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Flashcards in Haemorrhage Deck (23)
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1

Pulse pressure

SBP - DBP

2

Mean Arterial Pressure

DBP + 1/3 PP

3

Haemorrhage definition

Disruption or leakage from the circulatory system
Can be external, internally concealed or internally revealed

4

External Haemorrhage

Soft tissue, can be arterial, venous or capillary level.
The seriousness of the injury is related to vascular disruption and amount of blood lost

5

Internal Haemorrhage

occurs in a body cavity, caused by blunt or penetrating trauma

6

Internal Haemorrhage signs and symptoms

light headed, N+V, rapid weak thready pulse, rapid resps, pale cold clammy, thirsty, history, evidence from scene, blood from cavity is a bad sign

7

Haemostasis

blood clotting that stops haemorrhage therefore stopping bleeding

8

The Clotting Process

Vascular Spasm: vessel walls constrict due to nervous reflexes, minimising blood loss and allowing platelet plug to occur
Platelet Plug Formation: platelets adhere to collagen under the epithelium becoming sticky and attracting other platelets which forms a temporary plug
Blood Coagulation: Extrinsic pathway is initiated by liquid blood making contact with damaged tissue. Intrinsic pathway is initiated by liquid blood making contact with a foreign surface

9

Coagulation pathway

1. formation of prothrombin activator
2. conversion of prothrombin to thrombin
3. conversion of soluble fibrinogen which is converted to fibrin by thrombin

10

Drugs affecting clotting

Platelet inhibitors - stops production of thromboxane A required in platelet plug formation
Anticoagulants - interferes with Vitamin K dependent clotting factors
Thrombolytics - converts plasminogen into active plasmin-clot dissolving

11

Treatment of Haemorrhage

Firm, direct pressure without compromising circulation
Place more bandages over the top if still bleeding
Use a BP cuff or bandage if still bleeding

12

Shock Definition

a continuning process defined by a chain of event which leads to widespread reduction in tissue perfusion leading to impairment of cellular metabolism
Low systemic vascular resistance and perfusion pressure inadequate to move oxygen

13

Stages of Shock

Compensatory
Decompensatory
Irreversible

14

Compensatory Shock

Increase HR and PVR and vessels dilate to maintain BP
Blood shunts from less vital organs to the vital ones

15

Signs of Compensatory Shock

Tachycardia
Slightly Pale
BP remains stable - slight rise in SBP with PP increasing

16

Decompensating shock

body can't maintain BP, SBP drops first as it is more reliant on CO
decreases in cerebral blood flow and partial pressure of O2
Blood shunts to vital organs, body systems are shutting down

17

Decompensating shock signs

hypotension - pulse pressure reduces, tachycardia, tachypnoea - to get more oxygen in, pale and diaphoretic, developing ACS, reduced urine output, delayed capillary refill

18

Irreversible shock

cellular ischaemia and necrosis leads to release of contents into circulation
everything shuts down

19

Irreversible signs

bradycardia
life threatening dysrhythmias
severe unabated hypotension
abnormal resp patterns
ACS
cyanosis and mottling of skin
death

20

Absolute Fluid Loss

water and minerals lost due to dehydration, diarrhoea and vomiting, reduced fluid intake, excessive diuresis

21

Absolute Fluid Loss signs and symptoms

altered conscious, cool pale clammy, dizziness, nausea and vomiting, increased resps, increased HR, hypotension as late sign

22

Relative Fluid Loss

BP remains the same, but blood vessels capacity increase due to vasodilation e.g. anaphylaxis

23

Relative Fluid Loss signs and symptoms

skin may be warm and flushed due to pooling in periphery, tachypnoea, tachycardia, hypotension