Bleeding And Shock
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Transcript Bleeding And Shock
Bleeding And Shock
Chapter 6/8
Sources of External Bleeding
Arteries
Veins
Capillaries
Arterial Bleeding
Most
serious / arteries are usually
deep in the body
Rapid and profuse blood loss
Bright red / spurts
Less likely to clot
Must use external means to stop
blood flow
Venous Bleeding
Steady
flow / bluish-red
May be profuse
More easily controlled
Veins are closer to the body
surface
Can be serious
Capillary Bleeding
Easily
controlled
Blood oozes
–Road rash
Blood Vessel Spasm
Severed
arteries
– Artery draws back into the tissue
– Artery constricts and slows bleeding
Partially
severed arteries
– Associated with greater blood loss
– Example: amputations
Definitions
Hemorrhage:
Rapid blood loss
– Adult: 1 quart may lead to shock
– Child: 1 pint loss of blood
Dressing
– A protective covering for a wound –
p.150
Bandage
– A material used to hold a dressing in
place
Dressings
Used
to control bleeding
Prevents contamination
Dressings should be:
–Sterile
–Larger than the wound
–Thick, soft, compressible
–Lint free (no cotton balls)
Types of Dressings
Gauze
pads
Adhesive strips
Trauma
dressings
Improvise
Donut shaped
Dressings
Application
– Wash hands
– Dressing should extend over edges of wound
– Do not touch dressing surface that is to be next
to the wound
– Place medications directly onto pad
– Cover with a bandage
Removal
of Dressings
– Soak “stuck” dressing in warm water
Bandages Are Used For:
Holding
dressings in place
Applying pressure
Prevent or reduce swelling
Provide support or stability
Application of Bandages
Leave
toes and fingers exposed if
possible
– Bandage too tight? Check for
color, circulation, temperature
Wrap
towards the heart
– Small end of bone to large end
Types of Bandages
Roller
gauze
Improvised
Triangular
Cravat
Adhesive / paper tape
Adhesive strips
P.150-152
Tourniquets
–Rarely recommended
–Damages nerves and
vessels
Types of Wounds And
Application of Bandages And
Dressings Will Be Addressed
Later
Someone Has Cut Their Leg:
What Should You Do?
(external bleeding / depends on severity)
Call
for help when necessary
Protect yourself from bodily fluids
Expose the wound
Apply sterile gauze pad (dressing)
Apply constant, direct pressure
for 10 minutes (don’t peak)
Cut Leg
If
dressing becomes blood soaked
– do not remove dressing, add
others over it
After
10 minutes, if bleeding persists
– apply pressure harder and over a wider
area for 10 more minutes (seek help)
Additional Options
Elevate
limb above heart level
Apply pressure at a pressure point
When bleeding stops:
– Apply pressure bandage (roller
gauze)
– Wrap towards the heart
Problem Bleeders
Hemophiliacs
Aspirin
When Not To Apply Direct
Pressure
Protruding
bone
Skull fracture
Embedded object
May use a donut shaped pad
Internal Bleeding
Look
for abdominal:
–Pain
–Tenderness
–Rigidity
–Bruises
Internal Bleeding
Look
for:
–Black stools
–Bright red stools
–Cough or vomit with blood
–Fractured ribs or bruises
Internal Bleeding: What To Do
Monitor ABC’s
Lay
on side if appropriate (expect
vomiting)
Treat for shock
– Raise legs 8-12 inches (if conscious)
– Cover victim
Bruises: Ice, ace wrap, elevate
Shock
Occurs
when the circulatory
system fails
– Resulting in inadequate blood flow
to some part of the body
A MAJOR
CAUSE OF
DEATH !!!
Shock #2
Always
treat injured victims
for shock
Shock:
–can be prevented
–cannot be reversed
Types of Shock
Cardiogenic
–Heart fails to pump
sufficient blood supply
Types of Shock
Neurogenic
– Spinal cord damage
– Drug overdose
– Vessels dilate
– Blood supply insufficient to fill
vessels
Types of Shock #2
Septic
–Result of a bacterial
infection
–Vessels lose ability to
contract
Types of Shock #3
Hypovolemic
(Fluid Loss)
–Most common type
»Blood loss
»Dehydration from vomiting,
diarrhea or profuse sweating
Shock: What To Look For
Pale,
cold, clammy skin
Altered
mental status
– Rapid breathing and pulse
Unresponsiveness
Nausea
and vomiting
Shock: What To Do
First,
care for life threatening injuries
If the face is red, raise the head,
– (injuries to upper half of body – raise the
upper half of body)
If the face is pale, raise the tail.
(injuries to lower half of body, raise the
lower half of the body)
Shock: What To Do #2
conscious and appropriate, place
victim on back, raising legs 8-12 inches
If
EXCEPT those needing ½ sitting position
(listed on next slide)
Cover
Do
victim, over and under
not let victim eat or drink
– May suck on wet cloth
Shock: When To Place In A Half
Sitting Position
Difficulty
breathing
Head injuries (when appropriate)
Strokes
Chest injuries
Penetrating eye injuries
Heart attack
Unconsciousness
Anaphylaxis or
Anaphylactic Shock
Massive
allergic reaction by
the body’s immune system
Causes Of Anaphylactic Shock
Medications
» Penicillin and related drugs, aspirin, sulfa
drugs,meds and alcohol
Foods
and food additives
– Monosodium glutamate, peanuts
Plant
pollens
Bee
stings
Radiographic
dyes
Characteristics of Anaphylaxis
Usually
comes on in minutes /
Peaks in 15-30 minutes
Sensation
of warmth
Intense itching of soles of feet and
palms of hands
Breathing
difficulties
Tightness and swelling in throat
Coughing, sneezing, wheezing
Tightness in chest
Characteristics of Anaphylaxis #2
Increased
pulse rate
Swollen
Nausea
face, tongue, mouth
and vomiting
Dizziness
Blue around lips and mouth
Anaphylaxis: What To Do
Check ABC’s
– Use ice pack on bee sting
Inject epinephrine (dilates
bronchioles)
– P.442 (hopefully victim will have some)
– Inject in outside part of thigh, hold for
10 seconds
– May need to repeat
Get help immediately (float trip)
Benedryl – too slow for major
emergency, but worth a try