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CCSF EMTP: 123 Trauma > Ch. 30 - Bleeding / Assessment and Management of Shock > Flashcards

Ch. 30 - Bleeding / Assessment and Management of Shock Flashcards

1
Q

What is PVR?

A

Peripheral Vascular Resistance

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2
Q

For internal hemorrhage, PT must be treated promptly. Pay close attention to

  1. complaints of ____ and _________
  2. Development of _____________
  3. Pallor
A
  1. complaints of pain and tenderness
  2. Development of tachycardia
  3. Pallor
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3
Q

PVR is measured as ___.

A

PVR is measured as MAP (Mean Arterial Pressure).

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4
Q

____________ refers to the body’s nonstop balancing act intended to maintain a normal internal environment.

A

Homeostasis

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5
Q

Early decreased tissue perfusion may result in subtle changes in the PT’s status, such as abberant mental status, long before ______ ______ appear abnormal.

A

Vital Signs (VS)

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6
Q

The cells of the body require a steady supply of oxygen to create energy enough to function. They create this energy through a process called __________ ___________. This process happily creates a great deal of energy and relatively little waste product in the form of carbon dioxide and water.

A

Aerobic metabolism

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7
Q

Nontraumatic internal hemorrhage usually occurs in cases of: (3).

A
  1. GI bleeding
  2. Ruptured ectopic pregnancies
  3. Ruptured aneurysms
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8
Q

The average adult human heart contracts ___ times a minute. With each of those contractions, an average of ___ mL of blood is pumped out of the left ventricle into systemic circulation. This suggests that, on average, the adult human heart pumps just under 5000 mL of blood every minute of every day (70 x 70 = 4900).

A

70; 70 mL

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9
Q

How do you find MAP (Mean Arterial Pressure)?

A

Diastolic BP + 1/3 PP (pulse pressure) = MAP

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10
Q

(SV)(HR)(PVR) = __

A

(SV)(HR)(PVR) = BP

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11
Q

Vomited blood

A

Hematemasis

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12
Q

An abnormal state associated with inadequate oxygen and nutrient delivery to the metabolic apparatus of the cell.

A

Shock

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13
Q

If an injury is large enough, a peron can _________________ in just a few minutes.

A

Exsanguinate

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14
Q

What are 2 purposes of blood?

A
  1. Carry O2 and nutrients to tissues
  2. Carry cellular waste products away from tissues
    • Other functions of formed elements:
      • Fighing infection
      • Control bleeding
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15
Q

What is one early sign of hypoperfusion suggesting internal hemorrhage?

A

Tachycardia

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16
Q

What are the methods for controlling external hemorrhage?

A
  1. Direct, even pressure
  2. Pressure dressings and/or Splints
  3. Tourniquets
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17
Q

Blood in the Urine.

A

Hematuria

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18
Q

Passage of stools containing bright red blood.

A

Hematochezia

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19
Q

The delivery of oxygen and nutrients to the cells, organs, and tissues of the body.

A

Perfusion

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20
Q

The early stage of shock, in which the body can still compensate for blood loss. The systolic blood pressure and brain perfusion are maintained.

A

Compensated Shock

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21
Q

__________ is a primarily hereditary bleeding disorder, in which clotting dies not occur or occurs insufficiently.

A

Hemophilia

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22
Q

“Rest and digest” is controlled by…?

A

Parasympathetic Nervous System

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23
Q

The late stage of shock, when BP is falling.

A

Decompensated (Hypotensive) Shock

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24
Q

The proportion of red blood cells in the total blood volume.

A

Hematocrit

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25
The final stage of shock, prior to death is called ____________ \_\_\_\_\_\_.
**Irreversible Shock**
26
A component of blood, made of 92% water, 6%-7% proteins, and electrolytes, clotting factors, and glucose.
**Plasma**
27
Bood consists of: 1. \_\_\_\_\_\_\_\_ 2. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 3. ____ \_\_\_\_\_\_ \_\_\_\_\_ 4. _____ \_\_\_\_\_\_ \_\_\_\_\_ 5. \_\_\_\_\_\_\_\_
Bood consists of: 1. **Plasma** 2. **Formed elements in plasma** 3. **Red Blood Cells** 4. **White Blood Cells** 5. **Patelets**
28
The percentage of blood that leaves the heart each time that it contracts.
Ejection Fraction (EF)
29
The loss of the total blood volume, resulting in death.
Exsanguination
30
When externally hemorrhaging from the **capillary**, blood \_\_\_\_\_\_.
blood **OOZES**.
31
\_\_\_\_\_\_\_\_\_ nervous system adjusts blood flow to meet the body's needs.
Autonomic nervous system
32
Most cases of external hemorrhage can be controlled with _________ \_\_\_\_\_\_\_\_.
**Direct Pressure** to the bleeding site.
33
The body's natural blood-clotting mechanism.
**Hemostasis**
34
The pressure in the aorta against which the left ventricle must pump blood; increasing this pressure can decrease CO (Cardiac Output).
**Afterload**
35
A condition that occurs when the circulating blood volume is inadequate to deliver adequate oxygen and nutrients to the body.
**Hypovolemic Shock**
36
A condition in which volume is lost in the form of blood.
**Hemorrhagic Shock**
37
Insufficient circulation leads to ___________ or \_\_\_\_\_\_\_.
Hypoperfusion or shock
38
What 4 factors does the delivery of oxygen depend on?
1. Adequate HR 2. SV (stroke volume) 3. Hemoglobin Levels 4. Arterial Oxygen saturation
39
Cardiac Output = ____ X HR
Stroke volume
40
A condition when the level of tissue perfusion decreases below that needed to maintain normal cellular functions.
**Hypoperfusion**
41
Coughed-Up Blood
**Hemoptysis**
42
\_\_\_\_\_\_\_\_ ________ is the amount if blood pumped through the circulatory system in 1 minute. It equals the stroke volume multiplied by the pulse rate.
Cardiac Output (CO)
43
How do you find someone's pule pressure?
**SBP** (Systolic BP) - **DBP** (Diastolic BP) = **Pulse Pressure**
44
\_\_\_\_\_\_\_\_\_\_\_\_ _______ is the most common cause of hypovolemic shock.
**Hemorrhagic Shock**
45
What does **HEMORRHAGE** mean?
**Bleeding**
46
These chemical reactions convert food into energy, build and maintain body tissues, and then break down and eliminate waste products—and so much more.
Metabolism
47
Typically, more than _ L of blood loss will change vital signs.
1 L
48
The amount of blood that the left venticle ejects into the aorta per contraction.
Stroke Volume (SV)
49
Extent and severity of external hemorrhage is often a function of the type of _______ and \_\_\_\_\_\_\_\_.
wound and vessel.
50
The body cannot tolerate more than \_\_% blood loss.
**20%**
51
\_\_\_\_\_\_\_\_\_ is the circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs for oxygen, nutrients, and wate removal.
**Perfusion**
52
\_\_\_\_\_\_\_\_\_\_\_ center in the ________ \_\_\_\_\_\_\_\_\_ helps regulate BP (blood pressure).
**Vasomomotor center** in the **Medulla Oblongata** helps regulate BP.
53
\_\_\_\_\_ is the amount of blood returned to the heart to be pumped out.
**Preload** is the amount of blood returned to the heart to be pumped out.
54
Small cells in the blood that are essential for clot formation.
**Platelets**
55
A mass of bloof in the soft tissues beneath the skin; it indicates bleeding into the soft tissues and may be the result of minor or severe injury.
**Hematoma**
56
The Precontraction pressure in the heart, which increases as the volume of blood builds up.
**Preload**
57
\_\_\_\_\_\_\_\_\_\_\_\_ depends on how rapidly a person bleeds.
Compensation
58
Fall in BP causes the release of: 1. \_\_\_\_\_\_\_\_\_\_\_\_ 2. ____________ \_\_\_\_\_\_\_\_\_\_\_
Fall in BP causes the release of: 1. **Aldosterone** 2. **Antidiuretic hormone (ADH)**
59
Hypoperfusion (shock) occurs when the level of tissue ________ decreases below **normal**.
tissue **perfusion**
60
When externally hemorrhaging from the **Artery**, blood \_\_\_\_\_\_.
blood **SPURTS**.
61
Preload directly affects \_\_\_\_\_\_\_\_\_\_, the pressure in the aorta or the peripheral vascular resistance, against which the left ventricle must pump blood.
**Afterload**
62
If bleeding is present at the nose and a skull Fx is suspected, place a gauze pad _______ under the nose.
Loosely
63
Be alert for any early signs of \_\_\_\_\_\_.
**Shock**
64
Passage of dark, tarry stools.
**Melena**
65
When externally hemorrhaging from the **vein**, blood \_\_\_\_\_\_.
blood **FLOWS**.
66
"Fight, flight, or freeze" is controlled by ...?
**Sympathetic Nervous System**
67
Consider bleeding to be serious if what conditions are present? 1. 2. 3. 4. 5.
Consider bleeding to be serious if what conditions are present? 1. Significant MOI 2. Poor PT appearance 3. Signs and symptoms of shock 4. Blood loss \>20% 5. Uncontrollable bleeding
68
What are the three steps of **Hemostasis**?
Three steps of **Hemostasis**: 1. **Vasoconstriction** 2. **Platelet Agregation** 3. **Fibrinogen weaving into the clot** and forming fibrin to hold the clot together, controlling bleeding
69
What is the **Trauma Triad of Death**?
**Trauma Triad of Death** 1. **Hypothermia** 2. **Coagulopathy (clotting disorder)** 3. **Acidosis** These three conditions work to increase one another in a positive feedback loop, rapidly worsening the PT's condition.
70
Main causes of Shock from Respiratory Failure: 1. 2. 3. 4.
Main causes of Shock from Respiratory Failure: 1. **Obstruction**-airway or embolism 2. **Chest wall movement problems**-such as flail chest 3. **Diffusion problems** 4. **Toxic Exposures**-such as Carbon Monoxide and Cyanide
71
What are causes of shock from pump failure?
1. **Cardiogenic Shock** 2. **Intrinsic** 3. **Extrinsic** * **Cardiac Tamponade** * **Tension Pnuemothorax**
72
For PTs who have sustained significant MOI's, scene time should not exceed __ minutes and the most appropriate destination must be considered.
For PTs who have sustained significant MOI's, scene time should not exceed **10** minutes and the most appropriate destination must be considered.
73
If you suspect internal hemorrhage, begin management by keeping the PT warm and what else?
If you suspect internal hemorrhage, begin management by keeping the PT warm and **administering supplemental oxygen by nonrebreather at 15 LPM en route and promptly transport.**

CCSF EMTP: 123 Trauma (4 decks)

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