Bleeding Shock Soft Tissue Injuries Flashcards
what is a wound?
an injury, usually involving division of tissue or rupture of the integument (skin) or mucous membrane, due to external violence or some mechanical agency rather than disease
List and describe the five main types of wounds
CLIPS:
C Contusion - A Bruise
L Laceration - A Tear Like Wound
I Incision - A Clean Scalpel Cut
P Puncture - An object piercing the
skin and creating a hole
S Special - Ballistic Wound
Types of injuries
B Bruising
E Evisceration
A Abrasion
P Puncture (penetrating/perforation)
A Avulsion
I Incision
L Laceration
What is evisceration?
Injury in which organs protrude from the abdominal cavity through a wound in the abdominal wall
What are perforations?
Entry and Exit wounds present
Caused by gunshot, blast injuries etc
Complete head to toe examination if suspected
All injuries must be treated and bleeding controlled
What are avulsions?
Injury in which flaps of skin or tissue are torn loose or pulled completely off
What is an incision wound?
Usually caused by a sharp edged object
e.g. a knife or razor
Clean cut wound
Bleeds heavily and freely
Heals quickly
What is a haematoma?
an injury/trauma damages your veins and arteries
What is a haemmorhage?
bleeding
What are the types of bleeding?
Arterial Bleeding
Venous bleeding
Capillary Bleeding
What is arterial bleeding?
characterized by spurts with each beat of the heart, is bright red in colour.
What is venous bleeding?
characterized by a steady flow and the blood is dark, almost maroon in shade.
What is capillary bleeding?
characterized by slow & oozing in nature, this type of bleeding usually has a higher risk of infection.
What is shock?
- Failure of the cardiovascular system to adequately supply the body with oxygenated blood
- Bleeding is one of the most common causes
- State of collapse and failure of the cardiovascular system
- Blood circulation slows and eventually ceases
What happens if blood flow stops or slows significantly?
- Waste elimination ceases.
- Oxygen delivery would also be disrupted.
- Anaerobic metabolism begins
What is hypovolaemic shock?
an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body
What is haemostasis?
HOWTHE BODY STOPS BLEEDING
- When vessels are lacerated
- Open ends of the vessel begin to narrow
- Platelets aggregate at the site
- Bleeding will not stop if a clot does not form
- Direct contact with body tissues and fluids or the external environment commonly triggers the blood’s clotting factors
What are the three successive phases of shock?
- Compensated
- Decompensated
- Irreversible
What is the compensated phase of shock?
Earliest stage
Body can still compensate for blood loss
Level of responsiveness is best indicator of tissue perfusion
Blood pressure is maintained
Blood loss in hypovolaemic shock can be estimated at 15% to 30%
Narrowing of the pulse pressure occurs
Positive orthostatic tilt test result
Treatment will typically result in recovery
What is the decompensated phase of shock?
- Blood pressure is falling
- Blood volume drops by more than 30%
- Compensatory measures begin to fail
- Signs and symptoms are more obvious
- Cardiac output falls dramatically
- Treatment will sometimes result in recovery
What is irreversible shock?
Arterial blood pressure is abnormally low
Rapid deterioration
Life-threatening reductions in cardiac output, blood pressure and tissue perfusion
Cells begin to die
Vital organ damage cannot be repaired
what is the care management for a patient with external bleeding?
Scene Safety
BSI
PEEPS
Posture; Elevate; Examine; Pressure; Shock
O2 Therapy
ALS
Transport
What is a haemostatic dressing?
dressing with chemicals that help stop bleeding
Where is a tourniquet applied?
2-3 inches above the wound
What are the 4 pressure points?
TO STOP BLEEDING
- Brachial artery
- Radial artery
- Femoral artery
- Popliteal artery (back of knee)
What are the causes of non-traumatic internal bleeding?
Cases of GI bleeding from the upper or lower GI tract
Ruptured ectopic pregnancies
Ruptured aneurysms
What is the term for bleeding from the lungs?
Haemoptysis
Bright red and frothy coughed up through the trachea and airways
HE MOPS BITCH
What is the term for internal stomach bleeding?
(Haematemesis)
Dark coffee colour is vomited up. can range from frank blood to coffee ground in appearance
How does internal bleeding in the kidneys present?
Stains the urine into a smokey grey colour, can range from staining the urine to frank blood
How does internal bleeding in the large intestine present?
Passed by bowel as black tarry substance
what is malaena?
the production of dark sticky faeces containing partly digested blood, as a result of internal bleeding or the swallowing of blood
What is CSF?
internal brain bleed
blood escapes through the eyes/ears/nose
What are the signs and symptoms of bleeding?
Pulse – Rapid and weak
Respirations – Rapid and shallow (air hunger)
Pupils – Dilated / blurred vision
Skin – Pallor, cold extremities, cyanosis
Blood Pressure – Late sign BP Drops
What is the treatment for an internal haemorhage?
treat for shock
Administer high-flow supplemental oxygen
Assist ventilation if needed
Splint broken bones or joint injuries
Place blankets under and over the patient
Consider giving analgesia if required
Monitor the serial vital signs
LOAD AND GO
what is a crush injury?
body part stuck between two solid objects?
what happens to the body after it has been crushed for 4+hrs?
Arterial blood flow is compromised
Muscles are crushed beyond repair
Tissue necrosis (Rhabdomyolysis)
Influx of water, sodium chloride and calcium
Freeing the limb
“Smiling death”
Renal failure
Life-threatening arrhythmias
what are the 6 P’s of compartment syndrome?
Pain
Paraesthesia (Pins, Needles, Unusual, etc.)
Paresis (loss of movement)
Pressure
Passive stretch pain
Pulselessness
Delayed or nonspecific
If it persists for longer than 8 hours
what reasons would an EMT remove an impaled object?
if the object interferes with airway control
If the object interferes with chest compression
Impaled on an immovable object
