Chapter 25 Bleeding Flashcards
Atrium
Upper chamber of the heart
Ventricle
Lower chamber of the heart
Arteries
Carry blood away from the heart
Venues
Very small thin walled vessels that empty into the veins
Veins
Carry de oxygenated blood from the tissues to the heart
What does blood contain?
Red Blood cell- responsible for the trans portion of O2 White Blood Cells - responsible for fighting infection Platelets - responsible for forming blood clots Plasma- the fluid portion of blood
What is perfusion
It is the circulation of blood within an organ or tissue in adequate amounts to meet the cells’ current needs for oxygen, nutrients and waste removal
How long can the brain and spinal cord last without perfusion?
4 to 6 min
How long can the lungs survive without perfusion?
15 to 20 min
How long can kidney’s survive without perfusion?
45 min
How long can skeletal muscles last without perfusion?
2 to 3 hours
What is the normal body temp?
98.6 degrees
Hemorrhage
Excessive bleeding
How much blood loss can the body tolerate?
About 2 pints or 20% of blood volume
How much blood does the typical male have?
70 ml of blood per kilogram of body weight
How much blood does the typical female have?
Roughly 65ml of blood per kilogram of body weight
What are some adverse changes that will occur from significant blood loss.
- Increase in Heart rate - increase respiratory rate - decrease in blood pressure
If a person loses more than 1 unit or 500 lol of blood over a short period of time (under 15 min) what are they at risk of?
They may rapidly develop symptoms of hypovolemic shock
Discuss arterial bleeding
- Typically brighter red (rich with oxygen) and spurts in time with the pulse) - pressure causes blood to spurt and makes it difficult to control - decreases the amount of blood circulating in the body thus the blood pressure drops
Discuss venous bleeding
- blood is dark red - flows slowly - does not spurt - easier to manage - more likely to clot spontaneously than arterial bleeding
Discuss capillary bleeding
- dark red - oozes from wound steadily - more likely to clot spontaneously than arterial bleeding
How long should the clotting process take?
Within about 10 min
What are some possible causes of internal bleeding
- stomach ulcer - lacerated liver - ruptured spleen - broken bones - pelvic fracture
What is DCAP- BTLS?
Deformities Contusions Abrasions Puncture/ Penetrations Burns Tenderness Lacerations Swelling
What are some common signs and symptoms of internal bleeding?
Pain ( most common) Swelling Distention Hematoma Bruising Hematemesis
Hematoma
A mass of blood in the soft tissues beneath the skin
What is the first sign of Hypoperfusion(Hypovolemic shock)
Change in mental status
What are some signs of hypoperfusion (hypovelemic shock)?
Change in mental status Weakness, faintness, dizziness Change in skin color (pale looking)
What are some later signs of hypoperfusion
Tachycardia Thirst Cold moist clammy skin Nausea, vomiting Capillary refill greater than two seconds Weak thready pulse Decreasing Blood Pressure
What are some signs that signifies rapid transport is needed ?
Tachycardia Tachypnea Low blood pressure Weak Pulse Clammy skin
How often should you reassess an unstable patient?
Every 5 min
If internal bleeding is suspected what should you do?
Keep patient calm Apply high flow oxygen via NRB Maintain body temp Splint if applicable (air splint) Provide rapid transport
What is the most effective way to control external bleeding?
Direct pressure
How long should you hold direct pressure for when trying to control external bleeding ?
At least 5 min
What are the two forms of Hemostatic agents
Granular powder Gauze impregnated with a clay substance
How should you place a tourniquet?
Always proximal to the joint
What is an air splint also known as?
A soft splint or pressure splint
What do Rigid splints do?
Will help immobilize fractures Reduce pain Prevent further damage to soft tissue injuries
What is an epistaxis
A nosebleed
How can you control a Epistaxis
Pinching the nostrils together
