EC Chp 25 Bleeding and Shock

Question 1

Perfusion (adequate circulation of blood)

Answer 1

the supply of oxygen to and removal of wastes from the body’s cells and tissues as a result of the flow of blood through the capillaries

Question 2

Hypoperfusion (Shock)

Answer 2

the body’s inability to adequately circulate blood to the body’s cells to supply them with oxygen and nutrients

Question 3

Blood has several functions what are they?

Answer 3

Transportation of gases
Nutrition circulation to other body cells from intestines
Excretion of wastes
Protection with white blood cells and antiboies
Regulation

Question 4

Heart, blood vessels and blood are

Answer 4

The 3 main components of the circulatory system

Question 5

hemorrhage is also known as

Answer 5

severe bleeding

Question 6

external bleeding is bleeding that happens….

Answer 6

outside of the body visible on the surface of the skin

Question 7

Arterial bleeding is an example of external bleeding and signs of it are

Answer 7

spurting blood
pulsating flow
bright red

Question 8

Venous Bleeding is another external bleeding. what Types of signs would you see?

Answer 8

steady, slower flow then arterial and darker red color

Question 9

Junctional Hemorrhage happens in areas where veins and arteries tend to be less well protected. where are these places?

Answer 9

occurs where the appendages of the body connect to the trunk. Ex: neck, both armpits and sides of groin

Question 10

when is capillary bleeding at risk of high infection

Answer 10

when the it occurs over large areas

Question 11

Bleeding can also be accelerated if patients have underlying conditions and take medications for them. these meds are what and used for what?

Answer 11

blood thinners and used for patients with history of stroke or heart problems. Ex. asprin, warfarin, clopidogrel, pradaxa

Question 12

We also know that hypothermia has what affect on the body

Answer 12

it affects the body’s ability to clot

Question 13

First step in most cased in bleeding control is to

Answer 13

COMPRESS the wound with DIRECT PRESSURE

Question 14

with a pressure dressing using several gauze pads and roller bandage you must ensure you…

Answer 14

create enough pressure to control the bleeding

Question 15

What must you always do after controlling bleeding for an exteremity using a pressure dressing

Answer 15

check for a distal pulse to make sure the dressing has not been applied too tightly

Question 16

Do NOT use the elevating technique in an injury when…

Answer 16

you suspect a possible musculoskeletal injury

Question 17

Hemostatic agents are

Answer 17

products as powders, dressings, gauze or bandages designed to stop bleeding.

Question 18

For large cavity been formed from trauma direct pressure is not typically effective. You can address the issue by

Answer 18

filling the cavity with dressings or unrolled bandages and hemostatic agent as its for wound packing and an agent

Question 19

When Obvious bleeding and rapid soaking through of dressing are happening even with direct pressure what should you do?

Answer 19

apply a tourniquet! that closes off all blood flow to and from the extremity

Question 20

Tourniquets are only use on extremity injuries. Where should you place it approximately

Answer 20

approximately 2 inches above the bleeding wound

Question 21

If a tourniquet is not available you can use…

Answer 21

a cravat, or improvised materials, but should be 2 inches wide and several layers thick.

Question 22

how tight do you place the tourniquet?

Answer 22

There should be no distal pulse palpable

Question 23

You need to attach a notation to the patient alerting ALS regarding the tourniquet but you should also indicate what?

Answer 23

the Time it was applied

Question 24

if you find a “tourniquet” applied by a layperson has not stopped the bleeding. what do you do?

Answer 24

apply direct pressure and remove it, then proceed with your bleeding control as you normally would or apply a second one proximal to the first one

Question 25

American College of Surgeons recommended that all hemorrhage controls begins with directly pressure. If the bleeding is not controlled then

Answer 25

you should apply a tourniquet.

Question 26

Two other methods of bleeding control are?

Answer 26

Splinting and Cold Applicaton

Question 27

Air splints are useful if there are several wounds to the extremity or one that extends over the length of the extremity. they are mot effective for what bleedings?

Answer 27

Venous and Capillary

Question 28

Cold application does what for bleeding

Answer 28

Minimizes the swelling, reduces the bleeding by constricting the blood vessels.

Question 29

how long should you leave cold packs for?

Answer 29

no more than 20 min an never apply directly to skin

Question 30

Head injuries can cause cerebrospinal fluid (CSF) to come out from the ears and nose however it is not from the direct trauma it is actually from

Answer 30

the head injury results in increased pressure within the skull, which forces fluid out of the cranial cavity

Question 31

nose bleeds are also called Epistaxis and these are typically caused by

Answer 31

hypertension
sinus infection
digital trauma (nose picking)

Question 32

with Epistaxis you can stop it by?

Answer 32

sitting the patient down and lean forward
apply pressure to the nostril
do NOT let the patient lean back

Question 33

If a patient becomes unconscious from epistaxis or unable to control their airway you should…

Answer 33

place patient in recovery position on his side and be prepared to provide suction and airway mgt.

Question 34

what is the leading cause of internal injuries and what are mechanisms of blunt trauma?

Answer 34

blunt trauma

falls, MVC, auto-pedestrian crashes, blast injuries

Question 35

Signs of internal bleeding

Answer 35

injuries to surface of body
bruising, painful, swollen, or deformed extremities
bleeding from mouth, rectum, vagina
tender, rigid, distended abdomen
vomiting coffee grounds like substance
dark tarry stools or bright red stool
SHOCK

Question 36

compensated shock is when

Answer 36

the body is developing shock but the body is still able to maintain perfusion

Question 37

Shock(hypoperfusion) in general is the

Answer 37

the body’s reaction to decreased blood circulation to the organ systems

Question 38

A late sign of decompensated shock is

Answer 38

falling blood pressure

Question 39

hypovolemic shock is commonly known as caused by

Answer 39

is caused by uncontrolled bleeding or fluid loss o

Question 40

Hemorrhagic shock is

Answer 40

shock resulting from blood loss

Question 41

Cardiogenic shock is

Answer 41

lack of perfusion brought on by the heart’s inadequete pumping action (often due to heart attack

Question 42

Neurogenic shock is

Answer 42

shock resulting from uncontrolled dilation of blood vessels from nerve paralysis caused by spinal injuries. blood vessels dilate to a point blood can no longer fill it

Question 43

Although rare to see Neurogenic shock what are some causes?

Answer 43

Sepsis, anaphylactic reaction

Question 44

what are treatments for Neurogenic shock

Answer 44

Intravenous fluids

Early notification of the hospital

Question 45

Infants and children present a special problem with shock as they have efficient compensating mechanisms and can maintain a normal BP until how much blood is gone?

Answer 45

1/2 of their blood volume is gone. by the time BP drops they are near death

Question 46

what is the 1st sign of shock?

Answer 46

altered mental status

Question 47

what is the 2nd, 3rd, and 4th sign of shock

Answer 47

2. Pale cool and clammy skin
3. Nausea and vomiting
4. vital sign changes

Question 48

what are the vital sign changes in shock?

Answer 48

1st the pulse will increase to try to pump more blood
2nd Respirations increase to raise oxygen saturation
3rd. BP drops doe to compensation
4th. Pulse oximetry might not be accurate

Question 49

Other late signs of shock

Answer 49

thirst, dialated pupils and cyanosis

Question 50

golden hour is described as

Answer 50

the optimal time for the infliction of a traumatic injury until the patient receives definitive treatment in a hospital

Question 51

the goal for on-scene time when caring for a trauma or shock patient has been stated as a max of

Answer 51

10 minutes (unless lengthy extrication is required

Question 52

the goal for 10 min at the scene is also called

Answer 52

platinum 10 minutes

Question 53

some elements of the assessment should be done in route to hospital these include:

Answer 53

detailed exams, treatments, `

Question 54

preventing a shock/trauma patient from further blood loss and oxygenating can help prevent a condition called

Answer 54

acidosis ; when cells receive insufficient oxygen and generate acidic waste products that accumulate in the blood.