Ch. 14 EMR Book: Bleeding, Shock, and Soft-Tissue Injuries

Question 1

What does internal blood loss result in?

Answer 1

Shock

Question 2

What is shock?

Answer 2

A state of collapse of the cardiovascular system that results in inadequate delivery of oxygenated blood to the organs

Question 3

What should you do if the patient is losing a significant amount of blood during the primary assessment?

Answer 3

Temporarily halt the assessment and manage the problem

Question 4

What are some signs of shock?

Answer 4

Pale skin, increasing pulse rate, or decreasing blood pressure

Question 5

Where should you check for a pulse in a patient experiencing shock?

Answer 5

The carotid pulse

Question 6

What is cardiogenic shock

Answer 6

When the heart cannot pump enough blood to supply the needs of the body

Question 7

What can be a cause of failure of the heart’s pumping abilities?

Answer 7

Weakening of the heart due to a heart attack

Question 8

What can inadequate pumping of the heart cause?

Answer 8

Blood can back up in the vessels of the lungs, which causes CHF as well

Question 9

What is congestive heart failure (CHF)

Answer 9

Heart-disease characterized by breathlessness, fluid retention in the lungs, and generalized swelling of the body

Question 10

What happens if the capillaries dilate too much?

Answer 10

1. Blood pools in the capillaries and doesn’t circulate properly
2. Organs are deprived of blood
3. BP falls and shock results from this

Question 11

What is psychogenic shock?

Answer 11

Fainting; caused by a temporary reduction in blood supply to the brain as the body’s response to emotional or psychological stress and is the least serious type of shock

Question 12

What happens to the capillaries during psychogenic shock?

Answer 12

They expand which causes blood to pool and become unable to be delivered to the brain

Question 13

How can psychogenic shock be corrected?

Answer 13

Placing the patient in a horizontal position

Question 14

What is anaphylactic shock?

Answer 14

Shock caused by an extreme allergic reaction to certain foods, medication, or insect bites/stings

Question 15

What are some signs of anaphylactic shock?

Answer 15

Sneezing, itching, rash/hives, swelling of the face and tongue, blue discoloration around the mouth, flushed skin, difficulty breathing, wheezing, BP dropping, and weak pulse

Question 16

What is septic shock?

Answer 16

Shock resulting from an overwhelming infection that has spread throughout the body and is more common in older patients

Question 17

What happens to the blood vessels during septic shock?

Answer 17

They dilate and become more porous/leaky

Question 18

What are some signs of septic shock?

Answer 18

Weak and rapid pulse, rapid breathing, fever and chills, or low body temp

Question 19

What can septic shock result in?

Answer 19

Organ damage, making it a life-threatening emergency

Question 20

What is neurogenic shock?

Answer 20

Shock in patients who have sustained a spinal cord injury where the capillaries expand and blood pools in the area below the injury

Question 21

What are the 4 types of shock caused by expansion of the capillaries?

Answer 21

1. Shock induced by fainting
2. Anaphylactic shock
3. Septic shock
4. Neurogenic shock

Question 22

What is the most common cause of shock?

Answer 22

Fluid loss due to excessive bleeding

Question 23

What is a hemorrhage?

Answer 23

Excessive bleeding

Question 24

What happens in the body during excessive bleeding?

Answer 24

The heart pumps faster to compensate for fluid loss but soon results in cardiac arrest as it stops pumping after fluid continues to drain out of the system

Question 25

What are some signs of internal bleeding?

Answer 25

Bruising, swelling, and rigidity of the affected area

Question 26

How much blood is circulating in an adult’s system?

Answer 26

Around 6 L or 12 pints

Question 27

How much blood needs to be lost in order for the patient to experience shock?

Answer 27

11 L or 2 pints

Question 28

What are some general signs and symptoms of shock?

Answer 28

1. Confusion, agitation, restlessness, or anxiety
2. Cold, clammy, sweaty, pale skin
3. Rapid, shallow breathing
4. Rapid, weak pulse
5. Increased capillary refill
6. Nausea or vomiting
7. Weakness or fainting
8. Thirst

Question 29

What can be the first sign of shock?

Answer 29

Changes in mental status and changes in behavior

Question 30

What is the general treatment for shock?

Answer 30

1. Position the patient correctly
2. Maintain the patient’s ABCs
3. Treat the cause of shock, if possible
4. Maintain the patient’s body temp by placing blankets under and over the patient
5. Ensure the patient does not eat or drink anything
6. Assist with other treatments like administering oxygen
7. Arrange for immediate/prompt transport to an appropriate medical facility

Question 31

How should you position a patient in shock who does not have head injury, extreme discomfort, or difficulty breathing?

Answer 31

1. Place the patient on their back on a horizontal surface
2. Place a blanket under the patient
3. Elevate their legs

Question 32

How should you position a patient in shock who has a head injury, spine injury, or lower extremity injury?

Answer 32

Flat on their back without elevating the legs

Question 33

How should you position a patient in shock who is having chest pain or difficulty breathing with no suspected spinal injury?

Answer 33

Sitting or semireclining

Question 34

How can you treat excessive bleeding before the patient is in the hospital?

Answer 34

Direct pressure on the wound, elevation, or a tourniquet

Question 35

Why should patients experiencing shock never eat or drink anything?

Answer 35

It can cause them to vomit due to nausea or in case they need emergency surgery