Hemorrhage Management and Control

Questions and Answers

What defines clinical hypotension in a patient?

A systolic BP of 90 mm Hg with signs of dehydration

A systolic BP less than 90 mm Hg or a drop of 40 mm Hg from baseline (correct)

A systolic BP less than 80 mm Hg or a drop of 30 mm Hg from baseline

A systolic BP less than 85 mm Hg with no change from baseline

Which statement is true regarding the irreversible stage of shock?

Anaerobic metabolism is completely halted.

Blood pressure remains low despite treatment. (correct)

The patient responds well to treatment interventions.

The cardiovascular system maintains adequate MAP for tissue perfusion.

Which of the following respiratory conditions is expected in the progressive stage of shock?

Rapid shallow breathing (correct)

Increased tidal volumes

Complete respiratory failure without support

Normal respiratory rates

What is a characteristic finding in the irreversible stage of shock?

Erratic blood pressure readings Signup and view all the answers

Which of the following describes the skin condition during the progressive stage of shock?

Mottled with petechiae Signup and view all the answers

What condition is characterized by inadequate blood flow to tissues and cells?

Shock Signup and view all the answers

Which type of shock results from a severe allergic reaction?

Anaphylactic shock Signup and view all the answers

What occurs during Stage 1 of shock?

Compensation of blood pressure is maintained Signup and view all the answers

Which physiological response is NOT typically observed during Stage 1 of shock?

Increased skin temperature Signup and view all the answers

What mechanism is primarily responsible for the body's response during compensatory shock?

Stimulation of the sympathetic nervous system Signup and view all the answers

In the progressive stage of shock, what happens to the mean arterial pressure (MAP)?

Falls below normal limits Signup and view all the answers

What type of shock results primarily from infection or sepsis?

Septic shock Signup and view all the answers

Which of the following is NOT a consequence of sympathetic stimulation in shock?

Vasodilation of peripheral blood vessels Signup and view all the answers

What is the primary cause of severe hemorrhage?

Internal hemorrhage Signup and view all the answers

Which of the following is NOT a sign of internal bleeding?

Rash Signup and view all the answers

What should be done first when controlling external hemorrhage?

Apply direct, firm pressure Signup and view all the answers

When is it appropriate to apply a tourniquet?

When external hemorrhage cannot be controlled Signup and view all the answers

How should the patient be positioned when managing internal bleeding?

Supine position Signup and view all the answers

What is one of the management steps for internal bleeding?

Blood transfusion Signup and view all the answers

Which of the following is a method used to assess the patient's response to therapy in internal bleeding management?

ABG sample Signup and view all the answers

What action should you take if a patient has an amputation with uncontrollable hemorrhage?

Keep the tourniquet in place Signup and view all the answers

Study Notes

Minor and Severe Hemorrhage

Minor hemorrhage is typically venous and stops spontaneously unless influenced by bleeding disorders or anticoagulant medications.
Severe hemorrhage is a primary cause of shock, and internal hemorrhage can occur without visible external bleeding.
Internal spaces that can hold significant blood include the retroperitoneum, pelvis, chest, and thighs.

Control of External Hemorrhage

Direct, firm pressure should be applied using a pressure dressing to control external bleeding.
Pressure can be applied on the involved artery at a point proximal to the wound to effectively control hemorrhage.
Elevating the injured limb is advisable, along with immobilizing the affected extremity.
A tourniquet should be used if the bleeding cannot be controlled; it must be placed just above the wound.
Tagging the patient with a “T” on the forehead is crucial, indicating tourniquet location and application time.

Internal Bleeding

Signs and symptoms of internal bleeding include tachycardia, low blood pressure, increased thirst, apprehension, cool and moist skin, and delayed capillary refill.
Management of internal bleeding often requires blood transfusion, preparation for possible surgery, and obtaining arterial blood gas (ABG) samples for evaluation.
Monitoring and placing the patient in a supine position is essential for assessing condition.

Types of Shock

Shock is characterized by inadequate blood flow to tissues and body cells.
Types of shock include:
- Anaphylactic shock: due to severe allergic reactions.
- Cardiogenic shock: due to heart muscle impairment or failure.
- Distributive shock: results from displacement of intravascular volume.
- Hypovolemic shock: caused by decreased intravascular volume from fluid loss.
- Neurogenic shock: loss of sympathetic tone causing relative hypovolemia.
- Septic shock: due to widespread infection or sepsis.

Stages of Shock

Stage 1: Compensatory
- Blood pressure remains normal with compensatory mechanisms.
- Vasoconstriction, increased heart rate, and contractility help maintain cardiac output.
- Blood is shunted from non-essential organs to vital organs, leading to cool, pale skin, hypoactive bowel sounds, and decreased urine output.
Stage 2: Progressive
- Compensatory mechanisms fail; mean arterial pressure (MAP) drops below normal.
- Patients become hypotensive (BP <90 mm Hg) and show signs of altered mental status.
Stage 3: Irreversible
- There is no effective response to treatment; organ damage occurs.
- Blood pressure remains low despite interventions, and renal/liver dysfunction develops.
- Conditions such as acute metabolic acidosis and lactic acidosis worsen due to anaerobic metabolism.
- The cardiovascular system is unable to maintain adequate MAP for tissue perfusion.

Comparison of Stages of Shock

Finding
- BP: Normal in compensatory, hypotensive in progressive, erratic in irreversible.
- Respiratory Rate (RR): Elevated (>20 in compensatory) to requiring mechanical ventilation in irreversible.
- Skin: Varies from cold and clammy to mottled with petechiae and jaundice.
- Urine Output: Decreased across all stages, with significant concern in later stages.

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Description

This quiz focuses on the key concepts of managing minor and severe hemorrhage, including techniques for controlling external bleeding and recognizing signs of internal bleeding. Learn effective methods and best practices for handling hemorrhagic situations in medical emergencies.