EMT Chapter 25 - Bleeding Quiz

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Questions and Answers

Which section of the heart receives deoxygenated blood? (Select one)

  • Atria
  • Ventricles
  • Left
  • Right (correct)

In older patients, the first indicator of non-traumatic internal bleeding may be: (Select one)

  • A heart rate over 120 beats/min
  • Diaphoresis and pale skin
  • Weakness or dizziness (correct)
  • A low blood pressure

Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding? (Select one)

  • The patient has a history of hypertension
  • The patient has not eaten in 24 hours
  • The patient takes rivaroxaban (Xarelto) (correct)
  • The patient had a stroke 5 years prior

Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. On the basis of these findings, you should be MOST suspicious of injury to the: (Select one)

<p>Spleen (B)</p> Signup and view all the answers

Which organ or organ system has the greatest tolerance for lack of perfusion (shock)? (Select one)

<p>Gastrointestinal system (B)</p> Signup and view all the answers

Which portion of the blood carries oxygen to and wastes away from body tissues? (Select one)

<p>Red blood cells (C)</p> Signup and view all the answers

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. You should be MOST suspicious that this patient is experiencing: (Select one)

<p>Gastrointestinal bleeding (D)</p> Signup and view all the answers

Internal bleeding into a fractured extremity is MOST often controlled by: (Select one)

<p>Splinting the extremity (C)</p> Signup and view all the answers

What mechanism(s) does the body use to control bleeding? (Select one)

<p>All of these answers are correct (C)</p> Signup and view all the answers

Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______.

<p>perfusion</p> Signup and view all the answers

The severity of bleeding should be based on all of the following findings, EXCEPT: (Select one)

<p>Systolic blood pressure (C)</p> Signup and view all the answers

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: (Select one)

<p>A tourniquet proximal to the injury (D)</p> Signup and view all the answers

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: (Select one)

<p>Assist the patient's ventilations (A)</p> Signup and view all the answers

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: (Select one)

<p>Pinching the patient's nostrils and having him lean forward (D)</p> Signup and view all the answers

If applying a dressing to control the bleeding of a patient's arm, the EMT should ________. (Select one)

<p>All of these answers are correct (B)</p> Signup and view all the answers

Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? (Select one)

<p>Air splint (C)</p> Signup and view all the answers

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. (Select one)

<p>20% (A)</p> Signup and view all the answers

Hypovolemic shock occurs when: (Select one)

<p>The body cannot compensate for rapid blood loss (A)</p> Signup and view all the answers

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: (Select one)

<p>The tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released (A)</p> Signup and view all the answers

Which of the following statements regarding hemophilia is correct? (Select one)

<p>Patients with hemophilia may bleed spontaneously (A)</p> Signup and view all the answers

Flashcards

Right side of the Heart

Receives deoxygenated blood from the body and pumps it to the lungs.

Red Blood Cells

Carry oxygen to tissues and remove waste products.

Signs of GI Bleeding

Weakness, dizziness, and melena (dark, tarry stools).

Signs of Spleen Injury

Diffuse abdominal pain and shoulder pain post-trauma.

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GI System

The organ system most tolerant to a lack of perfusion.

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Tourniquet Use

Apply proximal to the injury if direct pressure fails.

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Bleeding Control

Clotting, coagulation, and vasoconstriction.

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20% Blood Volume Loss

Hypovolemic shock due to inability to compensate rapid blood loss.

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Treating Nosebleeds

Pinch nostrils and lean forward to prevent blood from going back into the throat.

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Treating Severe Nosebleeds

Pinch nostrils and lean forward.

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Dressing a Wound

Direct pressure, appropriate dressing size, and complete wound coverage.

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Splinting Extremities

Splinting to control bleeding and stabilize fractured bones.

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Preferred Splint for Open Fractures

Air splints

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Tourniquet Removal

Only remove in a hospital setting

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Tourniquet Placement

Apply above the injury site and prioritize direct pressure at proximal arterial points.

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Hemophiliac Patients

Can bleed spontaneously and should not take aspirin.

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Study Notes

Heart and Blood Flow

  • The right side of the heart receives deoxygenated blood.
  • Red blood cells transport oxygen to tissues and carry waste away.

Indicators of Internal Bleeding

  • In older patients, weakness or dizziness may be the first sign of non-traumatic internal bleeding.
  • Gastrointestinal bleeding can manifest as weakness, dizziness, and melena in older males with low blood pressure and high pulse rates.

Assessment of Internal Bleeding

  • Significant findings include the patient's history of medications like rivaroxaban (Xarelto), which affects bleeding risk.
  • In the event of blunt abdominal trauma, diffuse abdominal pain and shoulder pain could indicate a spleen injury.

Organ Tolerance to Perfusion

  • The gastrointestinal system has the greatest tolerance for lack of perfusion compared to other organ systems.

Emergency Response and Treatment

  • If direct pressure doesn’t control severe bleeding from an extremity, a tourniquet should be applied proximal to the injury.
  • Applying splints helps control bleeding in fractured extremities.

Bleeding Control Mechanisms

  • The body utilizes clotting, coagulation, and vasoconstriction to manage bleeding effectively.
  • Adequate perfusion is necessary for blood circulation to meet oxygen, nutritional, and waste removal needs in tissues.

Severity of Bleeding

  • Evaluation of bleeding severity includes clinical signs, general appearance, and the mechanism of injury; systolic blood pressure is not a defining factor.

Special Cases

  • In cases where a patient is shot in the abdomen and semi-conscious, assistance with ventilations is crucial while controlling external bleeding.
  • For severe nosebleeds, the recommended treatment is to pinch nostrils and lean forward; this approach prevents blood from traveling back into the throat.

First Aid and Treatment Techniques

  • When dressing a wound, direct pressure, the appropriate size of dressings, and complete coverage of the wound are essential.
  • For open fractures with external bleeding, air splints are the preferred option.

Blood Volume Loss and Shock

  • Significant vital sign changes are observed when an adult loses more than 20% of total blood volume, signaling hypovolemic shock, which occurs when the body cannot compensate for rapid blood loss.

Tourniquet Use

  • A tourniquet should only be removed in a hospital setting to prevent returned bleeding.
  • Tourniquets should be applied above the injury site, and direct pressure at proximal arterial points is prioritized.

Hemophilia

  • Patients with hemophilia can spontaneously bleed, highlighting the need for careful management; they do not benefit from aspirin, which enhances bleeding.

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