Shock/Bleeding

Question 1

What are the Internal S+S of Shock?

Answer 1

Hypo-perfusion to organs, Regulation of Blood volume (reduction of excretion), Vasoconstriction, Cardiopulmonary Response.

Question 2

What is Hypovolemic Shock?

Answer 2

Hypovolemia/Low Blood Volume… When blood is lost from the system, or when volume portion of blood is lost.

Question 3

What is Distributive Shock?

Answer 3

Blood Vessel tone is lost, Smooth muscle in vessels loses ability to maintain a normal diameter. Blood flow to cells is diminished.

Question 4

What is Cardiogenic Shock?

Answer 4

Pump Failure, causing cardiac output suffering. Dysrythmia/mechanical problems cause pump failure.

Question 5

What is Obstructive Shock?

Answer 5

Blockages occurring in the vessels, preventing blood flow. A fracture, or clot can cause this.

Question 6

Signs and Symptoms of Shock (visible)

Answer 6

Altered mental status, decreased urinary output, pale skin, delayed cap refill, narrow pulse pressure, increasing pulse + respiration rate.

Question 7

What would cause Obstructive Shock?

Answer 7

-pulmonary embolism
-cardiac tamponade
-tension pneumothorax

Question 8

What is the Care for Shock?

Answer 8

1. Initiate Transport to appropriate destination
2. Prevent Hypoxia - manage airway and oxygen
3. Prevent heat loss
4. Consider shock position - supine
5. Consider ALS

Question 9

What is Hypersensitivity?

Answer 9

An exaggerated response by the immune system to a particular substance.

Question 10

What is Hypo-perfusion?

Answer 10

The inability the body to adequately circulate blood to the bodies cells to supply with blood and oxygen.

Question 11

What is Metabolism?

Answer 11

Cellular function of turning nutrients into energy.

Question 12

What is Minute volume?

Answer 12

The (amount of air inhaled in one minute x # of breath per minute)

Question 13

What does Patent mean?

Answer 13

open + clear, free from obstruction

Question 14

What are the types of Distributive shock?

Answer 14

-Septic shock
-Anaphylactic shock
-Neurogenic shock
-Toxicologic shock
-Adrenal Crisis

Question 15

Types of Shock and their Key Interventions…

Answer 15

ALWAYS REQUEST ALS

Hypovolemic - Bleeding control, Rapid Transport

Cardiogenic - Request ALS

Distributive (anaphylaxis) - Epi

Distributive (septic) - Recognize and notify hospital/rapid transport

Question 16

Pathophysiology of Shock

Answer 16

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

Question 17

Describe an Arterial Bleed

Answer 17

-spurting
-pulsating flow
-bright red

Question 18

Describe a Venous bleed

Answer 18

-steady slow flow
-dark red colour

Question 19

Describe a Capillary bleed

Answer 19

-slow even flow
-red

Question 20

What is the funtion of blood?

Answer 20

Blood Carries-
•Hormones. •Enzymes
•Water. •Chemicals
•Salt

-Regulates body temperature
•carries body heat to lungs and skin surface.

-Promotes clotting and controlled bleeding

Question 21

What are our Blood Structures?

Answer 21

-Plasma
-Red Blood cells
-white blood cells
-platelets.

Question 22

What are the signs and symptoms of Neurogenic shock?

Answer 22

-slow pulse
-difficulty breathing
-irregular respirations
-low BP
-flushed warm extremities

Question 23

What is the proper care for closed wound care?

Answer 23

1. manage ABC’s, consider high concentration oxygen
2. manage as if there were internal bleeds
3. splint extremities that are painful, swollen, or deformed
4. stay alert for vomiting
5. monitor development of shock, transport promptly
6. apply cold packs to manage pain

Question 24

Describe the proper way to apply a tourniquet…

Answer 24

1. Apply the tourniquet proximal (nearest body attachment) and tighten till bleeding stops
2. Asses the patient and treat for shock
3. transport and minimize patient movement
4. notify receiving facility, include tourniquet info
5. reassess wound to ensure bleeding remains controlled

Question 25

What is the proper care for a nosebleed?

Answer 25

1. have patient sit down and lean forward
2. apply direct pressure to the area around the nostrils, hold for 5 minutes without checking.
3. keep patient calm, do not snort or forcibly wipe once pressure is released, dab excess bleeding
4. do not lean patient back
5. if patient is unconscious or goes unconscious, recovery position and suction.