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EMT Test 4 > Bleeding & Shock > Flashcards

Flashcards in Bleeding & Shock Deck (64)
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1

Arteries

Systemic
• Carry oxygen-rich blood away from the heart
• Comprised of thick, muscular walls that enable dilation and constriction
Pulmonary
• Pulmonary artery

2

Veins

• Carry oxygen-depleted blood rich in carbon dioxide back to the heart
• Contain one-way valves to prevent back flow of blood

3

Capillaries

• Microscopic blood vessels
• Vital exchange site: oxygen, nutrients passed through
capillary walls in exchange for
carbon dioxide from cells - occurs in the alveoli - circulatory system rich in CO2 (during exchange)

4

Functions of Blood

• Transportation of gases
• Nutrition
• Excretion
• Protection
• Regulation

5

Perfusion

Adequate circulations of blood throughout body

6

Hypoperfusion (Shock)

Inadequate circulations of blood to tissues and organs

Pump Problem - cardiogenic
Content - hypovolemic, dehydration, bleeding
Container Problem - Sepis, Anaphylaxis, neurogenic

7

Two Types of Bleeding

• External
• Internal -

main area you can loose enough blood to die in thorax, abdomen, pelvis, femur fracture

how much blood do I have to loose to have a problem

20% rule (circulating blood volume)

1200ml (6000ml x 20%)

8

External Bleeding What does it look like:
Arteries:
Veins:
Capillaries:

Arteries: Spurting Blood, Pulsating Flow, Bright Red Color

Veins: Steady, slow flow, Dark Red Color

Capillaries: Steady Even Flow

9

Arterial External Bleeding is?

Oxygen Rich
Rapid and profuse
Spurting with heartbeat
Most difficult to control

10

Venous External Bleeding is?

Rich in carbon dioxide & waste
Steady flow
Easier to control
low pressure system

11

Capillary External bleeding is?

Slow and Oozing
Easily controlled
Stops Spontaneously

12

Think About It: Bleeding

• How severe is the bleeding? Is it exsanguinating hemorrhage? If so, how does that affect the priorities of treatment?

13

Patient Assessment - Primary Assessment

Standard Precautions
Open Airway
Monitor Respirations
Ventilate if Necessary
Control Bleeding
Skin: Color, Temp, Condition, Check Pulses

14

Methods to Control External Bleeding

Direct Pressure
Elevate
Pressure Dressing
Tourniquet

15

Direct Pressure - How to

• Apply firm pressure to wound with gloved hand and gauze bandage
• Hold pressure until bleeding is controlled
• If necessary, add dressings when lower ones are saturated
• Never remove bandages—even when bleeding is controlled
• When controlled, check for pulse distal to wound - PMS

16

Elevate

• Elevate injured extremity above level of the heart while applying direct pressure
• Do not elevate if musculoskeletal injury is suspected

17

Pressure Dressing

• Place several gauze pads on wound
• Hold dressings in place with self-adhering roller bandage wrapped tightly over
dressings and above and below wound site
• Create enough pressure to control bleeding

18

Hemostatic Agents

• Commonly, dressing containing substance that absorbs and traps red blood cells
• Can be wadded up and inserted into wound
• May be a powder poured directly into the wound
• Manual pressure is always necessary

19

Tourniquet

• Use if bleeding is uncontrollable via direct pressure
• Use only on extremity injuries
• Once applied, do not remove or loosen
• Attach notation to patient alerting other providers tourniquet has been applied

20

Think About It: Bleeding

• Is the current method of bleeding control working? Do you need to move on to a more aggressive step? How would you
evaluate this?

21

Other Ways to Stop Bleeding

• Splinting
• Cold application
• Pneumatic anti-shock garment (PASG)

22

Special Bleeding Situations Head Injury

• Head injury
– From increased intracranial pressure, not direct trauma
– Stopping bleeding only increases intracranial pressure

23

Special Bleeding Situations Nose Bleeds (Epistaxis)

– Have patient sit and lean forward
– Apply direct pressure to fleshy
portion of nostrils
– Keep patient calm and quiet
– Do not let patient lean back
– If patient becomes unconscious, place patient in recovery position and be prepared to suction

24

Internal Bleeding

• Damage to internal organs and large blood vessels can result in loss of a large quantity of blood in short time
• Blood loss commonly cannot be seen
• Severe blood loss can even result from injuries to extremities

25

Blunt Trauma is..

• Leading cause of internal bleeding
– Falls
– Motor vehicle crashes
– Automobile–pedestrian collisions
– Blast injuries

26

Penetrating Trauma

• Common penetrating injuries
– Gunshot wounds
– Stab wounds
– Impaled objects

27

Signs of Internal Bleeding

• Injuries to surface of body
• Bruising, swelling, or pain over vital organs
• Painful, swollen, or deformed extremities
• Bleeding from mouth, rectum, or vagina
• Tender, rigid, or distended abdomen
• Vomiting coffee-ground or bright-red material

28

Pediatric Considerations Bleeding

• Infants and children—efficient
compensating mechanisms maintain blood pressure until half of volume is depleted
• Potential for shock must be recognized and treated before tell-tale signs appear

29

Cultural Considerations: Bleeding

• Places on body to look to assess circulation via skin color
– Fingernails and lips
– Conjunctiva in eyes
– Palms of hands; soles of feet

30

Treatment of Internal Bleeding

Administer Oxygen
Maintain ABC'c
Control External Bleeding
Rapid Transport to Appropriate Medical Facility