Shock/Bleeding Flashcards
What are the Internal S+S of Shock?
Hypo-perfusion to organs, Regulation of Blood volume (reduction of excretion), Vasoconstriction, Cardiopulmonary Response.
What is Hypovolemic Shock?
Hypovolemia/Low Blood Volume… When blood is lost from the system, or when volume portion of blood is lost.
What is Distributive Shock?
Blood Vessel tone is lost, Smooth muscle in vessels loses ability to maintain a normal diameter. Blood flow to cells is diminished.
What is Cardiogenic Shock?
Pump Failure, causing cardiac output suffering. Dysrythmia/mechanical problems cause pump failure.
What is Obstructive Shock?
Blockages occurring in the vessels, preventing blood flow. A fracture, or clot can cause this.
Signs and Symptoms of Shock (visible)
Altered mental status, decreased urinary output, pale skin, delayed cap refill, narrow pulse pressure, increasing pulse + respiration rate.
What would cause Obstructive Shock?
-pulmonary embolism
-cardiac tamponade
-tension pneumothorax
What is the Care for Shock?
- Initiate Transport to appropriate destination
- Prevent Hypoxia - manage airway and oxygen
- Prevent heat loss
- Consider shock position - supine
- Consider ALS
What is Hypersensitivity?
An exaggerated response by the immune system to a particular substance.
What is Hypo-perfusion?
The inability the body to adequately circulate blood to the bodies cells to supply with blood and oxygen.
What is Metabolism?
Cellular function of turning nutrients into energy.
What is Minute volume?
The (amount of air inhaled in one minute x # of breath per minute)
What does Patent mean?
open + clear, free from obstruction
What are the types of Distributive shock?
-Septic shock
-Anaphylactic shock
-Neurogenic shock
-Toxicologic shock
-Adrenal Crisis
Types of Shock and their Key Interventions…
ALWAYS REQUEST ALS
Hypovolemic - Bleeding control, Rapid Transport
Cardiogenic - Request ALS
Distributive (anaphylaxis) - Epi
Distributive (septic) - Recognize and notify hospital/rapid transport
Pathophysiology of Shock
Hypovolemia - Volume problem
•when blood is lost or liquid portion of blood is lost
-internal/external bleeds
-burns/dehydration
Cardiogenic - Pump Problem
•failure of heart to pump
-mechanical problem (ventricular rupture/closed valve)
usually fatal
Distributive Shock - Vessel Problem
•if blood vessel become affected, body will short out on nutrients, unable to compensate as that’s the blood vessels job.
-vessels dilate/constrict out of line
-will accompany anaphylaxis, sepsis, neurogenic failure
Describe an Arterial Bleed
-spurting
-pulsating flow
-bright red
Describe a Venous bleed
-steady slow flow
-dark red colour
Describe a Capillary bleed
-slow even flow
-red
What is the funtion of blood?
Blood Carries-
•Hormones. •Enzymes
•Water. •Chemicals
•Salt
-Regulates body temperature
•carries body heat to lungs and skin surface.
-Promotes clotting and controlled bleeding
What are our Blood Structures?
-Plasma
-Red Blood cells
-white blood cells
-platelets.
What are the signs and symptoms of Neurogenic shock?
-slow pulse
-difficulty breathing
-irregular respirations
-low BP
-flushed warm extremities
What is the proper care for closed wound care?
- manage ABC’s, consider high concentration oxygen
- manage as if there were internal bleeds
- splint extremities that are painful, swollen, or deformed
- stay alert for vomiting
- monitor development of shock, transport promptly
- apply cold packs to manage pain
Describe the proper way to apply a tourniquet…
- Apply the tourniquet proximal (nearest body attachment) and tighten till bleeding stops
- Asses the patient and treat for shock
- transport and minimize patient movement
- notify receiving facility, include tourniquet info
- reassess wound to ensure bleeding remains controlled
What is the proper care for a nosebleed?
- have patient sit down and lean forward
- apply direct pressure to the area around the nostrils, hold for 5 minutes without checking.
- keep patient calm, do not snort or forcibly wipe once pressure is released, dab excess bleeding
- do not lean patient back
- if patient is unconscious or goes unconscious, recovery position and suction.
