Hypovolemic Shock and Blood Circulation Quiz

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Questions and Answers

What is the relationship between hypovolemia and the body's need for oxygen?

Hypovolemia has no effect on oxygen delivery.

Hypovolemia enhances the body's ability to store oxygen.

Hypovolemia increases oxygen delivery to tissues.

Hypovolemia decreases oxygen delivery to tissues. (correct)

How is Cardiac Output (CO) calculated?

CO is the product of heart rate and stroke volume. (correct)

CO is the average blood pressure in the circulatory system.

CO is the measure of blood pressure over time.

CO is the sum of blood volume and stroke volume.

What happens to the vital signs of a person experiencing acute blood loss?

Heart rate stays the same, respiratory rate decreases, and blood pressure rises.

Heart rate decreases, respiratory rate decreases, and blood pressure remains stable.

Heart rate increases, respiratory rate increases, and blood pressure decreases. (correct)

Heart rate decreases, respiratory rate increases, and blood pressure rises.

What does 'Stroke Volume' (SV) refer to?

The amount of blood ejected per contraction of the heart. (D) Signup and view all the answers

What occurs when there’s an opening in blood circulation?

Blood loss negatively impacts organ and tissue perfusion. (D) Signup and view all the answers

Which vessel type carries blood with high oxygen content?

Arteries (C) Signup and view all the answers

What is the primary mechanism by which the body initially attempts to reduce blood loss from a lacerated vessel?

Vasoconstriction (D) Signup and view all the answers

Platelets play a crucial role in hemostasis. What is their primary function in this process?

To aggregate and plug the hole in the vessel (B) Signup and view all the answers

Which of the following is NOT a compensatory mechanism the body uses in response to blood loss?

Decreased heart rate (B) Signup and view all the answers

Which of the following best describes hypovolemic shock?

Inadequate tissue perfusion due to decreased fluid volume (A) Signup and view all the answers

Which type of hemorrhage is typically easier to recognize and manage in the prehospital setting?

External hemorrhage (A) Signup and view all the answers

Which of the following best describes arterial bleeding?

Bright red and spurting (A) Signup and view all the answers

What is the primary reason that arterial bleeds are more difficult to manage than venous bleeds?

Arteries are under much higher pressure (A) Signup and view all the answers

What is the primary reason for clearing away blood and debris when applying direct pressure to a wound?

To improve visualization of the bleeding source (D) Signup and view all the answers

When managing hemorrhage in a hollow space like the chest, what is a critical step one should AVOID?

Packing the wound (B) Signup and view all the answers

In the context of extremity hemorrhage management, when should a second tourniquet be considered?

If the initial tourniquet fails to control the bleeding (D) Signup and view all the answers

What is the MOST appropriate initial action when addressing hemorrhage in a junctional area like the groin?

Apply direct digital pressure (B) Signup and view all the answers

What is the purpose of using a small surface area when applying direct pressure to a bleeding wound?

To increase the effectiveness of the pressure on the specific bleeding point (D) Signup and view all the answers

When applying a tourniquet, which of the following is MOST appropriate?

Apply over a large muscle group and turn the windlass until tight, then according to manufacturer specific instructions for further tightening. (D) Signup and view all the answers

After properly packing a wound with a hemostatic dressing, what is the next essential step?

Cover and hold pressure on the wound for 3-5 minutes. (C) Signup and view all the answers

Which of these situations is a contraindication for applying hemostatic dressing?

An open skull fracture. (A) Signup and view all the answers

In the context of hemorrhage management, when is the initiation of IV fluid therapy most appropriate?

When a patient is hypotensive, and after addressing more pressing tasks, such as stopping the bleeding. (A) Signup and view all the answers

When managing a patient with major hemorrhage, what is the most appropriate action regarding transport to definitive care?

Prioritize rapid transport to a hospital with surgical capabilities as most major hemorrhages require hospital management. (B) Signup and view all the answers

For a patient with a minor laceration, what is the most appropriate option?

Pressure dressing (A) Signup and view all the answers

What is the primary purpose of a Kling dressing (rolled gauze)?

To wrap and secure other dressings in place (B) Signup and view all the answers

When should a tourniquet be applied?

If regular dressings are ineffective at stopping major extremity hemorrhage. (A) Signup and view all the answers

What is a key consideration when using a tourniquet?

Documenting the time of application both on the ACR and the tourniquet itself (B) Signup and view all the answers

Under which circumstance would a hemostatic dressing be the most appropriate choice?

When a tourniquet is both ineffective and contraindicated (A) Signup and view all the answers

Why is a pelvic binder applied to patients with significant MOI traumas?

To stabilize suspected pelvic fractures. (A) Signup and view all the answers

What is the primary function of trauma shears?

Cutting through clothing and bandages efficiently (C) Signup and view all the answers

Which of the following best describes the function of medical tape?

To secure dressings, IV lines, and advanced airways (A) Signup and view all the answers

What is the primary challenge in managing internal hemorrhage in a prehospital setting?

The difficulty in recognizing the extent of bleeding. (D) Signup and view all the answers

Which of the following is typically the earliest symptom associated with internal hemorrhage?

Pain that seems disproportionate to the injury. (C) Signup and view all the answers

Why is it difficult to estimate blood loss from external hemorrhage?

Blood appears differently on various surfaces. (A) Signup and view all the answers

During the initial assessment of a patient with major external hemorrhage, which of the following should be the first priority?

Management of the hemorrhage. (A) Signup and view all the answers

When managing a patient with multiple major injuries, what should be prioritized?

Controlling major hemorrhage before addressing other injuries. (D) Signup and view all the answers

What does the 'R' in the RED mnemonic for external hemorrhage management represent?

Rest (C) Signup and view all the answers

Which of the following is considered an aggressive treatment for a major hemorrhage?

Using tourniquets. (D) Signup and view all the answers

What is a key difference between occlusive and non-occlusive dressings?

Occlusive dressings are impermeable to air and moisture, while non-occlusive dressings are not. (A) Signup and view all the answers

When assessing a patient with a potential internal hemorrhage, which of the following findings should raise the highest level of suspicion?

A significant mechanism of injury with disproportionate pain. (A) Signup and view all the answers

What is the primary focus of a paramedic's role in wound management?

Emergency wound management (D) Signup and view all the answers

Study Notes

Hemorrhage Control

The average adult has approximately 6 liters of blood circulating (65-70mL/kg).
Blood loss affects all body systems.
Acute blood loss causes significant changes in vital signs (increased heart rate and respirations, decreased blood pressure).
Without adequate blood supply, tissues and organs are starved for oxygen and nutrients.

Hemorrhage Terms

Stroke Volume (SV): Amount of blood ejected per contraction.
Cardiac Output (CO): Amount of blood pumped through the circulatory system per minute (Heart Rate x Stroke Volume).
Blood: Consists of plasma, red blood cells (RBCs), white blood cells (WBCs), and platelets.
Systemic Vascular Resistance: Resistance to blood flow in the vasculature.
Perfusion: Delivery of oxygen and nutrients to cells, organs, and tissues.
Hypovolemia: Low blood volume.

Basic Anatomy

The heart circulates oxygenated blood throughout the body.
The left ventricle pumps blood through arteries and back to the heart via the vena cava.

Physiological Response to Blood Loss - Compensation

Arterial blood (bright red, high oxygen) spurts from wounds.
Venous blood (darker red, low oxygen) flows steadily.
Arterial bleeds are harder to manage than venous bleeds.
Hemostasis: Platelets aggregate at the injury site, plugging the hole, but may not stop bleeding quickly enough.
External aid helps reduce blood loss while the body compensates.
When blood is lost, the body compensates to maintain perfusion.
Increased heart rate and respiratory rate help circulate more oxygen.
Blood vessels constrict to maintain blood pressure while blood volume drops.
The body's ability to compensate depends on how quickly blood is lost and other factors (illness, injuries, age, fitness level).
Hypovolemic shock occurs when the cardiovascular system fails due to inadequate circulation and tissue perfusion due to reduced blood volume.

External vs Internal Hemorrhage

External: Bleeding that breaks through the skin; easily recognized and managed in pre-hospital settings.
Internal: Bleeding within a body cavity; harder to recognize; often requires surgical intervention.
Internal hemorrhage can be significant and contained in some body cavities (e.g., each thigh can hold up to 1.5 liters).
Signs of internal hemorrhage may include pain, tenderness, and the presence of hematoma, which can appear later.
Blood loss is more difficult to estimate with external hemorrhage based on different surfaces (e.g., saturated clothing, pooling on flat surfaces).

External Hemorrhage - Patient Assessment and Management

Scene assessment is crucial.
Severity and type of bleeding may necessitate additional personal protective equipment (PPE) like eye protection, gowns, face shields, procedural masks, and extra gloves..
The primary concern is still the ABCs (airway, breathing, circulation).
Major hemorrhage is a part of circulation and needs to be managed immediately.
If basic maneuvers don't control bleeding, rapid transport is needed.
Other injuries may be ignored until bleeding is controlled..
Continuous monitoring of patient condition and vital signs is necessary during transport.

External Hemorrhage - Management

Standard first aid treatment remains the basic method.
Follow the RED pneumonic (rest, elevate, direct pressure).
For minor hemorrhages, moderate direct pressure and simple dressings are often sufficient.
Major hemorrhages require more aggressive control.
Techniques differ based on injury location (tourniquets, hemostatic dressings, direct pressure).

External Hemorrhage - Dressings and Equipment

Dressings and equipment vary.
Consider specific requirements when deciding between moist or dry sterile dressings (occlusive vs non-occlusive).
Common examples include gauze pads (2x2, 4x4), pressure dressings (large and small), abdominal pads (8x10), and Kling dressings (rolled gauze).
Tourniquets: Used for major extremity hemorrhages that can't be controlled with direct pressure; different brands exist. Apply proximal to the injury and tighten to occlude flow distal to the device. Document application time; do not remove or cover it in-situ..
Hemostatic dressings: Saturated with chemical agents to aid clotting, used when regular dressings are ineffective, or tourniquets are contraindicated.

Internal Hemorrhage - Dressings and Equipment

Pelvic binder: Used to apply direct pressure externally to a pelvic fracture.

External Hemorrhage - Additional Equipment

Trauma shears: Used for cutting clothing, bandages, or other materials.
Medical tape: Used to secure dressings, IV lines, advanced airways, etc.

MAST Pants (PASG)

Inflatable garment for the legs and abdomen to counteract shock.
A controversial piece of equipment.

Hemorrhage Management - BLS PCS Pg/111

Clear pathways; expose wounds.
Apply direct pressure on the bleeding area, including extremities and junctions (e.g.,. head, neck, shoulders, groin, pelvis). A tourniquet may be needed on extremities in extreme cases.
If the wound is in a hollow space (e.g., skull, chest abdomen), pack with dressings. The time of application must always be documented and communicated to the receiving facility.
Do not insert fingers or other objects into hollow spaces.

Hemorrhage Management - Methods

Direct pressure, tourniquet application, and hemostatic dressing procedures and applications.
Methods, such as direct pressure on bleeding sites, and using tourniquets, or hemostatic dressings, must be done continuously until the bleeding is stopped and/or controlled.
The correct placement and method in managing hemorrhages are essential to prevent further injury.
IV fluid therapy may be helpful but not for hypotensive patients.

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Description

Test your knowledge on the concepts of hypovolemia, cardiac output, and the body's response to acute blood loss. This quiz covers essential topics such as stroke volume, vital signs changes, and bleeding types. Perfect for students or practitioners in the medical field.