Bleeding And Shock Chapter 6/8
Bleeding And ShockChapter 6/8
Sources of External Bleeding
ArteriesVeinsCapillaries
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
Venous Bleeding Steady flow / bluish-red May be profuse More easily controlled Veins are closer to the body
surface Can be serious
Capillary Bleeding Easily controlled Blood oozes
–Road rash
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
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
Dressings Used to control bleeding Prevents contamination Dressings should be:
–Sterile–Larger than the wound–Thick, soft, compressible–Lint free (no cotton balls)
Types of Dressings
Gauze pads Adhesive strips Trauma
dressings Improvise Donut shaped
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
Bandages Are Used For: Holding dressings in place Applying pressure Prevent or reduce swelling Provide support or stability
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
Types of Bandages Roller gauze Improvised Triangular Cravat Adhesive / paper tape Adhesive strips P.150-152
Tourniquets–Rarely recommended
–Damages nerves and vessels
Types of Wounds And Application of Bandages And Dressings Will Be Addressed Later
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)
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)
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
Problem Bleeders Hemophiliacs Aspirin
When Not To Apply Direct Pressure
Protruding bone Skull fracture Embedded object May use a donut shaped pad
Internal Bleeding
Look for abdominal:–Pain
–Tenderness
–Rigidity–Bruises
Internal Bleeding
Look for:–Black stools
–Bright red stools
–Cough or vomit with blood
–Fractured ribs or bruises
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
Shock Occurs when the circulatory
system fails– Resulting in inadequate blood flow
to some part of the body
A MAJOR CAUSE OF DEATH !!!
Shock #2 Always treat injured victims
for shockShock:
–can be prevented–cannot be reversed
Types of ShockCardiogenic
–Heart fails to pump sufficient blood supply
Types of ShockNeurogenic
– Spinal cord damage
– Drug overdose
– Vessels dilate
– Blood supply insufficient to fill vessels
Types of Shock #2Septic
–Result of a bacterial infection
–Vessels lose ability to contract
Types of Shock #3
Hypovolemic (Fluid Loss)
–Most common type»Blood loss
»Dehydration from vomiting, diarrhea or profuse sweating
Shock: What To Look For
Pale, cold, clammy skin Altered mental status
– Rapid breathing and pulse Unresponsiveness Nausea and vomiting
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)
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
Shock: When To Place In A Half Sitting Position
Difficulty breathing Head injuries (when appropriate) Strokes Chest injuries Penetrating eye injuries Heart attack Unconsciousness
Anaphylaxis or Anaphylactic Shock
Massive allergic reaction by the body’s immune system
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
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
Characteristics of Anaphylaxis #2
Increased pulse rate
Swollen face, tongue, mouth Nausea and vomiting Dizziness Blue around lips and mouth
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