Hemorrhage And Shock Flashcards
How many millimeters of blood does a typical adult have?
Approximately 70 mL/kg
At what percent will a body not tolerate an acute loss of blood?
Greater than 20%
How are vitals affected if a patient loses more than 1 liter of blood (2 pints)?
Increased heart rate
Increase repertory rate
Decrease in blood pressure
How much total blood volume does a 1 year old child have?
About 800 mL
What is hypovolemic shock?
Low blood volume results in inadequate perfusion
What color is arterial bleeding?
Bright red
What color is venous bleeding?
Dark red
What color is capillary bleeding?
Dark red
What is hemostasis?
Formation of a clot to plug openings in injured blood vessels and stop blood flow
What is coffee ground emesis a sign of?
Upper GI bleeding
What is melena?
Passage of dark, tarry stools
What is melena a sign of?
Upper GI bleeding
What is hematochezia?
Passage of stools containing bright red blood
What is hematochezia a sign of?
Bleeding close to the external opening of the colon
What tends to cause hematochezia?
Hemorrhoids in the lower colon
What is hematuria?
Blood in the urine
What is hematuria a sign of?
Serious renal injury or illness
What is a pulse point?
Spot where a blood vessel lies near a bone
What are hemostats?
Forceps used to clamp ends of vessels
What is the primary use of pneumatic antishock garment?
Stabilization of an unstable pelvis, especially when the patient is exhibiting signs of hypoperfusion
What is another name for PASG.
MAST
Military antishock trousers
What is the only true contraindication of pneumatic antishock garments (PASG)/military antishock trousers (MAST)?
Pulmonary edema
How do you treat suspected skull fracture bleeding?
Loosely cover the bleeding site with a sterile gauze pad
Don’t apply excessive pressure due to blood collecting in the head
What are the three parts of the cardiovascular system?
Pump (heart)
Container (vessels)
Fluid (blood)
In the cardiovascular system, what is the pump?
The heart
In the cardiovascular system, what is the container?
Vessels
In the cardiovascular system, what is the fluid?
Blood
What is the formula for cardiac output?
CO= HR ✖️ SV (stroke volume)
What is the formula for blood pressure?
BP= CO ✖️ SVR (systemic vascular resistance)
Where are three places that baroreceptors are located?
Aortic arch
Carotid sinuses
(As well as most of the large arteries of the neck and thorax)
What do baroreceptors monitor?
If they sense a decrease blood flow, then it activates the vasomotor center which begins constriction of the vessels which increases blood pressure
Monitors blood pressure
What does the vasomotor center do?
Oversees changes in the diameter of blood vessels
At what systolic BP does does the vasomotor center stimulate?
Between a systolic of 60-80 mmHg
Where are chemoreceptors located?
Carotid and aortic bodies
How are chemoreceptors simulated?
By decreases in PaO2 and increases in PaCO2
What do chemoreceptors regulate?
Respirations
What are three alpha 1 responses of the adrenal medulla?
Release of epinephrine for:
Vasoconstriction
Increased peripheral vascular resistance
Increased after load from the arteriolar constriction
What two catecholamines are secreted by the adrenal medulla?
Norepinephrine (alpha)
Epinephrine (beta)
What is chronotropic?
Influences heart rate
What is inotropic?
Influencing force of contractions
What is dromotropic?
Influencing heart conductivity
What is chronotropic?
Influences heart rate
What is inotropic?
Influencing force of contractions
What is dromotropic?
Influencing heart conductivity
How does epinephrine effect alpha 2?
Regulates release of alpha 1
What three ways does epinephrine effect beta 1?
Increased heart rate
Increased heart contractility
Increase heart conductivity
What two ways does epinephrine effect beta 2?
Bronchodilation
Gastrointestinal smooth muscle dilation
What are spincters under control of?
Autonomic nervous system
What are the three stages of shock?
Compensated
Decompensated
Irreversible
What is pulse pressure?
Difference between systolic and diastolic pressure
What two things does an orthostatic tilt test determine?
Dehydration
Hypovolemia
What are the two causes for obstructive shock?
Cardiac tamponade
Tension pneumothorax
What are three causes of distributive shock?
Anaphylaxis
Sepsis
Spinal shock
What pulse do you lose as you have decompensated shock?
Radial pulse
What are indications for PASG/MAST
Pelvic fracture with systolic <50
PASG/MAST does more harm than good during what five scenarios?
Pregnancy Penetrating chest/abdominal injuries Groin injuries Major head injuries Transport time <30 mins
What does the build up of lactic acid and carbon dioxide cause in regards to post capillary sphincters?
Vasodilation
What are four signs and symptoms of hypovolemic shock?
Rapid, weak pulse
Hypotension
AMS
Cool, clammy skin