EMT-B Bleeding and Shock (CH27)

Almost all external bleeding can be controlled by ______.

Direct pressure and elevation.

When direct pressure and elevation don't work on an external bleed, a ______ can be applied if the bleed is on an extremity.

tourniquet

Emergency care for internal bleeding is based on _______ and ______ for shock.

prevention, treatment

Early signs of shock.

restlessness, anxiety, pale skin, rapid pulse, rapid respirations

A late sign of shock

low blood pressure

How do you treat shock?

maintaining the airway, administering high-concentration oxygen, controlling bleeding, keeping patient warm.

True or false? Signs and symptoms of shock may no be evident early in the call, so treatment based on the mechanism of injury may be lifesaving.

true

One of the most important treatments of shock is ______.

early recognition and transport to the hospital

Arterial Bleeding

bleeding from an artery which is characterized by bright red blood that is rapid, profuse, and difficult to control

capillary bleeding

bleeding from capillaries, which characterized by a slow, oozing flow of blood

cardiogenic shock

shock, or lack of perfusion, brought on not by blood loss, but by the heart's inadequate pumping action. It is often the result of a heart attack or congestive heart failure.

Compensated shock

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

Decompensated shock

When the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident.

Hemorrhage

Bleeding, especially severe bleeding

Hemorrhagic shock

shock resulting from blood loss

Hemostatic agent

substances applied as powders, dressings, gauze, or bandages to open wounds to stop bleeding

Hypoperfusion

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

hypovolemic shock

shock resulting from blood or fluid loss

Irreversible shock

when the body has lost the battle to maintain perfusion to vital organs. Even if adequate vital signs return, the patient may die days later due to organ failure.

Neurogenic shock

Hypoperfusion due to nerve paralysis (sometimes cause by spinal cord injuries) resulting in the dialation of blood vessels that increases the volume of the circulatory system beyond the point where it can be filled.

Perfusion

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.

Pressure Dressing

a bulky dressing held in position with a tightly wrapped bandage, which applies pressure to help control bleeding

Shock

the body's inability to adequately circulate blood to the body's cells to supply them with oxygen and nutrients, which is a life-threatening condition.

Tourniquet

a device used for bleeding control that constricts all blood flow to and from an extremity

Venous Bleeding

bleeding from a vein, which is characterized by dark red or maroon blood and a steady, easy-to-control flow

Functions of blood

transportation of gases, nutrition, excretion, protection, regulation

Arterial external bleeding signs

spurting blood, pulsating flow, bright red color

Venous external bleeding signs

steady, slow flow; dark red color

Capillary external bleeding signs

slow, even flow

Signs of shock

altered mental status; pale, cool, clammy skin; nausea and vomiting; vital sign changes

Late signs of shock

thirst, dialated pupils, cyanosis around lips and nail beds, low blood pressure

Altered mental status occurs with shock because ______.

the brain is not receiving enough oxygen (sensitive to deficiencies). Even slight deprivation can cause behavioral changes.

Pale, cool, clammy skin occurs with shock because _____.

When the body senses low blood volume, natural mechanisms take over in an attempt to correct the problem. One of these mechanisms is to divert blood from nonvital areas to vital organs. Blood is quickly directed away from the skin to such organs as the br

Nausea and vomiting occur with shock because _____.

In the body's continuing effort to keep blood perfusing the vital organs, blood is diverting from the digestive system. This causes feelings of nausea and occasionally vomiting.

Pulse changes occur during shock because _____.

The pulse will increase in an attempt to pump more blood. As the pulse gradually increases, it becomes weak and thready. Most patients will become tachycardic with significant blood loss; however, a significant number do not, so you cannot rely solely on

Respiratory changes occur during shock because _____.

Respirations also increase in an attempt to increase the amount of oxygen in the blood. The respirations will become shallower and labored as shock progresses.

Blood pressure changes occur during shock because _____.

Blood pressure is one of the last signs to change. When blood pressure drops, the patient is clearly in a state of serious, life-threatening shock.

Narrowing pulse pressure occurs during shock. What does this mean?

The difference between the systolic and diastolic pressures will decrease (become closer together).