4th Lecture: Bleeding & Wound PDF

Presented by: Dr/ Eman ebrahim abdou Awad Outlines: Definition of Bleeding Causes of Bleeding Types of bleeding Sings and symptoms of bleeding Definition of wound Causes of wounds Classification of wounds Introduction Bleeding is one of the most common causes of death following...

Presented by: Dr/ Eman ebrahim abdou Awad Outlines: Definition of Bleeding Causes of Bleeding Types of bleeding Sings and symptoms of bleeding Definition of wound Causes of wounds Classification of wounds Introduction Bleeding is one of the most common causes of death following trauma, therefore controlling external bleeding is a main priority when administering care in a pre-hospital environment (first aid).  Hemorrhage/Bleeding Definition of Bleeding Is the loss of blood from the circulatory system. Causes of Bleeding 1-Traumatic injury (Abrasions &Lacerations (cuts) & Hematoma &Gunshot) 2-Medical conditions (Hemophilia &Leukemia &Liver disease &Vitamin K deficiency) 3-Medications (Aspirin and other NSAIDs)  Types of bleeding A. Internal bleeding. B. External bleeding. 1-Internal hemorrhage Bleeding without break in skin continuity  (A) Visible internal bleeding ▪ Bowel injury – bleeding from the anus ▪ Head injury – bleeding from the ears or nose ▪ Lung injury – coughing up frothy, bloodied sputum (spit) ▪ Urinary tract injury – blood in the urine.  (B) Invisible internal bleeding Injury to organs inside abdomen (liver, spleen, kidney etc.) → abdominal bleeding. Injury to organs inside skull → cerebral bleeding 2- External hemorrhage Is bleeding that can be seen through cut (wound) in the skin. Types of external bleeding: According to the type of blood vessel that has been injured: 1. Arterial bleeding. 2. Venous bleeding. 3. Capillary bleeding. 1. Arterial bleeding:  It is blood loss from an artery.  It is the most serious type of external bleeding.  It is the least common type of bleeding since arteries are deeper in the body.  It is bright red in color (oxygenated) and gushes from the wound. 2. Venous bleeding: It is blood loss from veins. It is dark blood because it is non-oxygenated. It is more controllable than arterial bleeding. It should be controlled quickly 3. Capillary bleeding: It is oozing of blood from the wound in minor cuts, abrasions. It is controlled by first aid procedures and by body’s normal clotting mechanisms. Sings & Symptoms of Internal Bleeding Pain and swelling. External bleeding through a natural opening: ◦ Blood through nose, mouth or ear. ◦ Blood in the stool. ◦ Blood in the urine. Skin color changes that occur several days after an injury  Sings &Symptoms of external bleeding Obvious bleeding. Pain Bruises Tenderness or swelling at site of injury. Cold and clammy skin. Excessive thirst. Drop in blood pressure. Decrease level of consciousness. Restlessness. Definition of wound It’s an interruption in the continuity of tissues Causes of wounds Inflammation. Puncture wounds are usually caused by a sharp pointed object entering the skin. Human and animal bites. Pressure sores (bed sores) Classification of wounds according to skin continuity : (A) Closed wounds (skin continuity is intact): - Abrasion - Contusion - Haematoma (B) Open wounds (skin continuity is interrupted): - Incised - Laceration - Avulsion (Crushed ) - Puncture Classification according to depth: (1) Superficial (on the surface) (2) Deep wounds (go through all skin layers and into underlying tissue like muscle or bone. Classification of wounds Closed Wound:  It is damage to underlying tissues without a break of the skin  Skin remains intact. Open Wound:  It is a break of the continuity of the skin or mucous membrane.  It is risk to bleeding, infection and shock, tissue and nerve damage can occur. Closed Wound: 1- Abrasion: loss of epidermis due to friction of hard surface Several layers of skin are torn or totally removed. Usually more painful than a deeper cut because scraping of skin exposes millions of nerve endings 2- Contusion: The most common type of closed wounds which is blood collecting or accumulating into the tissues that usually result from trauma that produces bleeding under the skin Signs & Symptoms: Swelling Pain to touch Redness Ecchymosis=bruising o accumulation of blood in skin & subcutaneous tissue o Result of bleeding; clotting or bleeding disorders o Bluish lesion at earliest stages of onset 3- Hematoma: it is localized collection of blood in tissue due to rapture of a vessel, result in a painful swelling II- Open Wounds: 1. Incision: - It is a straight healthy clean cut edges with a knife, or surgical incision or any sharp object. Bleeding, according to the depth and location of the cut; it is sever if blood vessels damaged”. 2- Laceration:  It is a jagged irregular cut or tear in the skin.  Minimal bleeding, minimal pain, & no numbness or tingling  Can be treated easily. But if deep lacerations should be stitched 3- Avulsion (Crushed ):  It is a full thickness skin loss; it is a completely pulled off tissues. e.g. loss of a fingertip.  Layers of skin torn off completely or only flap of skin remains  May be considerable bleeding 4- Puncture Wound: Penetration of skin by sharp object (Nails, tacks, knives, needles) May be small in diameter and not seem serious Require treatment by physician Can become infected easily because germs carried deep in the tissue Gunshot wound: - Laceration and puncture wound with inlet and exit.  ‫المعني‬ ‫الكلمة‬ ‫قرحة فراش‬ Pressure sores (bed sores) ‫خدش‬ Abrasions ‫ قطع‬/ ‫تمزق‬ Lacerations ‫تجمع دموي‬/ ‫كدمة دمويه‬ Hematoma ‫طلق ناري‬ Gunshot )‫مرض الهيموفيليا (يتميز بوجود خلل في عوامل تجلط الدم مما يؤدي الي نزف الدم‬ Hemophilia ‫يتدفق‬ gushes ‫كدمات‬ Bruises=Ecchymosis ‫كدمة‬ Contusion ‫قطع‬ Incised ‫تمزق‬ laceration ‫تهمتك او تمزق‬ Avulsion= Crushed ‫احتكاك‬ friction ‫مسنن‬ jagged ‫وخز‬ tingling ‫غرز‬ stitches ‫مدخل‬ inlet ‫مخرج‬ exit ‫فقاعة‬ Blister Thank you