Bleeding Flashcards
Blood
RBC make up 45%
WBC and platelets <1%
Plasma
Watery straw colored fluid that is more than half of all blood
Oxyhemoglobin Diassociation Curve
Determined by how readily hemoglobin acquires and releases oxygen molecules from surrounding tissue
(Pressure high in lungs, low in tissue)
Clotting proteins
Produced by the liver solidified rest of a blood clot
Perfusion
Circulation of blood within an organ or tissue in adequate amounts o meet cells needs
Vital Organs and kidneys
Will experience permanent damage after 45 minutes of inadequate perfusion
Skeletal muscles
More than 2 hours inadequate perfusion causes permanent damage
GI Tract
Can go many hours without blood
“Warm ischemic time”
Normal temp of a tissue or organ. Being cold can resist hypoperfusion because of the slowing of the body’s metabolism
Arteries
Spurt initially but begin to flow after pressure drops
Cut transverse will retract and stop own bleeding. Vertically will often continue to bleed
Caterizing injuries
Train runs over legs, may be little bleeding due to heat of train carterizing wounds
Blood Loss <20%
Vitals will change and body can’t tolerate
Femur Fractures
Hold up to 1L blood in femur
Consider Bleeding If:
Significant MOI Poor general appearance Hypoperfusion Blood loss Hemorrhage
Internal Clotting on Own
Bleeding tends to stop within 10 minutes on its own due to internal clotting factors
Open Vessel
Vessel is lacerated, blood flows rapidly from vessel
Open ends of vessel begin to constrict
Platelets agrregate at the site, plugging hole and sealing injured portions of vessel called hemostasis
Direct pressure of injury or environment triggers clotting factors
Medications Interfere
Aspirin, and beta blockers inhibit clotting and decrease vasoconstriction
Shock
All cases result in inadequate perfusion
Hemmorage Shock is most common
Hemorrhagic Shock
Three Phases: Compensated, Decompensated, Irreversible
Compensated Shock
Low circulating blood Volume with minimal signs of hypoperfusion
- agitation, anxiety, restlessness
- weak rapid pulse
- clammy, cool, moist skin
- nausea vomiting
- sob
Decompensated Shock
AMS Hypotension Labored Breathing Absent or threads pulse Mottled. Cyanotic skin Dialate Pupils
Class I
< 15% blood loss. Normal vitals. Slightly anxious
Class II
15-30% blood loss. Tachycardia. Normal BP. Narrowing pulse pressure. Cap refill delayed. Increased respirations. Cool pale skin
Class III
30-40% blood loss. Tachycardia. Systolic Low. Narrowing pressures. Delayed cap refill. Fast breathing. Cold pale moist skin. Needs fluid and blood
Class IV
> 40% blood loss. Tachycardia or bradycardic. Low pressure. Very narrow pressures. Cap refill absent. Resp rate increased or diminished. AMS. Cold Cyanotic. Fluid and Blood.