Bleeding and Shock

Question 1

When blood is lost only erythrocytes are lost. T/F?

Answer 1

False - in blood loss all components are lost equally

Question 2

What is the definition of shock?

Answer 2

Shock is a clinical syndrome where tissue perfusion and hence oxygenation, is inadequate to maintain normal metabolic function.

Question 3

What is the most common type of shock?

Answer 3

Hypovolaemic shock

Question 4

What is the cause of hypovolaemic shock?

Answer 4

This shock results from a haemorrhage (either internal or external) where loss of blood means there is less fluid to carry oxygen. It can result from burns, GI problems, sweating and dehydration

Question 5

What is cardiogenic shock?

Answer 5

The failure of the heart (left ventricle) to pump blood properly

Question 6

What is the cause of septic shock?

Answer 6

This results from a large immune response as a result of infection where vasodilation in inflammation has resulted in the leakage of fluid from blood vessels so that less fluid is available to carry oxygen

Question 7

What is the cause of spinal shock?

Answer 7

Damage to the spinal cord leading to altered or lost vascular tone and the leakage of fluid from the opening of blood vessels so that there is not enough fluid to carry oxygen

Question 8

What is anaphylactic shock?

Answer 8

When several types of shock combine

Question 9

What is the most reliable measure of the severity of shock?

Answer 9

Respiration rate

Question 10

What symptoms can indicate clinical shock?

Answer 10

Pulse rate increases
Respiration rate increases
Urine output decreases
Mental status of patient becomes increasingly anxious and confused
Blood pressure decreases (although this only occurs in the late stages)

Question 11

What is an abrasion and how is it caused?

Answer 11

A superficial wound caused by dragging the skin along an irregular surface.

Question 12

How is an abrasion treated?

Answer 12

The wound should be thoroughly cleaned and dressed. Large abrasions may need the patient to be put under anaesthetic for cleaning to take place.

Question 13

What is tattooing and how does it occur?

Answer 13

It is where dirt has been incorporated in with the new skin growth after an abrasion and results in dark patches. It is caused by ineffective cleaning of the wound.

Question 14

What is degloving?

Answer 14

This is when the skin and its blood supply are completely torn off, often seen in cases of ,major trauma to the limbs/digits.

Question 15

How is a degloving treated?

Answer 15

Blood loss should be stopped. The flap of skin can be placed back on top of the wound after cleaning but if the flap of skin is not viable then a skin graft will be required

Question 16

What does an incised wound look like and what is it caused by?

Answer 16

These wounds are deeper than they are wide and have clean edges and a uniform shape. They are caused by a sharp or penetrating trauma such as stabbing.

Question 17

How should an incised wound be treated?

Answer 17

Blood loss should be stopped with direct pressure. The wound can be explored for underlying damage in theatre.

Question 18

What does a laceration look like?

Answer 18

It is caused by blunt forced trauma. It involves skin splitting and tissue bridging and results in a wound with irregular edges and varying levels of depth.

Question 19

How is a laceration treated?

Answer 19

The bleeding is stopped and the wound cleaned. The wound is then closed with glue, steristrips, staples sutures.

Question 20

Why is it important the wounds from bites are thoroughly cleaned?

Answer 20

Because there is a high risk of infection of foreign bodies.

Question 21

Why are bites from humans particularly dangerous?

Answer 21

Because saliva can pass on blood-born infections

Question 22

What are the five steps of first aid treatment?

Answer 22

Airways 
Breathing
Circulation
Disability
Exposure