Chapter 26 - Bleeding Flashcards
know them all
A device that provides proximal compression of severe bleeding near the axial or inguinal junction with the torso.
junctional tourniquet
The coughing up of blood.
hemoptysis
The formation of clots to plug openings in injured blood vessels and stop blood flow.
coagulation
The blood vessels that carry blood from the tissues to the heart.
veins
A hereditary condition in which the patient lacks one or more of the blood’s normal clotting factors.
hemophilia
A buildup of blood beneath the skin that produces a characteristic blue or black discoloration as the result of an injury.
ecchymosis
The small blood vessels that connect arterioles and venules; various substances pass through capillary walls, into and out of the interstitial fluid, and then on to the cells.
capillaries
A life-threatening fracture of the pelvis caused by a force that displaces one or both sides of the pelvis laterally and posteriorly.
open-book pelvic fracture
A device to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption, and pain.
pelvic binder
A dressing impregnated with a chemical compound that slows or stops bleeding by assisting with clot formation.
hemostatic dressing
A condition in which the circulatory system fails to provide sufficient circulation to maintain normal cellular functions; also called hypoperfusion.
shock
A bruise from an injury that causes bleeding beneath the skin without breaking the skin; also see ecchymosis.
contusion
Narrowing of a blood vessel.
vasoconstriction
Blood in the urine
hematuria
The bleeding control method used when a wound continues to bleed despite the use of direct pressure; useful if a patient is bleeding severely from a partial or complete amputation.
tourniquet
The smallest branches of arteries leading to the vast network of capillaries.
arterioles
A condition in which the circulatory system fails to provide sufficient circulation to maintain normal cellular function; also called shock.
hypoperfusion
Bleeding.
hemorrhage
Very small, thin-walled blood vessels
venules
A condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, results in inadequate perfusion.
hypovolemic shock
A blood vessel, consisting of three layers of tissue and smooth muscle, that carries blood away from the heart.
artery
The flow of blood through body tissues and vessels.
perfusion
Black, foul-smelling, tarry stool containing digested blood.
melena
The main artery leaving the left side of the heart and carrying freshly oxygenated blood to the body.
aorta
A nosebleed.
epistaxis
Vomiting blood
hematemesis
A mass of blood that has collected within damaged tissue beneath the skin or in a body cavity.
hematoma
Bleeding is potentially dangerous, first causing _____
weakness and eventually, if left uncontrolled, shock and death.
hemorrhage
severe, uncontrolled bleeding
hypoperfusion
shock
perfusion
the passage of blood, a blood substitute, or other fluid through the blood vessels or other natural channels in an organ or tissue.
volemia
blood volume is the volume of blood (blood cells and plasma) in the circulatory system of any individual
hypovolemia
a decreased volume of circulating blood in the body
hypovolemic shock
is an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working. Not all hypovolemic shocks are due to hemorrhage (eg. vomiting, diarrhea, burns.)
diaphoresis
is a medical term for excessive sweating, or perspiration, that is not caused by physical exertion or warm temperatures.
hyperemesis
excessive vomiting
the most common cause of hypoperfusion following a traumatic injury is
hemorrhage
the cardiovascular system circulates blood to the body’s cells and tissues, delivering ________
oxygen and nutrients and carrying away metabolic waste products.
The cardiovascular system is the main system responsible for __________
supplying and maintaining adequate blood flow.
Cardiovascular system consists of three parts which are:
The pump (heart), a container (the blood vessels that reach the cells of the body), and the fluid (blood and body fluids).
Difference between arteries and veins
Arteries carry blood away from the heart, and veins carry blood towards the heart. With the exception of pulmonary blood vessels, arteries carry oxygenated blood and veins carry deoxygenated blood. Arteries have thick walls with muscle tissue. Veins have thinner walls and use valves to keep your blood flowing.
Explain perfusion
Perfusion is the circulation of blood within an organ or tissue to allow it to meet the cells’ current needs for oxygen, nutrients, and waste removal.
Blood enters an organ or tissue first through the arteries, then the arterioles, and finally, the capillary beds. As it passes through the capillaries, the blood delivers nutrients and oxygen to the surrounding cells and picks up the wastes they have generated.
Blood must pass through the cardiovascular system fast enough to maintain adequate circulation throughout the body and to avoid clotting, yet slow enough to allow each cell time to exchange oxygen and nutrients for carbon dioxide and other waste products. Some tissues never rest and require constants blood supply, most require a large volume of circulating blood only intermittently, with less required at rest.
Which organs require a rich supply of blood and do not tolerate interruption of blood supply for even a few minutes without sustaining damage?
Heart - Cardiovascular system
Brain - Central nervous system
Lungs - Respiratory system
Kidneys - Renal system
What happens and how quick to following organs when there is an interruption to blood supply?
Heart
Brain and spinal cord
Lungs
Kidneys
Skeletal muscle
Gastrointestinal tract
Heart - needs constant blood supply
Brain and spinal cord - cells will start to die within 4 to 6 minutes (they do not regenerate)
Lungs - 15-20 minutes
Kidneys - 45 minutes
Skeletal muscle - 2 to 3 hours
Gastrointestinal tract - last little more than skeletal muscle
The typical adult male body contains approximately ______mL of blood per kilogram of body weight. whereas an adult female contains approximately ______mL of blood per kilogram of body weight.
70mL for male
65mL for female
The body cannot tolerate more than ____% of its total blood volume, or more than __ pints (approximately __L) in the average adult.
20%
2 pints (1L)
With significant blood loss, adverse changes in vital signs will occur, including _______________.
increased heart and respiratory rates and decreased blood pressure.
On it’s own, bleeding tends to stop within about ___ minutes.
What happens when a person’s skin is broken?
1-9 minutes - double check text book
Blood flows rapidly from the open blood vessel, soon afterward, the cut ends of the blood vessel begins to narrow (vasoconstriction), reducing the amount of bleeding. Then a clot forms, plugging the hole and sealing the injured portions of the blood vessel. This process is called coagulation.
With a severe injury, the damage to the blood vessel may be so great that a clot cannot completely block the hole. Bleeding will never stop if an effective clot does not form, unless the injured blood vessel is completely cut off from the main blood supply by direct pressure or a tourniquet.
A healthy adult can comfortably donate __ unit, or roughly __ pint ( ___mL ) of blood within ___ to ____minutes and adapt well to this decrease in blood volume. If this blood volume occurs during a much shorter period, however, symptoms of _________________, a condition in which ______________, might develop.
1 unit/1 pint
15 to 20 minutes
hypovolemic shock, a condition in which low blood volume results in inadequate perfusion and even death, might develop.
In any situation, severe blood loss presents an immediate life threat. Your priority is to quickly control major external bleeding, even before you address _________ and _________ concerns.
airway and breathing concerns.
In characteristics of external bleeding, you should consider bleeding to be severe if any of the following conditions exist:
Assessment reveals signs and symptoms of shock (hypoperfusion).
You note a significant amount of blood loss.
The blood loss is rapid and ongoing.
You cannot control the bleeding.
The bleeding is associated with a significant MOI (mechanism of injury.)
Typically, an arterial bleeding from an open artery is __________ and __________.
bright red (because it’s oxygen rich) and spurts in time with the pulse.
As the amount of blood circulating in the body drops, so does the patient’s ___________ and, eventually, the _________.
blood pressure
arterial spurting.
The _________ that causes the blood to spurt also makes arterial bleeding difficult to control.
pressure
Venous bleeding from an open vein is ________ than arterial blood and can flow _____ or ______ depending on the ______ of the vein.
darker (because it is oxygen poor)
slowly or rapidly
size
Because it is under less ____, most venous blood does not ____ and is easier to manage; however, it can be profuse and life threatening.
pressure
spurt
What is profuse?
a lot!
profuse bleeding - a lot of bleeding
profuse rain - a lot of rain
profuse vomit - a lot of vomit
Capillary bleeding from damaged capillary vessels is ______ and oozes from a wound _____ but _____.
dark red
steadily but slowly
Venous and capillary blood is more likely to _____ spontaneously than ______ blood.
clot
arterial
Despite the efficiency of the circulatory system, it may fail in certain situations such as __________ commonly affect the bloods’ _______ factors.
movement
disease process
certain medications (such as blood thinners
removal of bandages
external environment
body temperature
a small portion of the population lacks one or more of the blood’s clotting factors, a condition called _________.
hemophilia
a driver involved in a rollover motor vehicle crash will most likely experience serious injuries or death if he or she:
is ejected or partially ejected.
According the ACS_COT, an adults trauma patient should be transported tot he highest level of trauma center if he or she:
has a GCS score of less than or equal to 13 with a mechanism attributed to trauma.
Factors that should be considered when assessing a patient who has fallen include:
the height of the fall
the surface struck
the primary impact point
Force acting over a distance is the definition of:
work.
The phenomenon of pressure waves emanating from the bullet, causing damage remote from its path, is known as
cavitation.
A fractured femur can result in the loss of _____ or more of blood into the soft tissues of the thigh.
1L
Bleeding from the nose following head trauma is
a sign of a skull fracture and should not be stopped.
Gastrointestinal bleeding should be suspected if a patient presents with
hematemesis (blood in vomit.)
Hypoperfusion is another name for
shock
Hypovolemic shock occurs when
low fluid volume leads to inadequate perfusion.
