CHAPTER 25 Flashcards
This is when blood escapes from the cardiovascular system or when it cannot be efficiently pumped to tissues the cells become insufficiently oxygenated and this is called?
hypoperfusion or shock
the supply of oxygen to and removal of wastes from the body cells and tissues as a result of the flow of blood through the capillaries
perfusion
the bodys inability to adequately circulate blood to the bodys cells to supply them with oxygen and nutrients
hypoperfusion
the bodys inability to adequately circulate blood to the bodys cells to supply them with oxygen and nutrients which is a life threatening condition
shock
the ______ system is responsible for the distribution of blood to all parts of the body
circulatory ( cardiovascular )
the cardiovascular system has 3 components
heart, blood vessels, blood
the hearts job is to pump blood which supplies _____ and ______ to the bodys cells
oxygen and nutrients
blood is circulated through the body through 3 major blood vessels such as
1.) arteries 2.) veins 3.) capillaries
these carry oxygenated blood sometimes deoxygenated blood AWAY from the heart
arteries
these have thick muscular walls that enable it to dilate or constrict depending on the oxygen and nutrients need by the cells
arteries
oxygen rich blood is emptied from the arteries into here_____ which supply every cell of the body
capillaries
these are one way valves that carry blood to the heart
veins
blood in a vein is under _____ pressure than in a artery
less
blood thats been depleted of oxygen and loaded with carbon dioxide and other wastes are emptied into here?
veins
the blood has several functions:
1.) transportation of gases 2.) nutrition 3.) excretion 4.) regulation 5.) protection
______ or ( expansion) of the blood vessels increases blood flow to the skin which increases heat loss from the skin surface
dilation
______ or narrowing of blood vessels decreases blood flow to the skin which decreases heat loss so core temp can be preserved
constriction
bleeding especially severe bleeding is called?
hemorrhage
____ is the main cause of shock in trauma
severe bleeding or hemorrhage
______ is caused when a force penetrates the skin or lacerations destroy underlying blood vessels
external bleeding
bleeding from an artery which is characterized by bright red blood that is rapid, profuse, and difficult to control
arterial bleeding
bleeding from a vein that is dark red or maroon blood and a steady easy to control flow
venous bleeding
______ hemorrhage occurs when extensive wounds open up large blood vessels or many smaller blood vessels
massive
blood coming from the heart is generally well _____
oxygenated
bleeding from an artery can be seen ____ with each beat of the heart
spurting
wounds to large veins such as the _____ veins can also cause massive bleeding
jugular
_______ hemorrhage occurs where the appendages of the body connect to the trunk
junctional
this is a sign of spurting blood, pulsating flow and bright red blood
arteries
this is a sign of steady slow flow, dark red blood
veins
these flow evenly and slow
capillaries
bleeding from capillaries which is characterized by a slow oozing flow of blood
capillary bleeding
medications such as aspirin, warfarin, xarelto, pradaxa can prevent _____
clotting
reduced body temperature such as ______ can prevent the ability to clot
hypothermia
a _____ hemorrhage can be compressible for the most part that is can be controlled by pressing the tissue around the wound or the vessel that is bleeding
external
when caring for an external hemorrhage you should wear what 3 things
1.) a gown 2.) eye protection 3.) a mask
anytime someone has blood loss you should treat for ____
shock
signs of shock are?
1.) altered mental status 2.) pale, cool, clammy skin 3.) nausea and vomiting 4.) vital signs change
altered mental status occurs in shock because the ____ isn’t getting enough oxygen
brain
pale, cool and clammy skin is a result of low _____ so in this case the body gets blood from nonvital organs to take to the rest of the body
blood volume
in ______ and _______ shock the skin is typically warm, flushed, and dry because the circulatory system has lost the ability to constrict blood vessels in the skin
anaphylactic and neurogenic
in the bodys continuing effort to keep blood perfusing the vital organs blood is diverted from the _____ system causing nausea
digestive
in shock the pulse will _____ and become weak and thready
increase
respirations will____ in shock they will also become more shallow and labored as shock progresses
increase
the blood pressure will _____ in a serious life threatening stage of shock
decreases or drop
the systolic and diastolic pressures will ___ meaning they will be closer together
decrease
late signs of shock include?
thirst, dilated pupils, cyanosis
one of the most important elements in the prevention of shock is to control _____ bleeding
external
the major methods of controlling external bleeding are:
1.) direct pressure 2.) elevation of a limb 3.) hemostatic agent 4.) tourniquet 5.) splinting 6.) cold application
for a patient with signs of shock control the bleeding and consider providing _____
oxygen
the first step in controlling bleeding is ____ this compresses the tissue around the wound and diverts blood flow from the affected blood vessels
direct pressure
______ dressing may be used to stop bleeding if pressure alone doesn’t work
hemostatic
if pressure and hemostatic dressings do not stop the bleeding apply and tighten a ______ until the bleeding stops
tourniquet
do not removing a dressing on a wound because you might remove _____ that have formed
clots
a bulky dressing held in position with a tightly wrapped bandage which applies pressure to help control bleeding
pressure dressing
after controlling bleeding from an extremity using a pressure dressing always check for a ____ to make sure that the dressing has not been applied to tightly
distal pulse
______ is usually the quickest and most effective method of controlling external bleeding
direct pressure
______ of an injury above the level of the heart, gravity helps reduce the blood pressure in the extremity , slowing bleeding
elevation
substances applied as powders, dressings, gauze, or bandages to open wounds to stop bleeding
hemostatic agents
products designed to enhance direct pressures ability to control bleeding
hemostatic agent
a device used for bleeding control that constricts all blood flow to and from an extremity
tourniquet
____ is a device that closes off blood flow to and from a extremity
tourniquet
if the bleeding is not controlled by direct pressure and the wound is on a extremity then a ____ should be applied
tourniquet
if direct pressure is ineffective and the wound is on the trunk or head then a _____ should be applied
bandage or hemostatic agent
we ____ to prevent further movement to damaged bones
splint
______ splints also called air splints may be used to control internal and external bleeding these splints may also control bleeding even if there are no suspected injury
inflatable
____ splints are most effective for venous and capillary bleeding
air splints
do not leave ice packs on the skin for no longer than __ mins
20
____ packs minimize swelling and reduces the bleeding by constricting blood vessels
cold
_____ carry oxygenated blood and deoxygenated blood away from the heart
arteries
the ____ artery carries deoxygenated blood because its going away from the heart to the lungs
pulmonary
these have thick muscular walls that enable dilation and constriction
arteries
these carry deoxygenated blood toward the heart
veins
these have one way valves that help to keep blood from backing up and going in a different direction
veins
these are microscopic blood vessels
capillaries
this is the site of oxygen and gas exchange this is where oxygen picks up carbon dioxide and carry it back to the lungs
capillaries
what are the functions of blood?
1.) transportation 2.) excretion 3.) nutrition 4.) protection 5.) regulation
blood transports _____ and _____
oxygen and nutrients
during excretion blood carries away ____ and waste products
carbon dioxide
during nutrition blood distributes _____
nutrients
the blood has _____ that fight infection during protection
antibodies
during regulation _____ and _____ carry blood to keep you warm keeps the blood circulating
hormones and electrolytes
adequate circulation of blood throughout the body is ____
perfusion
inadequate circulation of blood to tissues and organs is ______
hypoperfusion
what is the role of the respiratory system in the circulatory system?
it delivers oxygen to the blood to supply the body
this type of bleeding oozes?
capillary bleed
this type of bleeding is slow,even,and can be bright or dark red
capillary bleeding
this is spurting blood
arterial bleed
this type of bleeding is a pulsating flow, bright red color because its highly oxygenated
arterial bleed
this is a steady, slow bleed?
venous bleed
this type of bleed is dark red because its deoxygenated bleeding
venous bleed
this kind of bleed requires atlas 5 mins of direct pressure and blood thinners can interrupt clotting
arterial bleed
this type of bleed requires direct pressure for 1 min unless on blood thinners
venous bleed
this means your bleeding out or bleeding to death
exsanguinating bleeding
the standard precautions to take if someones bleeding is ?
wear gloves, a gown, eye protection , and a mask
when should you apply a tourniquet? at what time
after you have applied a hemostatic agent
_____ is the single best way to control bleeding
direct pressure
when applying direct pressure apply pressure with your _____ hand and gauze bandage
gloved
apply direct pressure until when?
the bleeding is controlled
true or false: you should NEVER remove a dressing after its saturated and needs more dressings
true
after the bleeding has been controlled you should do what?
check for a distal pulse
elevation slows bleeding by ____
gravity slows the bleeding
this is wrapping several dressings in place with ace bandage or roller bandage wrap tightly over dressings above and below wound
pressure dressings
this is a type of dressing where you place several dressings over a wound
pressure dressing
this is dressing containing substances that absorb and trap red blood cells
hemostatic agents
these dressings can be wadded up and placed into a wound
hemostatic agents
if bleeding cant be controlled with direct pressure a ____ would be used
tourniquet
you only use a tourniquet on _____ injuries
extremity
what are the signs someone is going into shock
altered mental status, bp drops, tachycardia increased heart rate, pulse is irregular
what would be a commercial tourniquet used in substitution?
blood pressure cuff
when a ___ is applied never remove or loosen it and make sure you document when it was put on
tourniquet
attach notation to the patient alerting other providers that a ____ has been applied
tourniquet
_____ is a good way to stop bleeding because it keeps you from moving and causing bleeding
splinting
splinting helps to keep you from moving and it also does what ?
reduces pain which lowers the bp and calms the patient down
this is a type of bleeding control that helps the skin to clot, it causes vasoconstrction which limits bleeding
cold application
this is a result from blood flowing from your nose or ears?
head injury
when we have a head injury we will see an increased ______ pressure that may or may not be from direct pressure
intracranial
during a head injury stopping the bleeding only increases _____ pressure because your brain is still going to swell
intracranial
a ____ is a nosebleed
epistaxis
____ can cause a nosebleed
high bp
_____ is damage to internal organs and large blood vessels it can result in loss of a large quantity of blood in a short time
internal bleeding
during _____ bleeding blood loss is not usually seen
internal
an example of a atraumatic bleed that is a medical bleed that can cause an internal bleed is____
GI bleeds
severe blood loss can result from injury to extremities injury to the _____ can cause internal bleeding
femur
signs of shock can indicate _____
internal bleeding
_____ trauma means no external bleeding
blunt
whats some leading causes of internal bleeding
falls, motor vehicle crashes, auto-pedestrian collisions, blast injuries
most internal damage will be recognized by looking at the ____
MOI
a patient cool, pale and sweaty can’t really remember what happened, coming in and out of consciousness bp is 88/40 you would put a ___ on them
tourniquet
some examples of penetrating traumas would be:
gunshot wound, stab wound, impaled objects
signs of internal bleeding would be:
1.) shock 2.) MOI 3.) injuries to the body surface 4.) bruising, swelling, organs painful when palpating5.) painful, swollen, deformed extremities 6.) bleeding from the mouth, rectum and vagina 7.) tender, rigid or distended abdomen 8.) vomiting coffee ground or bright red material
_____ indicates new blood
bright red blood
children compensate when they are very ill they can maintain a normal bp until half their ____ is lost
blood volume
when trying to determine a trauma you would use your ____ of the scene
MOI
what signs will children show if their in shock r going into shock
altered mental status, pale, cool, clammy, listless they don’t recall what your saying
whats some things to do when treating for shock in a internal bleed
keep the patient warm, give oxygen, keep the patient still, lay the patient down
_____ is the inability to supply cells with oxygen and nutrients
shock
this is the inadequate removal of waste products from cells
shock
this is a type of shock when the heart loses the ability to pump
cardiogenic
this is a type of shock when the blood vessels dilate making too large a container to fill
neurogenic shock
this is shock that occurs when you loose too much blood
hypovolemic shock
in this stage of shock your body is still working?
compensated
this is when your body senses the decrease in perfusion and attempts to compensate for it
compensated shock
during early signs of shock what does your vital signs do?
HR increases, RESP RATE. increases, BLOOD PRESSURE increases, you become cool, pale, sweaty and you have a NORMAL mental status
this is a shock when your body isn’t working any more
decompensated
this is when the body can no longer compensate for low blood volume or lack of perfusion
decompensated shock
during decompensated shock late shock what does your vital signs do?
you have an ALTERED MENTAL STATUS, BP decreases, HR decreases, RESP RATE. decreases
this is what type of shock? loss of circulating blood volume
hypovolemic shock
this type of shock is called hemorrhagic shock if its caused by uncontrolled bleeding internal and external
hypovolemic shock
this type of shock is caused by burns and crush injuries
hypovolemic shock
this type of shock is seen in patients suffering myocardial infarction ( heart attack )
cardiogenic shock
in this shock you have inadequate perfusion to heart which decreases contractions
cardiogenic shock
malfunction of the hearts electrical system causing the heartbeat to be slow, too fast or irregular is what type of shock?
cardiogenic shock
this type of shock is the inability to control dilation of blood vessels because of nerve paralysis
neurogenic
is this type of shock you have no blood loos but vessels dilate so much blood volume can’t fill them
neurogenic
anaphylactic and septic shock are examples of this type of shock
neurogenic shock
signs of shock are
altered mental status, pale, cool, clammy, nausea and vomiting, vital signs change
treatment for shock:
aggressive airway maintenance, give oxygen, attempt to stop cause of shock, splint bone or joint injuries, prevent heat loss, deliver patient to appropriate hospital, calm patient down
how should you care for an amputated hand?
wrap in a dry dressing
almost all external bleeding can be controlled by _____ and _____
elevation and direct pressure
any time someone is bleeding treat for ______
shock
early signs of shock are:
restlessness, anxiety, pale skin, rapid pulse, rapid respirations, tachycardia
signs and symptoms of shock may not be evident early treatment is based on____
MOI
_____ develops if the heart fails, blood volume is lost, or blind vessels dilate
shock
this is a reflecting of the body trying to compensate for inadequate perfusion
shock
the most significant treatment for __patients is early recognition, treat them before you see it
shock
never push _____ into an internal wound such as a penetrating trauma to the abdomen or chest
dressings
obvious bleeding and soaking through the dressings is signs that your direct pressure isn’t working working and you should apply a ____
tourniquet
do not apply a tourniquet directly over a ___ place it 2 inches above the wound
joint
never apply _____ directly to the skin this can cause frostbite and further tissue damage, wrap the ice pack in a cloth before applying to the skin, never leave on longer than 20 mins at a time
ice or cold packs
when pressure receptors in the aorta and carotid artery sense decrease flow they stimulate the release of epinephrine and _____ into the bloodstream
norepinephrine
when an infection spreads through the body via the bloodstream ___ or blood poisoning is present
sepsis
the goal for on scene time when caring for a trauma or shock patient is ___ mins
10
_____ is an impaired ability to clot
coagulopathy
