bleeding and shock chapter 6/8. sources of external bleeding u arteries u veins u capillaries
TRANSCRIPT
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Bleeding And ShockChapter 6/8
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Sources of External Bleeding
ArteriesVeinsCapillaries
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Arterial Bleeding Most serious / arteries are usually
deep in the body Rapid and profuse blood loss Bright red / spurts Less likely to clot Must use external means to stop
blood flow
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Venous Bleeding Steady flow / bluish-red May be profuse More easily controlled Veins are closer to the body
surface Can be serious
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Capillary Bleeding Easily controlled Blood oozes
–Road rash
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Blood Vessel Spasm
Severed arteries– Artery draws back into the tissue
– Artery constricts and slows bleeding Partially severed arteries
– Associated with greater blood loss
– Example: amputations
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Definitions Hemorrhage: Rapid blood loss
– Adult: 1 quart may lead to shock– Child: 1 pint loss of blood
Dressing– A protective covering for a wound –
p.150 Bandage
– A material used to hold a dressing in place
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Dressings Used to control bleeding Prevents contamination Dressings should be:
–Sterile–Larger than the wound–Thick, soft, compressible–Lint free (no cotton balls)
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Types of Dressings
Gauze pads Adhesive strips Trauma
dressings Improvise Donut shaped
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Dressings Application
– Wash hands– Dressing should extend over edges of wound– Do not touch dressing surface that is to be next
to the wound– Place medications directly onto pad– Cover with a bandage
Removal of Dressings
– Soak “stuck” dressing in warm water
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Bandages Are Used For: Holding dressings in place Applying pressure Prevent or reduce swelling Provide support or stability
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Application of Bandages
Leave toes and fingers exposed if possible– Bandage too tight? Check for
color, circulation, temperature Wrap towards the heart
– Small end of bone to large end
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Types of Bandages Roller gauze Improvised Triangular Cravat Adhesive / paper tape Adhesive strips P.150-152
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Tourniquets–Rarely recommended
–Damages nerves and vessels
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Types of Wounds And Application of Bandages And Dressings Will Be Addressed Later
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Someone Has Cut Their Leg: What Should You Do? (external bleeding / depends on severity)
Call for help when necessary Protect yourself from bodily fluids Expose the wound Apply sterile gauze pad (dressing) Apply constant, direct pressure
for 10 minutes (don’t peak)
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Cut Leg
If dressing becomes blood soaked
– do not remove dressing, add others over it
After 10 minutes, if bleeding persists– apply pressure harder and over a wider
area for 10 more minutes (seek help)
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Additional Options Elevate limb above heart level Apply pressure at a pressure point When bleeding stops:
– Apply pressure bandage (roller gauze)
– Wrap towards the heart
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Problem Bleeders Hemophiliacs Aspirin
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When Not To Apply Direct Pressure
Protruding bone Skull fracture Embedded object May use a donut shaped pad
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Internal Bleeding
Look for abdominal:–Pain
–Tenderness
–Rigidity–Bruises
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Internal Bleeding
Look for:–Black stools
–Bright red stools
–Cough or vomit with blood
–Fractured ribs or bruises
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Internal Bleeding: What To Do
Monitor ABC’s Lay on side if appropriate (expect
vomiting) Treat for shock
– Raise legs 8-12 inches (if conscious)– Cover victim
Bruises: Ice, ace wrap, elevate
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Shock Occurs when the circulatory
system fails– Resulting in inadequate blood flow
to some part of the body
A MAJOR CAUSE OF DEATH !!!
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Shock #2 Always treat injured victims
for shockShock:
–can be prevented–cannot be reversed
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Types of ShockCardiogenic
–Heart fails to pump sufficient blood supply
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Types of ShockNeurogenic
– Spinal cord damage
– Drug overdose
– Vessels dilate
– Blood supply insufficient to fill vessels
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Types of Shock #2Septic
–Result of a bacterial infection
–Vessels lose ability to contract
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Types of Shock #3
Hypovolemic (Fluid Loss)
–Most common type»Blood loss
»Dehydration from vomiting, diarrhea or profuse sweating
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Shock: What To Look For
Pale, cold, clammy skin Altered mental status
– Rapid breathing and pulse Unresponsiveness Nausea and vomiting
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Shock: What To Do First, care for life threatening injuries If the face is red, raise the head,
– (injuries to upper half of body – raise the upper half of body)
If the face is pale, raise the tail.(injuries to lower half of body, raise the
lower half of the body)
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Shock: What To Do #2 If conscious and appropriate, place
victim on back, raising legs 8-12 inches EXCEPT those needing ½ sitting position (listed on next slide)
Cover victim, over and under Do not let victim eat or drink
– May suck on wet cloth
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Shock: When To Place In A Half Sitting Position
Difficulty breathing Head injuries (when appropriate) Strokes Chest injuries Penetrating eye injuries Heart attack Unconsciousness
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Anaphylaxis or Anaphylactic Shock
Massive allergic reaction by the body’s immune system
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Causes Of Anaphylactic Shock
Medications» Penicillin and related drugs, aspirin, sulfa
drugs,meds and alcohol
Foods and food additives– Monosodium glutamate, peanuts
Plant pollens Bee stings Radiographic dyes
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Characteristics of Anaphylaxis Usually comes on in minutes / Peaks in
15-30 minutes Sensation of warmth Intense itching of soles of feet and palms
of hands Breathing difficulties Tightness and swelling in throat Coughing, sneezing, wheezing Tightness in chest
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Characteristics of Anaphylaxis #2
Increased pulse rate
Swollen face, tongue, mouth Nausea and vomiting Dizziness Blue around lips and mouth
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Anaphylaxis: What To Do
Check ABC’s– Use ice pack on bee sting
Inject epinephrine (dilates bronchioles)– P.442 (hopefully victim will have some)
– Inject in outside part of thigh, hold for 10 seconds
– May need to repeat
Get help immediately (float trip) Benedryl – too slow for major
emergency, but worth a try