Bleeding and Shock Study Guide PDF

BLEEDING AND SHOCK STUDY GUIDE 1. Bleeding a. Arterial i. Bright red ii. Spurting iii. Most dangerous b. Venous i. Darker red ii. Flows iii. Can still be dangerous...

BLEEDING AND SHOCK STUDY GUIDE 1. Bleeding a. Arterial i. Bright red ii. Spurting iii. Most dangerous b. Venous i. Darker red ii. Flows iii. Can still be dangerous c. Capillary i. Oozes ii. Threat of infection 2. Controlling Bleeding (Major hemorrhage needs to be controlled in the primary assessment!) a. Direct pressure - First step b. Uses i. Gauze pads for small wounds ii. Multitrauma dressings for gaping wounds c. If a major bleed is found in primary assessment, use your gloved hand until dressing can be applied! 3. Tourniquets a. To be used if direct pressure does not control bleeding b. Place proximal to wound, but as close to the wound as possible c. Document time and notify hospital d. Never loosen once applied 4. Epistaxis a. Treatment: i. -Sit patient down ii. -Lean patient forward iii. -Pinch fleshy part of nose 5. Closed soft tissue injuries a. Contusion i. Bruise 1. AKA Ecchymosis b. Hematoma i. Similar to contusion ii. Usually involves larger blood vessel 6. Open soft tissue injuries a. Abrasions i. Scraping, rubbing, or shearing away of the epidermis  BLEEDING AND SHOCK STUDY GUIDE b. Lacerations i. Regular or irregular break in the skin of varying depth c. Avulsions i. Loose flap of skin ii. Partial (still attached) or Complete (unattached) iii. If complete, wrap in sterile dressing, put on ice and transport to ER with patient d. Amputations i. Disruption in the continuity of an extremity ii. If able, put amputated part in sterile dressing, on ice, and transport with patient to ER. e. Punctures i. Sharp, pointed object being pushed into soft tissue f. Impaled objects i. An object still embedded in wound ii. Never remove unless through cheek or neck and cause airway compromise iii. Stabilize/Bulky dressings 7. Bandages and Dressings a. Dressings (cover the wound) - 4x4’s, gauze pads b. Bandages (secure a dressing in place) - Kerlix, roller gauze 8. SHOCK a. Hypoperfusion, Inadequate tissue perfusion b. Causes i. Inadequate blood volume ii. Inadequate pump function iii. Inadequate vessel tone c. Categories i. Hypovolemic shock 1. Hemorrhagic 2. Non-hemorrhagic 3. Burn shock ii. Cardiogenic shock 1. AMI 2. CHF 3. Dysrhythmias 4. Medications iii. Distributive shock 1. Anaphylaxis 2. Septic shock  BLEEDING AND SHOCK STUDY GUIDE 3. Neurogenic shock iv. Obstructive shock 1. Pulmonary embolism 2. Tension pneumothorax 3. Pericardial tamponade (cardiac tamponade) d. Specific types of shock i. Hemorrhagic 1. Loss of whole blood 2. Includes not only volume, but oxygen carrying capacities as well ii. Non-hemorrhagic 1. Loss of plasma and water 2. Oxygen carrying capacity is still available 3. Dehydration 4. Hx of recent illness (dehydration) 5. Poor skin turgor iii. Burn shock 1. Type of nonhemorrhagic shock 2. Damaged capillaries leak plasma out of vessels into interstitial spaces 3. Swelling 4. May take hours for onset iv. Septic shock 1. Distributive shock 2. Massive infection leading to wide spread vasodilation 3. Skins may be Flushed/Hot/Dry 4. Sepsis a. Any 2 of the following signs/symptoms in a patient with suspected infection i. Temp >100.9° or 90 bpm iii. Resp rate >20 breaths/minute iv. Altered mental status v. Blood glucose