Bleeding and soft tissue trauma Flashcards
Severity depends on what 5 things?
- Amount of blood loss
- Rate of blood loss
- Other injuries
- Patients existing medical problems
- Age
Arterial bleeding characteristic
- Bright red, spurting blood from a wound
Venous bleeding characteristic
- Dark red blood that steadily flows
Capillary bleeding characteristic
- Slowly oozing blood that is dark or intermediate color of red
First method of controlling a bleed
- Direct pressure
How high above the injury do you place a touniquet
- 2 inches
what are hemostatic agents
dressing gauze or sponge that are designed to improve clotting and control life threatening bleeds that cant be controlled by direct pressure
How long do you hold the hemostatic dressing in the wound
3 min with direct pressure
What are junctional areas
Areas in which the extremities and head meet the torso or core of the body
* Groin
* Armpit
* shoulder
* neck
Epistaxis
Define
- nose bleed
Bleeding from nose, ears, or mouth
Causes (7)
- Skull injury
- Facial trauma
- Digital trauma (nose picking)
- Sinusitis and other URI
- Hypertension
- Clotting disorders
- Esophageal disease
Sinustitis
Define/Complication
- sinuses are inflamed and swollen
- Makes it hard for the sinuses to drain
What is bleeding from ears or nose indicitive of?
Skull fracture
If you have bleeding from the nose or ears and suspect skull fracture do you stop the bleed?
Tell me why!
Hint: Aint nothing bout a heart ache… is wrong.. Tell me why!
- Stop the bleed is nothing but a mistake! Tell me why
- Causes increased ICP
I never want to hear you sayyyy
I stopped that nose bleed
( back street EMT said so)
What factors increase bleeding
- Movement
- Low body tempurature
- Medications
- IV fluids
- removal of dressings and bandages
Tourniquet precautions
(6)
- Make sure the pockets are empty
- Place 2 inches above the injury
- Dont tourniquet joints
- Dont use on head or neck
- Can be used over clothing
Why is a significant risk factor with abrasions?
- Infection
Avulsion
Define
- Flaps of skin torn or cut but still loosly attached
Hematoma
Define
- A collection of blood outside the blood vessles
- Fancy word for bruises
Hemorrhagic shock
S/S Mental status
- Restlessness
- Anxiety
- AMS
Hemorrhagic shock
S/S vitals signs
- Increased pulse rate with weak and thready pulse
- Increased RR that can be deep or shallow, labored, and irregular
- Dilated pupils
- Marked thirst
- N/V
- Decreased blood pressure
- Pallor with cyanosis to the lips
Ecchymosis
Define
- Black and blue discoloration associated with a hematoma
3 layers of the skin
- Epidermis
- Dermis
- Subcutaneous
Contusions
Define
- An injury to the tissue and blood vessels contained within the dermis
Abrasion
Define
- Scraping, rubbing, or shearing away of the epidermis
What is the biggest concern with abrasions?
Infection
Two types of lacerations
- Linear
- Stellate (irregular)
What are the common causes of a linear laceration
And why do they heal better than stellate lacerations
- Knife, razor, or broken glass
- Heal better becuase they have smooth edges
Common cause for a stellate laceration
- Blunt force trauma
How do you determine severity of an alvulsion?
- Directly related to the effectiveness of circulation and perfusion distal to the injury
- Cap refill
- CMS
Cellulitis
Define
- Inflammation of skin cells
Complications with dog bites
- Cellulitis (inflammation of skin cells)
- Septicemia (blood infection)
- Rabies
- Tetanus
Clamping injuries
Define
- Occurs when a body part is caught of strangles by some piece of machinery, a tool, or other object or equipment
Clamping injuries
Emergency care
- If pt is stable apply a lubricant and slowly attempt to wiggle the part loose
- if possible elevate injury above pts head to decrease circulation pressure
- Cant get them out bring it with
- If the object is too big have fire cut it to a more managable size
Penetrating chest wounds
Emergency care
- Cover with an occlusive dressing secured with tape on 3 sides to allow air to escape as the patient exhales to prevent a tension pneumothorax
Evisceration
Define
- Abdominal organs protrude through the open wound
Evisceration
Emergency care
- Do not touch the organ
- Cover with a wet sterile dressing
- Then cover dressing with occlusive dressing taped on all 4 sides
Impaled objects
When can you remove them
- Only if impaled through the cheek
- Or neck if its obstructing airflow through trachea
- AND THATS IT. Nothing else gets removed
Emergency care for impaled objects
- Manulally secure object
- Remove clothing from around the wound
- Control bleeding
- Stabilize the object with dressings and then tape it securely
What do you do with an amputated body part?
- remove any gross contamination by flushing the part with sterile water or slaline
- Wrap it in a dry sterile gauze dressing
- put it in a plastic bag
- Keep amputated part cool but dont freeze it
- Transport it with the patient if possible
Air embolism
What is that?
- With an open neck wound air can be sucked into a neck vein and carried to the heart. that is potentially lethal
Large open neck injuries
Emergency care major goals
- Bleeding control and prevention of an air embolism
DCAP BTLS
Whats that stand for?
- D - Deformities
- C- Contrusion
- A - Abrasions
- P- Punctures
- B - Burns
- T - Tenderness
- L - Lacerations
- S - Swelling
Blood volume
Adult : 70 mL/kg (5 liters)
Child: 80 mL/kg
