Ch. 14 EMR Book: Bleeding, Shock, and Soft-Tissue Injuries Flashcards
What does internal blood loss result in?
Shock
What is shock?
A state of collapse of the cardiovascular system that results in inadequate delivery of oxygenated blood to the organs
What should you do if the patient is losing a significant amount of blood during the primary assessment?
Temporarily halt the assessment and manage the problem
What are some signs of shock?
Pale skin, increasing pulse rate, or decreasing blood pressure
Where should you check for a pulse in a patient experiencing shock?
The carotid pulse
What is cardiogenic shock
When the heart cannot pump enough blood to supply the needs of the body
What can be a cause of failure of the heart’s pumping abilities?
Weakening of the heart due to a heart attack
What can inadequate pumping of the heart cause?
Blood can back up in the vessels of the lungs, which causes CHF as well
What is congestive heart failure (CHF)
Heart-disease characterized by breathlessness, fluid retention in the lungs, and generalized swelling of the body
What happens if the capillaries dilate too much?
- Blood pools in the capillaries and doesn’t circulate properly
- Organs are deprived of blood
- BP falls and shock results from this
What is psychogenic shock?
Fainting; caused by a temporary reduction in blood supply to the brain as the body’s response to emotional or psychological stress and is the least serious type of shock
What happens to the capillaries during psychogenic shock?
They expand which causes blood to pool and become unable to be delivered to the brain
How can psychogenic shock be corrected?
Placing the patient in a horizontal position
What is anaphylactic shock?
Shock caused by an extreme allergic reaction to certain foods, medication, or insect bites/stings
What are some signs of anaphylactic shock?
Sneezing, itching, rash/hives, swelling of the face and tongue, blue discoloration around the mouth, flushed skin, difficulty breathing, wheezing, BP dropping, and weak pulse
What is septic shock?
Shock resulting from an overwhelming infection that has spread throughout the body and is more common in older patients
What happens to the blood vessels during septic shock?
They dilate and become more porous/leaky
What are some signs of septic shock?
Weak and rapid pulse, rapid breathing, fever and chills, or low body temp
What can septic shock result in?
Organ damage, making it a life-threatening emergency
What is neurogenic shock?
Shock in patients who have sustained a spinal cord injury where the capillaries expand and blood pools in the area below the injury
What are the 4 types of shock caused by expansion of the capillaries?
- Shock induced by fainting
- Anaphylactic shock
- Septic shock
- Neurogenic shock
What is the most common cause of shock?
Fluid loss due to excessive bleeding
What is a hemorrhage?
Excessive bleeding
What happens in the body during excessive bleeding?
The heart pumps faster to compensate for fluid loss but soon results in cardiac arrest as it stops pumping after fluid continues to drain out of the system
What are some signs of internal bleeding?
Bruising, swelling, and rigidity of the affected area
How much blood is circulating in an adult’s system?
Around 6 L or 12 pints
How much blood needs to be lost in order for the patient to experience shock?
11 L or 2 pints
What are some general signs and symptoms of shock?
- Confusion, agitation, restlessness, or anxiety
- Cold, clammy, sweaty, pale skin
- Rapid, shallow breathing
- Rapid, weak pulse
- Increased capillary refill
- Nausea or vomiting
- Weakness or fainting
- Thirst
What can be the first sign of shock?
Changes in mental status and changes in behavior
What is the general treatment for shock?
- Position the patient correctly
- Maintain the patient’s ABCs
- Treat the cause of shock, if possible
- Maintain the patient’s body temp by placing blankets under and over the patient
- Ensure the patient does not eat or drink anything
- Assist with other treatments like administering oxygen
- Arrange for immediate/prompt transport to an appropriate medical facility
How should you position a patient in shock who does not have head injury, extreme discomfort, or difficulty breathing?
- Place the patient on their back on a horizontal surface
- Place a blanket under the patient
- Elevate their legs
How should you position a patient in shock who has a head injury, spine injury, or lower extremity injury?
Flat on their back without elevating the legs
How should you position a patient in shock who is having chest pain or difficulty breathing with no suspected spinal injury?
Sitting or semireclining
How can you treat excessive bleeding before the patient is in the hospital?
Direct pressure on the wound, elevation, or a tourniquet
Why should patients experiencing shock never eat or drink anything?
It can cause them to vomit due to nausea or in case they need emergency surgery
