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HEMORRHAGE AND SHOCK Flashcards

(41 cards)

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1
Q

What is hemorrhage?

A

A serious matter requiring control and management to stop bleeding and restore blood loss.

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2
Q

What are the two main causes of hemorrhage?

A
  • Traumatic Injury
  • Medical condition
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3
Q

What are the intravascular changes that can cause hemorrhage?

A
  • Increased blood pressure
  • Decreased clotting factors
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4
Q

What are the intramural changes that can cause hemorrhage?

A
  • Aneurysms
  • Vasculitis
  • Varicose veins
  • Oesophageal Varices
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5
Q

How is hemorrhage classified according to the source?

A
  • Arterial
  • Venous
  • Capillary
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6
Q

What characterizes arterial hemorrhage?

A

Bright red, spurting jet, less liable to clot, excessive blood loss.

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7
Q

What characterizes venous hemorrhage?

A

Dark red, flows steadily, relatively easier to control.

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8
Q

What characterizes capillary hemorrhage?

A

Bright red, may be rapid ooze, usually least serious.

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9
Q

What are the two types of hemorrhage due to trauma?

A
  • Internal
  • External
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10
Q

What are the clinical presentations of hemorrhage?

A
  • History of trauma
  • Sense of Coldness
  • Thirst sensation
  • Anxiety and irritability
  • Evidence of external bleeding
  • Increasing pallor
  • Moist sweaty skin
  • Tachycardia, tachypnea, hypotension
  • Delayed capillary refill
  • Oliguria
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11
Q

What are the four classes of hemorrhage based on blood loss?

A
  • Class I: ≤ 750 ml
  • Class II: 750-1500 ml
  • Class III: 1500-2000 ml
  • Class IV: ≥ 2000 ml
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12
Q

What is the pulse rate for Class II hemorrhage?

A

100-120 beats per minute.

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13
Q

What is the blood pressure status in Class I hemorrhage?

A

Normal.

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14
Q

What is the primary goal of emergency management for hemorrhage?

A
  • Control bleeding
  • Maintain adequate circulating blood volume
  • Prevent shock
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15
Q

What are the methods for controlling external bleeding?

A
  • Direct, firm pressure
  • Apply a firm pressure dressing
  • Elevate the injured part
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16
Q

What is hypovolemic shock?

A

A state of inadequate tissue perfusion leading to inadequate O2 utilization by the cell.

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17
Q

What factors affect adequate tissue perfusion?

Study These Flashcards
A
  • Blood volume
  • Capacitance of the blood vessels
  • Pumping action of the heart
18
Q

What are the causes of hypovolemic shock?

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A
  • Loss of blood (hemorrhage)
  • Loss of plasma (burn)
  • Loss of water (vomiting-diarrhea)
19
Q

What are the pathophysiological responses at the site of bleeding?

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A
  • Vasoconstriction
  • Retraction of the intima
  • Clot formation
20
Q

What is the role of adrenaline in maintaining circulatory volume?

Study These Flashcards
A

Increases cardiac output and systolic blood pressure.

21
Q

What are the clinical signs of hypovolemic shock?

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A
  • Cold and thirsty feeling
  • Cold skin
  • Weakness
  • Loss of consciousness
  • Tachycardia
  • Hypotension
  • Tachypnea
22
Q

What is the definition of irreversible shock?

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A

Shock that fails to improve despite proper resuscitation.

23
Q

What is the management protocol for a shocked patient?

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A
  • Arrest blood loss
  • Restore volume loss
  • Administer fluids
  • Blood transfusion
  • Use inotropic drugs
  • Provide analgesics
  • Administer oxygen
24
Q

What are common sources of infection leading to septic shock?

Study These Flashcards
A
  • Peritonitis
  • Cholangitis
  • UTI
  • Pelvic abscess
  • Puerperal sepsis
25
What are the predisposing factors for septic shock?
* Diabetes Mellitus * Immunosuppressive drugs * Corticosteroids * Chemotherapy * Old age
26
What are common causative organisms in septic shock?
* Gram-negative bacilli (e.g., E. coli, Klebsiella) * Gram-positive bacteria (e.g., Clostridial species)
27
What is the pathophysiological process in septic shock?
* Destruction of bacterial cell membranes leading to release of endotoxins * Severe inflammatory response * Damage to vascular endothelium * Hypoxic tissue damage
28
What are the stages of septic shock clinical picture?
* 1st stage: Hyperdynamic (warm stage) * 2nd stage: Cold stage (late)
29
What is the first stage of septic shock characterized by?
* Fever * Mild hypotension * Tachycardia * Oliguria * Warm flush dry skin
30
What are the types of blood products used in transfusions?
* Packed red cells * Fresh frozen plasma * Platelet concentrates * Cryoprecipitate
31
What is a common complication of blood transfusion?
* Pyrogenic reaction * Allergic reaction * Hemolytic transfusion reaction * Anaphylactic reaction * Blood-borne infections
32
What are signs of a hemolytic transfusion reaction?
* Fever * Rigors * Nausea * Chest pain * Tachycardia * Hypotension
33
What is the management for a hemolytic transfusion reaction?
* Stop transfusion * Sample for repeat typing and cross-matching * Administer IV corticosteroids * Correct shock
34
What should be done if a complication occurs during a blood transfusion?
Stop transfusion, sample to repeat type and cross match, administer IV corticosteroids, correct shock ## Footnote These are immediate steps to manage an adverse reaction during a blood transfusion.
35
What is an anaphylactic reaction in the context of blood transfusion?
Severe form of allergy, within minutes of transfusion, may be life-threatening ## Footnote Symptoms include flushing and swelling of the face, edema of the larynx, dyspnea, and hypotension.
36
Which blood-borne infections can be transmitted through blood transfusion?
* HIV * B and C viral hepatitis * CMV * Malaria (only RBCs) ## Footnote These infections highlight the importance of screening blood products.
37
What condition is caused by repeated blood transfusions leading to iron overload?
Hemochromatosis ## Footnote This condition occurs due to accumulation of iron in the body.
38
What is Acute Lung Injury in relation to blood transfusion?
Condition of severe pulmonary insufficiency developing within 4 hours of transfusion ## Footnote This serious complication can lead to significant respiratory distress.
39
What complication can arise from massive blood transfusions?
Volume overload leading to a picture of CHF ## Footnote This occurs when the volume of blood transfused exceeds the heart's capacity to handle it.
40
What does DIC stand for and how is it related to blood transfusion?
Disseminated Intravascular Coagulation, due to repeated blood transfusion ## Footnote DIC is a serious condition characterized by abnormal blood clotting throughout the body's blood vessels.
41
What are some other complications associated with blood transfusion?
* Hypothermia * Air embolism * Citrate toxicity * Hypo or hyperkalemia ## Footnote These complications can arise due to various factors during the transfusion process.

GENERAL SURGERY (5 decks)

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