Bleeding

Question 1

What is blood composed of?

Answer 1

• plasma 55%
• RBC 45%
• WBC and platelets 1%

Question 2

What is the purpose of plasma?

Answer 2

It carries nutrients, minerals, and chemicals throughout the body.

Plasma is the carrier for blood.

Question 3

What is the purpose of platelets?

Answer 3

Build up clots to stop bleeding.

Question 4

What is the purpose of Red Blood Cells (RBC)?

Answer 4

It carries oxygen throughout the body via hemoglobin (Hgb).

Question 5

What is the purpose of hemoglobin?

Answer 5

It carries oxygen molecules throughout the body.

Question 6

Define:

perfusion

Answer 6

The circulation of blood to meet an organ’s or tissue’s oxygen demand.

Question 7

How much blood volume is in the body?

Answer 7

• Male: 70 ml/kg
• Female: 65 ml/kg

Question 8

What is the Oxyhemoglobin diassociation curve?

Answer 8

Check the image.

Question 9

Fill in the blank.

The clotting proteins are produced by the _____.

Answer 9

liver

Question 10

Describe how blood flows in the physiology of an arterial injury.

Answer 10

Blood spurts initially due to high pressure, but begins to flow steadily as the pressure drops.

Question 11

How much internal bleeding can possibly occur with femur fractures?

Answer 11

1 liter

Question 12

What medications interfere with clotting abilities?

Answer 12

• Aspirin
• Beta blockers
• Blood thinners

Question 13

What is the process in which platelets aggregate at an injured site in order to stop bleeding?

Answer 13

hemostasis

Question 14

What is the condition in which a person lacks appropriate clotting factors?

Answer 14

hemophilia

Question 15

Name the three classes of hemorrhagic shock.

Answer 15

1. Compensated
2. Decompensated
3. Irreversible

Question 16

What are the vitals and blood loss from Compensated Shock?

Class I and II

Answer 16

Vitals:

• HR: <100 or >100 bpm
• BP: normal
• RR: 14-30 breaths per min
• CNS: slightly to mildly anxious
• Skin color: cool, pale or pink
• Fluid replacement: crystalloid

Blood Loss: 750-1500ml

Question 17

What are the vitals and blood loss from Decompensated Shock?

Class III

Answer 17

Vitals:

• HR: 30-40 bpm
• BP: Low
• RR: 30-40 breaths per min
• CNS: anxious and/or confused
• Skin color: cold, pale, moist
• Fluid replacement: crystalloid and blood

Blood Loss: 1,500-2,000 ml

Question 18

What are the vitals and blood loss from Irreversible Shock?

Class IV

Answer 18

Vitals:

• HR: >140 bpm
• BP: really low
• RR: >35 breaths per min
• CNS: confused and lethargic
• Skin color: cold, cyanotic
• Fluid replacement: crystalloid and blood

Blood Loss: >2,000ml

Question 19

What is a vomited blood called?

Answer 19

hematemesis

Question 20

What is a coughed-up blood called that is typically bright red?

Answer 20

hemoptysis

Question 21

What is a black, tarry stool, that is composed of digested blood?

Answer 21

melena

Indicates lower GI bleed.

Question 22

Fill in the blank.

Blood in the urine is called _____.

Answer 22

hematuria

Question 23

Fill in the blank.

Hematochezia is the passage of ______ ____ blood.

Answer 23

bright red

It typically indicates hemorrhoids in the lower GI.

Question 24

What is the sign for internal bleeding with referred left shoulder pain?

Answer 24

Kehr’s Sign

Indicates an injured or ruptured spleen.

Question 25

How do you manage **external hemorrhage**?

Answer 25

1. **Apply direct pressure** with a dry, sterile dressing. 2. Apply **pressure dressing**. 3. If not controlled, apply a **tourniquet**.

Question 26

What do you apply to a wound that is **spurting** blood?

Answer 26

* direct pressure * pressure dressing

Question 27

What do you apply to a wound that is spurting **bright red blood** uncontrollably?

Answer 27

tourniquet

Question 28

List the **DO's** and **DONT's** for applying a tourniquet.

Answer 28

**DO:** * Use a commercial tourniquet (TQ) or the widest bandage possible. * Apply the windlass until the distal pulse is absent. * Write the time of application on the TQ. * Leave a 2-finger distance from the joint. **DO NOT:** * Apply over a joint. * Use wire, rope, or a belt. * Cover a TQ with a bandage.

Question 29

What do you use to **stop internal bleeding** from a **pelvic fracture**?

Answer 29

pelvic binder/splint

Question 30

How do splints help to decrease bleeding?

Answer 30

It **stabilizes movement** of broken bones in the pelvic cavity. ## Footnote Broken bones lacerate surrounding tissues and exacerbate the injury.

Question 31

What type of material should be used in **packing a wound**?

Answer 31

hemostatic agent

Question 32

What are the steps to a **Primary Assessment**? ## Footnote List the steps in order.

Answer 32

* **H**emorrhage * **A**irway * **B**reathing * **C**irculation * **D**isability * **E**nvironment ## Footnote If there is visible bleeding, identify the source and address it.