Chapter 25 Bleeding And Shock Flashcards
Circulation of blood
Three major types of blood vessels
Arteries capillaries veins
Veins
Have one-way valves prevents the blood from flowing in the wrong direction
Been under less pressure
Nutrition
Blood circulates nutrition from the intestines or storage tissue (fatty tissue the liver muscle cells)
Regulation
Blood carries substances that control body functions or moans water salt enzymes and chemicals also important role in regulating body temperature caring heater long skin surface where is dissipated
Hemorrhage
Major cause of shock in trauma
Inadequate perfusion of body cells will eventually lead to death of tissue and organs the brain, the spinal cord and the kidneys most sensitive to in adequate perfusion
External bleeding
Bleeding that Occurs outside the body
How much a person bleeds is a function of several factors size and severity of the wound size and pressure of the blood vessel that has been ruptured as well as ability to clot and stop bleeding
Massive hemorrhage
Occurs when Extensive Wounds open large blood vessels or many smaller vessels
arterial bleeding blood coming from the heart is generally well oxygenated
the iron Atoms in hemoglobin turn bright red when they bind with oxygen
Three types of external
Arteries veins capillaries
Arteries- spurting blood pulsating flow bright red color
Veins- steady slow flow dark red color
Capillaries-slow even flow
Sites where massive bleeding is likely
Neck
both armpits
Both sides of the groin
Capillary bleeding
Bleeding from capillaries which is characterized by slow oozing flow of the blood under very low pressure
Two points to keep in mind when differentiating serious bleeding from massively bleeding
All bleeding is bad for patients should be stopped When to do so will depend on what other threats to life the patient may have
Another important point to keep in mind is identifying the type of bleeding is irrelevant and time consuming
Blood thinning Medications
Aspirin, arfarin, clopidogrel, Pradaxa, xarelto
Identifying massive external bleeding
Massive hemorrhage must be identified and controlled with in the first seconds of the primary assessment
If you find life-threatening hemorrhage must take immediate steps to correct it before performing any other assessment or treatment
Amount of blood loss on the ground
This technique is in accurate but can be used four differentiating alot from a little external blood loss
Controlling external bleeding
One of the most important elements in the prevention and management of shock
Major methods of controlling external bleeding
Direct pressure, elevation of a limb hemostatic agent, Tourniquet, splinting and cold application, administer oxygen
Splinting
Inflatable splints air splint used to control internal and External bleeding from an extremity
Form of direct pressure is full with several wins the extremity or one that extends the length of the extremity
Best use for Venus and capillary bleeding Not useful for high pressure bleeding
Cold application
Called minimize swelling reduces bleeding by constructing the blood vessels
Do not apply ice pack straight to the skin wrap it with cloth or towel do not leave it in place for longer than 20 minutes
Bleeding
Most often caused by direct drama striking or being struck or cut by something such as a collision or a fall, stabbing or shooting
Nosebleeds (epistaxis)
Caused by direct trauma or increase blood pressure sinus infections digital drama
Hard to stop nose bleeds if taking anticoagulants such as warfarin (Coumadin)
Internal bleeding
Damage to internal organs and large blood vessels can result in loss of large quantities of blood in short period of time
Internal blood loss can result from external injuries sharp bone ends of fractured femur can cause enough tissue and blood vessel damage to cause hypoperfusion
Signs of internal bleeding
Bruising swelling tenderness over vital organs specially chest and abdomen
Bleeding from the mouth rectum vagina or other body orifice
Tender rigid or distend abdomen
vomiting coffee grinds like substance or bright red vomitus indicating the presence of blood
Red blood is a new active or current injury dark blood is usually old
Shock
The body’s reaction to decrease blood circulation to the organ system
Compensated shock
The body senses the decrease in perfusion attempts to compensate for it
Increased heart rate increased respiration construction of the Paris feel circulation pale cool skin
Infants and children increased capillary refill time
Decompensated Shock
At the point when the body can no longer compensate for blood volume or lack of perfusion
Low blood pressure Irreparable damage to vital organs such as the kidney and death
Hypovolemic shock
Hypovolemic shock most common seen by Emt’s
caused by uncontrolled bleeding hemorrhaging also can be called hemorrhagic shock
Burns or crash injuries where plasma is lost or dehydration
Cardiogenic shock
Develop some patient suffering from Myocardial infarction or heart attack
Electrical system of the heart my be malfunctioning causing a heartbeat too slow to fast for irregular
Congestive heart failure look for low blood pressure edema in the feet ankles or other signs of heart failure
Neurogenic shock
Uncontrolled dilation of blood vessels from nerve paralysis cause my spinal cord injury
Sepsis, anaphylactic reaction may result in vasodilation that may cause shock
Signs and symptoms of shock
Altered mental status pale cool and clammy nausea and vomiting vital sign changes late signs include Thirst dilated pupils cyanosis around lips and nail beds
Acidosis
A condition that occurs when cells receive insufficient oxygen and generate acidic waste products that accumulate in the blood
