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Z - AET 261 > Hemorrhaging & soft tissue injuries > Flashcards

Hemorrhaging & soft tissue injuries Flashcards

1
Q

blood functions

A
  • transport waste, gas, nutrients
  • protect against disease
  • maintain body temperature
  • blood loss can be internal or external
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2
Q

Arterial bleed

A
  • bright red blood
  • spurt w each heart beat, high pressure
  • rapid + profuse = large, severe blood loss
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3
Q

venous bleeding

A
  • dark red
  • steady flow, less pressure
  • can be severe if enough vessels are damaged
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4
Q

capillary bleeding

A
  • red colour
  • ooze, low pressure
  • coagulate quick
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5
Q

blood loss amounts before critical

A
  • adult normal = 6.6L
    lethal = 2.2L
  • adolescents normal = 3.3L
    lethal = 1.3L
  • child normal = 1.5-2L
    lethal = 0.5-0.7L
  • infant normal = 300mL
    lethal = 30-50mL
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6
Q

phases of wound healing

A

executive (1): bring in fibrin, collagen and clog the wound

resorptive (2): scavenger cells remove dead cells and germs

proliferative (3): new cells formed and fill wound

repair (4): cell form around edge of wound, wound closes

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7
Q

Recovery time for areas w/ good and poor blood supply

A

good (face) = 5-6 days
poor (knee) = ~17 days

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8
Q

granulation

A
  • occur due to gap in wound edges
  • new tissue grow from inside out
  • scar tissue
  • slow healing
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9
Q

healing

A

primary intention: edges close together, not need new cells

secondary intention: bigger gap, need new tissues to fill cells and more scarring happens , not as strong

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10
Q

infection

A
  • minor: wash for 5 min under running water
  • major: RTD, bleed control (more important than clean)
  • use sterile, non adherent, do not touch, wear gloves
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11
Q

s/s of local infection

A
  • swelling, redness to the area
  • warm to touch
  • throbbing pain
  • pus discharge
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12
Q

s/s of systemic infection

A

life threat!
- flu like (fever, nausea, malaise)
- red streaks running from wound to heart
- swollen lymph nodes

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13
Q

tetanus

A

MOI: bacterial spores from Clostridium tetani (soil, dust, animal feces)
- spores develop into bacteria that like low O2 (puncture wounds are at greatest risk)
- affect CNS
- irreversible once in nervous system

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14
Q

S/S of tetanus

A
  • difficulty swallowing
  • irritable
  • headache
  • fever
  • muscle spasms near affected area
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15
Q

gangrene and it’s S/S

A

bacterial infection thrive in low O2 or loss of blood supply
S/S
- sudden pain and swell
- local tissue discoloration
- brownish, smelly watery discharge
- low grade fever
- shock

  • can lead to necrotizing fasciitis (flesh-eating disease)
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16
Q

pressure bandage

A
  • for minor-moderate amounts of bleeding

place dressing to apply direct pressure (add more when saturated through) to wound, which compresses the blood vessels, restricts the blood flow and allows clotting

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17
Q

rules for dressing and bandages

A
  • patient seated or recumbent position
  • place direct pressure w/ gloved hand
  • apply sterile dressing place your gloved hand over the dressing and apply firm pressure
  • apply bandage over dressing to maintain direct pressure and hold in place
  • if blood soak through add more (DO NOT remove)
  • if bleed continues apply tourniquet if you can
  • avoid covering fingers/toes
  • distal to proximal
  • avoid digging into tissue and restrict circulation
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18
Q

Stitches

A

close a wound that might not heal cleanly
- speed healing process
- prevent infection
- reduce scarring
- first few hours of injury

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19
Q

wounds that need stitches

A
  • hemorrhaging
  • jagged edges
  • > 2.5 cm (1”) long
  • on face or head
  • gape wide or show bone/muscle
  • on joint, hands, feet
  • large/deep puncture or embedded object
  • human or animal bite
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20
Q

tourniquet

A
  • blocks blood completely from extremity
  • used w bandage/dressing, as last resort
  • use in mass casualty
  • 2-4in prox to injury site
  • tighten until bleeding stop, secure
  • document time applied
  • RTD
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21
Q

internal bleed

A
  • hemorrhaging btwn organs/structures of the body
    KEYS
  • MOI/HIstory
  • difficult to reconize should always suspect if MOI indicates
  • Major fractures can puncture organs
  • might become visible in secondary assessment
22
Q

internal bleed s/s

A
  • discolouration of skin (bruising)
  • cool/moist/pale/blue skin
  • rapid, weak pulse
  • decrease LOR or BP
  • nausea/vomiting
  • anxiety, restless
  • ST is tender, swollen, firm
  • tachypnea
  • excessive thirst
23
Q

internal bleed treatment

A

minimize movement of person/limb
keep patient calm
monitor ABC and vitals
administer O2
maintain normal body temp
RTD

24
Q

epistaxis

A

nose bleed
MOI: direct blow, sinus infection, dry nasal membrane, foreign bodies, hypertension, altitude changes
- pinch nostril, lean forward
- nasal plug/gauze pads
- ice bridge of nose
- avoid rub, blow, pick 2-3hrs
- ask if they have blood thinners
- Bleeding not controlled w/in 10-15 RTD

25
closed wounds
any wound occur w/o breaking the skin (not worry about infections, more internal bleeds) - abscess - dermatitis - subungual hematoma
26
abscess
localized collection of pus w/in tissues - rupture on own, do not pop - often around hair follicle - alternate hot, warm compresses - cover w sterile dressing - monitor for saturation and infection - face, neck, groin, buttocks or pain = physician
27
subungual hematoma
collection of blood/fluid under nail bed - clean area, place finger on firm surface, drill into nail to relieve pressure (last resort) - clean and apply sterile dressing
28
dermatitis
inflammation of the skin MOI: direct contact w chemical or allergy - red, irritated, swell - itchy, pain - thickening or cracking of epidermis - blisters - avoid touch; dress it; physician
29
open wound
an injury in which the skin is interrupted, exposing the tissue beneath - abrasion - laceration - avulsion - puncture - control external bleed, protect against infection, check for internal injuries
30
Abrasion
(most common) -epidermis has been scraped away - capillaries only blood ves effected - nerve endings exposed - infection is concern because dirt and other matter is easily embedded cleaning wound is IMPORTANT
31
Laceration
cut, usually from sharp object - jagged or smooth ends - sharp or blunt object is MOI - deep lacerations can affect muscle and fat, damage nerves and blood vessels - watch for shock
32
Avulsion
Portion of the skin + soft tissue partially/fully turn away - leave attached - bleeding and infection control are priorities
33
Puncture
skin pierced with pointed object - entrance and exit wound - usually seal around object, little bleeding - high infection risk (tetanus) clean thoroughly - ex. bullet wound
34
Impaled object
object penetrate skin and remain in the body - not a lot of blood, act as a plug - do not remove! splint around for support, stop the bleed
35
impaled object exception
only remove an impaled object if it interferes with the patient's airway or breathing - neck, mouth, lungs
36
major soft tissue trauma
amputation crush injuries compartment syndrome blast injuries high-pressure injection injuries
37
Amputation
body part fully/partly severed from the body - multiple injuries (muscle, bone, blood vessel) - not a lot of blood (vessels constrict, retract) - rinse w saline - wrap in non adherent gauze, cool amputated part; label with day, name, time -RTD
38
crush injuries
body subjected to intense blunt force - hard to tell internal injuries (fracture, bleed, etc) - dead tissue become systemic, toxins build up and spread due to low O2 - crush syndrome - RTD
39
crush syndrome
Patient subjected to crushing force >1hr hypoxic tissues function anaerobically, cause toxins made. When the force is released the toxins become systemic. - impaired heart, kidney failure - life threat; RTD
40
compartment syndrome
pressure in muscle compartments build up to dangerous level, blocking O2 to cells. - swell/bleed cause pressure on caps, which collapse - lack of O2 and nutrients cause nerve/muscle death MOI: trauma, badly bruised muscle, post-surgery complications, crush injury, anabolic steroids RTD, limb threat
41
6 P's of compartment syndrome
- pain - pressure - paresthesia (n/t) - paresis (muscle weakness) - pallor - pulselessness - all 6 = irreversible (death, disability)
42
blast injuries
heat & pressure waves from explosion strike, pass thru body MOIs: blast itself, shrapnel, thrown by blast - internal bleed, hemorrhage, edema, pulmonary embolism - RTD - primary(blast itself), secondary (debris, thrown) & tertiary (crush injur. propelled into solid object)
43
high pressure injections (HPI) injuries
a substance injected into the body under high pressure - industrial work (grease gun, pressure washer) - small puncture visible (2000 psi enough to break skin) - RTD
44
burns
area of body receive more heat producing energy than it can absorb w/o injury to contact tissue - thermal: flame, steam, hot items - chemical: acids or alkalines - electrical: lightning, electrical outlet - radiation: nuclear source, sun
45
superficial burn
1st degree - epidermis damaged - red, dry, painful - 5-6 days recovery - clean, running water
46
Partial thickness
2nd degree - epidermis and dermis damaged - red, pain, swollen skin, blisters - recover 3-4wks - clean surrounding area, no pressure/wrap - damaged nerve endings
47
full thickness burn
3rd degree - epidermis, dermis, underlying structures damaged - charred skin, deep tissue white, painful OR pain-free - surrounded by partial thickness burn - can be life threat (lose body fluid)(hypovolemic shock)
48
immediate advanced care for burns
- any full thickness burn - partial thickness >10% - partial/full burn to child/elderly - inhalation or respiratory injuries from burn - burn mouth, hands, nose, feet, genitals - chemical, explosive, electrical burns - lots of pain - unresponsiveness
49
Rule of 9's
Head and neck = 9% Upper Ex = 9% each Lower Ex = 9% each Front trunk = 18% Back trunk = 18% estimate amount of body that is burned - varies if a child vs adult
50

Z - AET 261 (6 decks)

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