Bleeding: Shock Overview

Question 1

Hypoperfusion (lack of blood supply) of the body’s vital tissues and organs due to a loss of fluid. Causes include severe dehydration and/or blood loss (also called hemorrhagic shock)

Answer 1

Hypovolemic shock

Question 2

In the presence of a severe hemorrhage what is the priority?

Answer 2

Stop of the bleeding. While airway and breathing come before circulation in an A,B,C assessment, in trauma, a massive hemorrhage is a life threat which if not corrected immediately will make the patient’s airway or respiratory status inconsequential.

Question 3

High pressure, relatively thick walled vessel that carries blood from the heart to the lungs, organs, and peripheral tissues. The majority of arteries carry oxygenated blood (exception: pulmonary arteries).

Answer 3

Artery

Question 4

Due to high pressure, an arterial bleed will generally involve rapid spurting. Blood is generally a bright red color.

Answer 4

Arterial bleed

Question 5

A relatively thinner walled vessel that is of lower pressure. Brings blood from the lungs, tissues, and peripheral tissues back to the heart. Most veins are deoxygenated (exception: pulmonary veins).

Answer 5

Vein

Question 6

Venous bleed will involve pooling of blood that is generally a darker red color.

Answer 6

Venous bleed

Question 7

Microscopic blood vessels that allow for the exchange of nutrients/oxygen to the tissues and the removal of waste such as CO2.

Answer 7

Capillary

Question 8

Oozing of blood. Small bleed should generally stop on their own with little intervention. Most capillary bleeds will respond to direct pressure and bandaging.

Answer 8

Capillary bleed

Question 9

Coughing up of blood. (hem/o = blood) (-ptysis = spitting up)

Answer 9

Hemoptysis

Question 10

Blood, generally bright red, that is mixed with stool. (hem/o = blood) (chez/o = defecate)

Answer 10

Hematochezia

Question 11

Dark black and tarry stool indicated of blood that has remained in the bowel/GI tract for some time.

Answer 11

Melena

Question 12

Stages of shock

Answer 12

Compensated shock. Decompensated shock. Irreversible shock.

Question 13

The body responds to the poor perfusion by increasing heart rate, contraction strength, and vasoconstriction of peripheral vessels. These adaptations can temporarily maintain normal blood pressure and delay decompensated shock.

Answer 13

Compensated shock

Question 14

Increased heart rate. Normal blood pressure. Anxiety/restlessness/combativeness. Thirst. Weakness. Air hunger/elevated respiratory rate. Cool and clammy skin peripherally. May be cyanotic or pale peripherally as well.

Answer 14

Compensated shock (signs and symptoms)

Question 15

The bodies mechanism of compensating for poor perfusion have been exhausted and the body begins to shock further signs of poor perfusion.

Answer 15

Decompensated shock

Question 16

Peripheral pulses may be gone. Failure to maintain blood pressure (~systolic <90). Altered mental status or loss of consciousness. Slow respirations or apnea.

Answer 16

Decompensated sock (signs and symptoms)

Question 17

If decompensated shock is not corrected immediately, poor perfusion of body tissues and organs will leads to wide spread cell death, irreversible damage that will kill the patient.

Answer 17

Irreversible shock

Question 18

Systolic range is 90 to 120 (adults). <90 is indicative of hypotension or low blood pressure.

Answer 18

Adult systolic blood pressure

Question 19

Refers to the body’s ability to deliver blood to all organs and tissues.

Answer 19

Perfusion

Question 20

Inadequate distribution of blood to the body’s tissues.

Answer 20

Hypoperfusion