Bleeding And Shock

Question 1

You should consider bleeding to be serious if the following conditions are presented

Answer 1

• It is associated with a significant MOI
• The patient has a poor general appearance and is calm
• Assessment reveals signs and symptoms of shock
• You note a significant amount of blood loss
• The blood loss is rapid
• You cannot control the bleeding

Question 2

On its own bleeding tends to stop rather quickly within

Answer 2

10 min

Question 3

Things that effect blood clotting

Answer 3

Movement
Medications
Removal of bandages
External Enviroment

Question 4

Internal bleeding commonly occurs from

Answer 4

Falls
Blast injuries
MVA

Question 5

Common nontraumatic internal bleeding causes

Answer 5

Bleeding ulcers
Bleeding from colon
Ruptured ectopic pregnancy
Aneurysms

Question 6

In older pt’s the 1st couple signs of of non traumatic internal bleeding is

Answer 6

Dizziness
Faintness
Weakness

Question 7

Hematoma

Answer 7

Mass of blood in the soft tissues beneath the skin

Question 8

The first sign of hypovoelmic shock is

Answer 8

Anxiety
Restlessness
Combativeness

Question 9

Signs and symptoms of hypovolemic shock

Answer 9

• Rapid, weak pulse
• Low BP (late sign)
• Change in mental status
• Cool, Clammy skin
• Cyanosis (lips, oral membranes, nail beds)

Question 10

Shock can be caused by

Answer 10

Bleeding
Respiratory failure
Acute allergic reactions
Overwhelming infection

Question 11

3 basic causes of shock

Answer 11

Pump failure
Low fluid volume
Poor vessel function

Question 12

Causes of pump failure

Answer 12

Heart attack
Trauma to heart
Obstructive causes
Cardiogenic shock

Question 13

Causes of low fluid volume

Answer 13

Trauma to vessels or tissues
Fluid loss from GI tract (vomiting/diarrhea can also lower the fluid component of blood)
Hypovoelmic shock

Question 14

Causes of poor vessel function

Answer 14

Infection
Drug OD (narcotic)
Spinal cord injury
Anaphylaxis

Question 15

Cardiogenic Shock develops when

Answer 15

The heart cannot maintain sufficient cardio out out to meet the demands of the body

Question 16

Two of the most common examples of obstructive shock

Answer 16

Cardiac tamponade

Tension pneumothorax

Question 17

The four most common causes of distributive shock are

Answer 17

Septic shock
Neurogenic shock
Anaphylaxis
Psychogenic shock

Question 18

You should expect shock of a patient has any of the following conditions

Answer 18

Multiple severe fractions
Abdominal or chest injury
Spinal injury
A severe infection
A major heart attack
Anaphylaxis

Question 19

A common form of shock associated with trauma is

Answer 19

Hemorrhagic shock

Question 20

The population most at risk for trauma and trauma death is

Answer 20

The young adult male

Question 21

The circulatory (cardiovascular) system has 3 basic components

Answer 21

Heart
Blood vessels
Blood

Question 22

Stroke volume

Answer 22

The volume of blood ejected from the heart with each beat

Question 23

Preload

Answer 23

Blood flowing to the heart

*The precontraction pressure in the heart as the volume of blood builds up

Question 24

After load

Answer 24

The resistance to blood flow out of the heart

Question 25

The vascular system

Answer 25

A continuous series of hollow tubes (blood vessels) distributing blood to and from body tissues.

Question 26

Microcirculation

Answer 26

Blood flow in the arterioles, capillaries, and venules.

Question 27

Types of hemorrhage

Answer 27

Capillary Venous Arterial

Question 28

Erythrocyte

Answer 28

Peripheral blood cell that contains hemoglobin; responsible for transport of 02 to the cells

Question 29

Capillary hemorrhage

Answer 29

Involves the smallest of blood vessels and generally oozes from the wound. It is normally caused by a abrasion and clots quickly on its own. *the blood is often bright red because it is well oxygenated

Question 30

Venous hemorrhage

Answer 30

Glows more quickly, though it, too, generally stops in a few minutes. Blood lost with venous hemorrhage is generally dark red because 02 has surrendered as red cells passed through the capillary beds. *Venous hemorrhage volume can sometimes be extensive because of the size of the vessels involved.

Question 31

Hemostasis

Answer 31

The body's three step response to local hemorrhage, comprising a vascular phase that reduces blood flow, a platelet phase in which aggregating platelets from a weak clot, and a coagulation phase that results in the formation of fibrin, creating a strong clot

Question 32

Vascular phase

Answer 32

First step in the process of Hemostasis , in which smooth blood vessel muscle contracts, reducing the vessel lumen and the flow of blood through it

Question 33

Platelet phase

Answer 33

Second phase in the process of Hemostasis in which platelets adhere to blood vessels walls and to each other

Question 34

Coagulation phase

Answer 34

Third step in the process of Hemostasis, which involves the formation of a protein called fibrin that forms a network around a wound to stop bleeding, ward off infection, and lay a foundation for healing and repair of the wound

Question 35

Underlying killer of all trauma and medical patients

Answer 35

Shock

Question 36

Hemorrhagic shock

Answer 36

Blood loss (internal or external) from vascular container

Question 37

Common cause of shock and death in trauma patients

Answer 37

Hemorrhagic shock

Question 38

Class 1 Hemorrhage

Answer 38

Blood loss of up to 15% of circulating blood volume (0-500cc) BP remains constant, as do pulse pressure, RR, urine output

Question 39

Class II hemorrhage

Answer 39

15-30% of blood volume lost (1000cc blood loss) Tachycardia evident; diastolic pressure rises; pulse pressure narrows; pulse strength diminishes

Question 40

Class III hemorrhage

Answer 40

Blood loss of 30 to 40% of blood volume (1500cc) - Classic signs of shock - Tachycardia more pronounced as blood pressure begins to fail - Pulse barely palpable, air hunger, anxiety, restlessness, pale cool diaphoretic, urinary output declines

Question 41

Class IV hemorrhage

Answer 41

Blood loss greater than 40% of total blood supply (2000cc blood loss) -pulse barely palpable in central arteries, respirations very rapid, shallow, ineffective, very lethargic and confused

Question 42

Class V

Answer 42

2500cc blood loss Death HR 140 Barely palpable carotid