Circulation and Control of Hemorrhage Flashcards
What are the major assessment parameters for circulation and hemorrhage?
level of consciousness, skin color, and pulse
What can the use of AVPU reveal?
patient’s level of consciousness and help determine if the initial assessment may proceed as ABC or reprioritize ABC to address hemorrhage
When assessing for circulation what is one of the first things you want to evaluate?
hemorrhage in the abdomen and pelvis or anyone with sustained blunt trauma
What do you inspect for circulation?
- uncontrolled bleeding
- skin color
What do you auscultate for in circulation?
- muffled heart sounds
What do muffled heart sounds indicate?
pericardial tamponade
What do you palpate for in circulation?
- presence of carotid/femoral pulses (rate, rhythm, strength)
- skin temp/moisture (cool/diaphoretic or warm/dry)
What do you do if pulses are absent?
- initiate life support
- assess for signs of uncontrolled internal bleeding
- penetrating wound to the heart
- pericardial tamponade
- rupture of great vessels
- abdominal hemorrhage
What are common sites for hemorrhage?
- chest
- abdomen
- pelvis
- long bones
- external bleeding from wounds/amputation
What do you inspect if pulses are present?
- external bleeding
- skin color
What do you palpate for if pulses are present?
- central pulses
- skin temp and moisture
What does a strong, regular, and normal pulse rate indicate?
normovolemia
What does a rapid, thready pulse indicate?
hypovolemia
What does an irregular pulse indicate?
cardiac dysfunction
What do you do if pulses are present but circulation is ineffective?
- assess for signs of uncontrolled bleeding
- consider common sites for hemorrhage (chest, abdomen, pelvis)
What interventions do you do for circulation?
- control/treat bleeding
- cannulate two veins
- intervene in life-threatening situations
How do you control/treat uncontrolled bleeding?
- apply direct pressure
- apply pressure over arterial sites
- pelvic binder for unstable pelvic fx
- tourniquet
- take blood pressure (base line, trending)
Why would you want to cannulate two veins?
- type and crossmatch blood
- infusions of warmed isotonic crystalloid solution
- blood administration tubing and NS to facilitate for possible blood administration
- administer blood/blood products
- use rapid infusion devices per protocol
What should you do if you are not able to place an IV?
consider IO or central venous access
What are some interventions you can do for life-threatening situations?
- prepare/assist with thoracotomy
- prepare/assist with pericardial needle aspiration to relieve cardiac tamponade
- prepare pt transfer to operating suite
What could elevated blood pressure do?
dislodge blod clots and promote further bleeding
What is suggested for fluid resuscitation?
- component therapy - RBC, plasma, platelets
