Chapter 25 bleeding and shock

Question 1

structure of arteries

Answer 1

from outer layer to inside layer

• external elastic membrane
• smooth muscle (thicker for higher pressure of arteries)
• internal elastic membrane
• endothelium
• lumen

Question 2

structure of viens

Answer 2

outer to inside

• external elastic membrane
• smooth muscle (thinner because of lower vein pressure
• internal elastic membrane
• endothelium
• lumen

-one way valve (in veins only)

Question 3

capillary

Answer 3

made of the endothelium only

Question 4

external bleeding

Answer 4

-arteries
spurting blood
pulsating flow
bright red color

-veins
steady slow flow
dark red color (deoxygenated blood)

-capillaries
slow even flow (like oozing)

Question 5

vulnerable arteries

Answer 5

areas that the appendages connect to the body.

• neck
• arm pits
• groins

these are sites where massive bleeding is likely

Question 6

external hemorrhage

Answer 6

vast majority of external hemorrhage is not massive.

Question 7

skin is warm, flushed and dry during_______?

Answer 7

anaphylactic and neurogenic shock.

the circulatory system looses the ability to constrict blood vessels in the skin.

Question 8

vital signs during shock

Answer 8

pulse and respirations increase in an attempt to compensate for hemorrhage.

the last vital to change is blood pressure.

if and when the BP drops, the patient is in imminent danger. a narrowing of the Systolic and diastolic pressure get closer together, will be a clear sign of this.

Question 9

late signs of shock

Answer 9

• thirst
• dilated pupils
• cyanosis around the lips and nail beds

Question 10

control of external bleeding is one of the most important elements in the prevention of shock.

Answer 10

if bleeding is not controlled, shock will continue, and worsen ultimately leading to the patients death.

Question 11

direct pressure

Answer 11

often direct pressure is the first step to bleeding control

-often the quickest most effective method of controlling external bleeding

Question 12

elevating wound above heart

Answer 12

gravity helps slow bleeding and reduces blood pressure to that area.
-be sure that there are no muscleskeletal injuries or spinal injuries.

Question 13

tourniquet placement

Answer 13

place tourniquet roughly 2 inches above joints (elbow, knees)

Question 14

epistaxis

Answer 14

nosebleed

-can be caused by direct impact or from increased blood pressure

Question 15

internal bleeding (blunt trauma)

Answer 15

blunt trauma- is the leading cause of internal bleeding

• falls
• motocycle and automobile
• blast injuries

Question 16

internal bleeding (penetrating trauma)

Answer 16

also a common form of internal bleeding.

• always check for exit wounds. some mechanisms of injury for penetrating trauma are.
• gunshot wounds
• stab wounds from knife, icepick, screwdriver ect.
• impaled objects

Question 17

EMTs best clue indicating the possibility of internal bleeding______?

Answer 17

the presence of the mechanism of injury that could have caused internal bleeding

Question 18

neurogenic shock

Answer 18

rarely seen in the field, but could be caused by sepsis, or an anaphylactic reaction.