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Ch 26 Bleeding

EMT Bleeding

Hypovolemia / Hypovolemic shock Acute loss of fluid. Can be blood or fluids from vomiting, diarrhea, burns (blisters)
Hemerrhage Uncontrolled bleeding. Most common form of hypoperfusion (low blood flow). External is "visible hemorrhage"
The cardiovascular system (CVS) is responsible for? Supplying and maintaining adequate blood flow to the brain and body
The cardiovascular system (CVS) consists of 3 parts Pump (heart) Container (blood vessels) Fluid (blood and body fluids)
The heart cannot tolerate disruption of blood for for? More than a few minutes
The two paired pumps of the heart Atrium (upper chambers) Ventricles (lower chambers)
Blood leaves that heart through? A one-way valve into the Aorta (the largest artery in the body)
The small vessels that connect the arteries and capillaries are ______ Arterioles
Capillaries Small tubes with the diameter of a single red blood cell They link Aerterioles and Venules
Blood leaving the distal side of capillaries Flow into venules, empty into veins, veins empty into the Inferior and Superior Venae Cavae
Blood contains Red cells, white cells, platelets and plasma
Blood clots Control blood loss. Platelets collect at the site of an injury, red cells clump, protein in plasma reinforces developing the clot by creating a thread-like mesh
Autonomic Nervous System Automatic Adjusts blood flow by constricting, dilating vessels Redirects blood away from other organs to the heart, brain, lungs, kidneys Adapts the CVS
Hypoperfusion / Shock Blood volume is diminished and the system fails to provide enough circulation for every body part to perform its function (high HR, high RR, low BP)
Perfusion The circulation of blood within an organ or tissue to meet cells needs for oxygen, nutrients and waste removal
Blood enters tissues in this order Enters an organ/tissue through 1: Arteries 2: Arterioles 3: Capillaries
Blood circulation Blood must pass through the CVS fast enough to maintain adequate circulation and to avoid clotting, but slow enough to allow O2, CO2 and nutrient exchange
Blood requirements during work and rest Some tissues require more or less blood depending on what's happening Skeletal muscle needs less during sleep, but more during exercise GI needs more during a meal, but less after
Critical organs with constant blood flow Heart (CVS) Brain (CNS) Lungs (Resp System) Kidneys (Renal System)
Without blood flow, cells in the brain and spinal cord start to die after? 4 to 6 minutes These cells do not have the ability to regenerate
Without blood flow the lungs can survive for? 15 to 20 minutes
Without blood flow the kidneys can survive for? 45 minutes
Without blood flow skeletal muscle and the GI can survive for? 2 to 3 hours
Can organs survive damage better at lower or higher temperatures? Lower
Examples of Visible Hemorrhage Nose bleeds, open wound bleeding, ear bleeding, etc
Serious external bleeding; it's often difficult to determine? Amount of blood lost Blood will look different on different types of surfaces, lighting, and can be absorbed into things like clothing or diluted with water
Treatment should be based on? Patients presentation and MOI Estimating blood loss is important, but can be difficult
Adult male bodies contain About 70mL of blood per kg of weight 79kg (175lbs) has 5.5L of blood
Adult female bodies contain About 65mL of blood per kg of weight 79kg (175lbs) has 5.1L of blood
The body cannot tolerate acute loss of ______ of total blood volume 20% or 1L in the average adult
Adverse changes in vitals will occur with? Significant blood loss Increased HR, RR Decreased BP
Infants and children have less ______ and these effects are seen with less _____ Blood Volume, Blood Loss
How well a body can compensate for blood loss is related to How rapidly the blood loss occurs
A healthy adult can donate _______ with little issue (adapt within 15-20min) 1 Pint or 500mL
Consider bleeding to be severe if any of these conditions exist: Poor general appearance Signs of shock Significant blood loss Rapid/ongoing blood loss Cannot control bleeding Associated with significant MOI
Types of bleeding Arterial (artery): Bright red, spurts Venous (veins): Darker than arterial, steady flow Capillary: Dark red, oozes slow and steady
On its own, bleeding tends to stop in _________ About 10 minutes
Bleeding patients may expose you to? Infectious body fluids Keep spare gloves Wear a gown, mask, eye pro incase of splatter
Soon after a cut, it will Vasoconstrict Blood vessel narrowing
Coagulation Clots forming to plug holes caused by cuts, etc
If damage to a vessel is too large Bleeding may not stop because a clot cannot form
Tourniquet A tool used to completely cut off main blood supply with direct pressure
Situations where the circulatory system may fail / affect blood's clotting factor Movement Disease Medications (like blood thinners) Removal of bandages External Environment Body Temperature
Hemophilia Lacking one or more of the blood's clotting factors Most are hereditary and some severe
Sometimes bleeding occurs spontaneously in patients with? Hemophilia
Internal bleeding Bleeding that occurs in a cavity or space inside the body. Can be very serious. Not easy to detect
Internal bleeding can cause Hypovolemic shock Because it's hard to detect, there can be extreme fluid/blood loss
Other ways of significant internal bleeding Lacerated liver Ruptured spleen or gallbladder Broken bones (a femur can lose 1L) Pelvic fracture (life-threatening)
Contusion or Ecchymosis Local swelling and bruising
If you suspect internal bleeding Treat for shock and transport (supine, legs elevated, keep warm - Trendelenburg)
Internal bleeding commonly occurs from falls, blast injuries, motor vehicle crashes, other blunt or penetrating trauma
Look for signs of injury with DCAP-BTLS Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, Swelling
Illnesses that can cause internal bleeding Ulcers Bleeding colon Ruptured ectopic pregnancy Aneurysms
Frequent symptoms Abdominal tenderness Guarding Rigidity Pain Distention Dizziness (especially older) Faintness (non-traumatic) Weakness (non-traumatic)
Intra-abdominal bleeding will often cause? Pain and abdominal distention
Bleeding into the chest or lung may cause? Dyspnea (difficult breathing) Tachycardia Hemoptysis (coughing bright red blood) Hypotension
Always ask a patient who's bleeding if they take ________ Blood-thinning medications (asprin, warfarin)
Internal and External bleeding can cause? Shock
Methods to control bleeding in order: Direct Pressure Pressure Dressing Tourniquet Splinting
A skull fracture may cause Bleeding from the nose, ears, and/or mouth
Other factors that can cause bleeding from nose, ears, mouth High BP Sinus infections Intracranial pressure
Bleeding around the face always presents a risk of? Airway Obstruction or Aspiration Maintain a clear airway and suction
If bleeding at the nose, suspect a? Skull fracture
How to treat a nose bleed Place a gauze pad loosely under the nose. If the bleeding isn't from a skull fracture, pinch the nose for 15min
Signs of serious internal bleeding Vomiting bleed (hematemesis) Black, tarry stool (melena) Coughing up bleed (hemoptysis) Distended abdomen Broken ribs
Created by: cmoney833
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