___ from hypoperfusion

A

Resist damage

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21
Q

Bleeding

A

Hemorrhage

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22
Q

Visible hemorrhage

A

External bleeding

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23
Q

Treatment of a patient with external bleeding should be based on ___

A

The patient’s presentation and MOI

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24
Q

Amount of blood in the typical adult male body

A

70 mL of blood per kg of body weight

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25
Q

Amount of blood in the typical adult female body

A

65 mL of blood per kg of body weight

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26
Q

The body cannot tolerate an acute blood loss of greater than ___

A

20% of total blood volume

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27
Q

Typical blood volume of a 1-year old

A

27 oz (800 mL)

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28
Q

A child will show significant symptoms of blood loss after only ___

A

3 to 6 oz (100 to 200 mL)

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29
Q

20% of blood loss in an adult is about how much blood?

A

2 pints (1L)

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30
Q

Volume of blood in a typical 175 lb adult male

A

10 to 12 pints (6L)

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31
Q

An adult can comfortable donate ___ of blood within ___ and adapt well to this decrease in blood volume

A
  1. 1 pint (500 mL)
  2. 15 to 20 minutes
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32
Q

If the volume of blood loss occurs in a much shorter time, symptoms of ___ might result

A

Hypovolemic shock

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33
Q

You should consider bleeding to be severe if any of the following conditions exist ___

A
  1. The patient has a poor general appearance and has no response to external stimuli
  2. Assessment reveals signs and symptoms of shock
  3. You note a significant amount of blood loss
  4. The blood loss is rapid and ongoing
  5. You cannot control the bleeding
  6. The bleeding is associated with a significant MOI
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34
Q

On its own, bleeding tends to stop within about ___

A

10 minutes

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35
Q

Soon after being cut, the ends of the blood vessels begin to ___

A

Vasoconstrict

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36
Q

Lacking one or more of the blood’s clotting factors

A

Hemophilia

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37
Q

Any bleeding that occurs in a cavity or space inside the body

A

Internal bleeding

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38
Q

Local swelling and bruising around a broken none

A

Contusion or ecchymosis

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39
Q

A contusion or ecchymosis is caused by ___

A

The accumulation of blood around the ends of the broken bone

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40
Q

If you suspect that a patient is bleeding internally, ___

A

Treat for shock and promptly transport to the hospital

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41
Q

Always suspect internal bleeding in a patient who as sustained ___

A

A penetrating injury or blunt trauma

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42
Q

Some of the more common causes of nontraumatic internal bleeding

A
  1. Bleeding ulcers
  2. Bleeding from the colon
  3. Ruptured ectopic pregnancy
  4. Aneurysm
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43
Q

In older patients, ___ may be the first sign of nontraumatic internal bleeding

A

Dizziness, faintness, or weakness

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44
Q

Ulcers or other GI problems may cause ___

A

Vomiting of blood or bloody diarrhea

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45
Q

Frequent signs of nontraumatic internal bleeding (not always present)

A
  1. Abdominal tenderness
  2. Guarding
  3. Rigidity
  4. Pain
  5. Distention
46
Q

Internal bleeding is most common in ___

A

Head, extremity, and pelvic injuries and is often associated with significant abdominal trauma

47
Q

Intra-abdominal bleeding will often cause ___

A

Pain and abdominal distention

48
Q

Bleeding into the chest cavity or lung may cause ___

A

Dyspnea, tachycardia, hemoptysis, and hypotension

49
Q

The coughing up of bright red blood

A

Hemoptysis

50
Q

A mass of blood that has collected in the soft tissues beneath the skin

A

Hematoma

51
Q

The only sign of severe pelvic or abdominal trauma may be ___

A

Redness, skin abrasions, or pain

52
Q

Blood in the urine

A

Hematuria

53
Q

Bleeding from any body opening usually indicates ___

A

Internal bleeding that is not easy to see or control

54
Q

Bright red bleeding from the mouth or rectum or blood in the urine may suggest ___

A

Serious internal injury or disease

55
Q

___ vaginal bleeding is always significant

A

Non-menstrual

56
Q

Vomiting of blood

A

Hematemesis

57
Q

If the blood vomited has been partially digested, the vomit may look like ___

A

Coffee grounds

58
Q

Black, foul-smelling, tarry stool that contains digested blood

A

Melena

59
Q

Other signs and symptoms of internal bleeding in trauma and medical patients

A
  1. Hematemesis
  2. Melena
  3. Pain, tenderness, bruising, guarding, or swelling
  4. Broken ribs, bruises over the lower part of the chest, or a rigid, distended abdomen
60
Q

Pain, tenderness, bruising, guarding, or swelling, especially in an extremity may mean that ___

A

A closed fracture is bleeding

61
Q

Broken ribs, bruises over the lower part of the chest, or a rigid, distended abdomen may indicate a ___

A

Lacerated spleen or liver

62
Q

Patients with an injury to their spleen or liver may have referred pain in the ___

A
  1. Right shoulder (liver)
  2. Left shoulder (spleen)
63
Q

First sign of hypovolemic shock

A

Change in mental status

64
Q

In a nontrauma patient___ can all be early signs of hypovolemic shock

A

Weakness, faintness, or dizziness on standing

65
Q

Later signs of hypovolemic shock suggesting internal bleeding

A
  1. Tachycardia
  2. Weakness, fainting, or dizziness at rest
  3. Thirst
  4. Nausea and vomiting
  5. Cold, moist skin
  6. Shallow, rapid breathing
  7. Dull eyes
  8. Slightly dilated pupils that are slow to respond to light
  9. Capillary refill time longer than 2 seconds in infants in children
  10. Weak, rapid pulse
  11. Decreasing BP
  12. Altered level of consciousness
66
Q

If the patient has obvious, life-threatening external bleeding, treat it ___

A

First

67
Q

Cool, moist skin that is pale or gray suggests a ___ problem

A

Perfusion

68
Q

If the patient is able to speak, this indicates that the airway is ___

A

Patent

69
Q

It is important to ask the bleeding patient if they take ___ medications

A

Blood thinning

70
Q

Blood-thinners are often prescribed for patients with a history of ___

A

Stroke, pulmonary embolism, or heart attack

71
Q

Common blood thinners

A
  1. Antiplatelets such as aspirin, clopidogrel (Plavix), and ticagrelor (Brilinta)
  2. Anticoagulants such as warfarin (Coumadin), rivaroxaban (Xarelto), dabigatran (Pradaxa), apixaban (Eliquis), and edoxaban (Savaysa)
72
Q

When examining the head, be alert for ___

A

Uncontrolled bleeding from large scalp lacerations

73
Q

When examining the abdomen, ___

A

Feel all four quadrants for tenderness or rigidity

74
Q

In the extremities, record ___

A

Pulse, motor, and sensory function

75
Q

In an adult patient, a systolic BP less than ___ with a ___ and ___ are signs of hypoperfusion that require immediate attention

A
  1. 100 mm Hg
  2. Weak, rapid pulse
  3. Cool, moist skin that is pale or gray
76
Q

Children will compensate well for blood loss and then ___

A

Crash quickly

77
Q

Whenever you suspect significant bleeding, either external or internal, and signs of shock are present, provide ___

A

High-flow oxygen

78
Q

Methods to control bleeding

A
  1. Direct pressure
  2. Pressure dressings and/or splints
  3. Tourniquets
  4. Junctional tourniquet
  5. Hemostatic dressing
  6. Wound packing
79
Q

Never remove an object protruding from a wound, unless ___

A

It is in the cheek and blocking the patient’s airway

80
Q

Apply bulky dressings to stabilize the impaled object in place, and apply pressure as best you can for at least ___

A

5 minutes without interruption

81
Q

Once you have applied a dressing to control bleeding, create a pressure dressing to maintain the pressure by ___

A

Firmly wrapping a sterile, self-adhering roller bandage around the entire wound

82
Q

Use ___ for small wounds and ___ for larger wounds

A
  1. 4 x 4-inch sterile gauze pads
  2. Sterile universal dressings
83
Q

If direct pressure fails to immediately stop hemorrhage, then ___

A

Apply a tourniquet above the level of the bleeding

84
Q

If tourniquet is not possible because the wound is too proximal, then consider a ___

A

Junctional tourniquet or wound packing with a hemostatic dressing if available

85
Q

Dressing impregnated with a chemical compound that slows or stops bleeding by promoting clot formation

A

Hemostatic dressing

86
Q

If the tourniquet does not immediately control bleeding ___

A

Apply a second one adjacent to the first

87
Q

Never use ___ for a tourniquet

A

Wire, rope, al belt, or other narrow material that could cut into the skin

88
Q

If it is possible to do so without causing a delay, consider placing ___ under the tourniquet as you apply it

A

Padding

89
Q

Allows for proximal compression of life-threatening bleeding in areas where a standard tourniquet application is not possible

A

Junctional tourniquet

90
Q

Junction of the torso with the arms

A

Axillary area

91
Q

Inguinal area

A

Legs

92
Q

Some junctional tourniquets may also be used as a ___ for suspected unstable pelvic fractures

A

Pelvic binder

93
Q

Known as soft splints or pressure splints

A

Air splints

94
Q

Can help control internal or external bleeding associated with severe extremity injuries, such as fractures

A

Air splints

95
Q

Type of splint that may be indicated for a suspected closed unstable pelvic fracture

A

Pelvic binder

96
Q

Helps to control internal bleeding from an open-book pelvic fracture

A

Pelvic binder

97
Q

A life-threatening fracture of the pelvis caused by a force that displaces one or both sides of the pelvis laterally and posteriorly

A

Open-book pelvic fracture

98
Q

Trochanters

A

Hips

99
Q

How to apply a pelvic binder

A
  1. Slide the binder under the supine patient with the device centered over the trochanters
  2. Secure and tighten device
100
Q

Pediatric patients who weigh less than ___ may be too small for an adult pelvic binder

A

50 lbs

101
Q

After you have applied a splint, be sure to___

A

Monitor pulse and motor and sensory function in the distal extremity

102
Q

Bleeding around the face always presents a risk for ___

A

Airway obstructions or aspiration

103
Q

Conditions that can result in bleeding from the nose, ears, and/or mouth

A
  1. Fracture of the base of the skull
  2. Facial injuries
  3. Sinusitis, infections, nose drop use and abuse, dried or cracked nasal mucosa, intranasal use of street drugs, or other abnormalities
  4. High BP
  5. Coagulation disorders
  6. Digital trauma
  7. Cancer
104
Q

Nosebleed

A

Epistaxis

105
Q

The tissue dividing the nostrils

A

Septum

106
Q

Head position when treating a nosebleed

A

Leaning forward, head tilted forward

107
Q

Apply direct pressure to a nosebleed for at least ___

A

15 minutes

108
Q

Other method to stop a nosebleed

A

Place a rolled gauze bandage between the upper lip and the gum and apply pressure by stretching the upper lip tightly against the bandage and pushing it up into and against the nose

109
Q

Bleeding from the nose or ears following a head injury may indicate a ___. In these cases, do not ___

A
  1. Skull fracture
  2. Attempt to stop the blood flow
110
Q

If blood or drainage contains cerebrospinal fluid, you will see a ___

A

Characteristic staining of the dressing much like a target or halo shape

111
Q

If you suspect a skull fracture, ___

A

Loosely cover the bleeding site to collect the blood and help keep contaminants away from the site. Apply light compression by wrapping the dressing loosely around the head

Emergency Medical Technician (100 decks)

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