Bleeding And Shock Chapter 6/8

Bleeding And ShockChapter 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 10minutes(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 • If consciousand appropriate, place victim on back, raising legs 8-12 inches EXCEPT those needing ½ sitting position (listed on next slide) • Cover victim, over and under • Do 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 face, tongue, mouth • Nausea 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

Bleeding And Shock Chapter 6/8