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Ch 26 Bleeding
EMT Bleeding
| Question | Answer |
|---|---|
| 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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