12 Bleeding and Shock

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12-1

Bleeding and

Shock

Lesson 12

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12-2

Bleeding

External or internal

bleeding common

with trauma

patients

Control bleeding

quickly to prevent

shock

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12-3

Bleeding, continued

Risk of infectious disease from contact with thepatients blood or body fluids

Follow standard precautions

Serious injury may prevent effective clotting Significant blood loss will cause shock and

possibly death

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Types of External Bleeding

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12-5

Assessing External Bleeding

Perform the standard assessment

Estimate severity of blood loss

Assess the patient for shock

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12-6

Skill:Bleeding Control

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12-7

Place sterile dressing on

wound.

Apply direct pressure

with hand.

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12-8

If needed, put another

dressing on top of first.

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12-10

Tourniquet

Used rarely as an extreme last resort

A life or limb decision

Use a wide band just above the wound; tighten

only enough to stop bleeding

Record time of application

Once applied, do not loosen or remove

Do not cover

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12-12

Internal Bleeding

Commonly occurs with blunt trauma

Suspect based on the mechanism of injury

Bleeding is concealed

Causes shock and is life threatening

Cannot control internal bleeding

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12-13

Signs and Symptoms of Internal

Bleeding Discolored, tender, swollen or hard skin, rigid

abdomen

Absence of distal pulse

Increased respiratory and pulse rates Pale, cool, moist skin

Nausea and vomiting

Thirst

Mental status changes

Bleeding from body orifices

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12-14

Care for Internal Bleeding

Perform standard patient care

Manage any external bleeding

Keep patient in a position of comfort

Keep patient warm Limit movement of a deformed extremity

Treat for shock

Administer high-flow oxygen

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12-15

Shock

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12-16

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12-17

Shock (Hypoperfusion)

Results from the inadequate delivery of

oxygenated blood to body tissues

May result from any condition involving:

Failure of the heart to provide oxygenated

blood (pump failure)

Abnormal dilation of the vessels (pipe failure)

Blood volume loss (fluid failure)

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12-18

Causes of Shock

Severe bleeding

Severe burns

Heart failure

Heart attack

Head or spinal

injuries

Allergic reactions

Dehydration

Electrocution

Serious infection

Extreme emotional

reactions

(temporary/less

dangerous)

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12-19

Signs and Symptoms of Shock

Restlessness, anxiety

Extreme thirst

Rapid, weak pulse

Rapid, shallowrespirations

Mental status changes

Pale, cool, moist skin

Decreased blood

pressure (late sign)

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12-20

Emergency Care for Shock

Perform standard patient care

Prevent further blood loss

Put patient in shock position

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12-21

Have patient lie onback and raise legs 8

12 inches

Loosen any tightclothing

Maintain normal body

temperature

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Care for Shockcontinued

Do not give the patient anything to eat or drink.

Provide care for specific injuries.

Administer high-flow oxygen if available

Monitor the patients breathing and vital signs every 5minutes