CATA 262 Ecare > Bleeding Management > Flashcards

Bleeding Management Flashcards

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1
Q

What should you adjust before an event? What research?

A

Bleeding kit if there’s sharp object

Research if the sport had lots of blood injury

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2
Q

What is hemorrhage

A

Rapid blood loss

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3
Q

What can blood loss result in

A

SHOCK

Hypovolemic shock

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4
Q

What is a dressing

A

Protective covering for a wound

Provide, retain or remove moisture

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5
Q

What is a bandage

A

A material used to hold a dressing in place

Relieve pain

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6
Q

What is a hypoperfusion (4 steps)

A

Lack of proper blood flow

Losing blood in system

Tissues and cells don’t receive enough O2

Organ dysfunction

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7
Q

What are dressings used for

A

Used to control bleeding
Prevents contamination

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8
Q

What should a dressing be? Characteristics?

A

Sterile
Larger than the wound
Thick soft compressible
Lint free

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9
Q

What are types of dressings

A

Gauze pads
Adhesive strips
Trauma dressings
Donut shapes

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10
Q

What should you do when you see any big wound 📸📸📸📸📸

A

📸📸📸📸

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11
Q

What is the role of the skin

A

Protection
Water balance
Temp regulation
Excretion
Shock absorption

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12
Q

What do you do with the wound classification chart

A

Put it in report for EMS

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13
Q

What is an open wound

A

Open skin

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14
Q

What is a close wound

A

Contusion, internal

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15
Q

What is an acute wound

A

Just happens

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16
Q

What is a chronic wound

A

Old

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17
Q

What is a contaminated wound

A

Any bodily fluids that need to be cleaned

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18
Q

How much of body weight is artery

A

8%

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19
Q

How long for blood to circulate while body

A

75seconds

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20
Q

What is the total artery volume of blood

A

5-6L

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21
Q

When does moderate shock start (blood loss)

A

15% loss

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22
Q

When does severe or fatal shock occur with blood loss

A

30%

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23
Q

What is the blood composition

A

Mostly plasma
RBC
WBC
platelets

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24
Q

What are the steps for hemostasis

A
  1. Blood vessel spasm
  2. Formation of the platelet plug
  3. Blood clotting (coagulation)
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25
How long does hemostasis take
6-10mins
26
Why is the time for hemostasis important
Some sports have a 60sec blood control rule
27
What is hemostasis
Process of clotting
28
How does stress affect blood clotting
More stress makes the platelets less sticky
29
What can cause no clotting
Haemophiliacs Aspirin Large vessel lacerated Large space lacerated
30
What is haemophilia
Medical condition where walls don’t close Needs medical clearance
31
What are some factors of external bleeding
Obvious Dangerous Infection Shock Weakness
32
What is life threatening bleeding
Confused or unconscious victim Soaked bandages Pooling blood Blood spurting Loss of limb
33
What are the three types of bleeding
Arteries Veins Capillaries
34
What characterizes artery bleeds
Spurting blood Pulsating flow Bright red colour
35
What characterizes vein bleeding
Steady slow flow Dark red colour
36
What characterizes capillary bleeding
Slow even flow
37
What kind of patients bleed more
Athletes after exercising Hypertensive individuals Hemophiliacs Anti-coagulants
38
What does a bloated abdomen signify
Potential internal organ bleed
39
What are the solid organs (6)
Liver Spleen Pancreas Kidney Ovaries Adrenal
40
What are hollow organs (7)
Gallbladder Stomach Small and large intestine Bladder Bile duct Ureters
41
What do hollow organs secrete internally if not blood
Bile Acid
42
What’s the first step for controlling external bleeding
PPE: mask, glasses, gloves ERP ready and blood kit
43
How do you control external bleeding
Maintain direct pressure with non adherent gauze Ideally sterile Keep adding dressing and never remove last layer
44
What should you scan for when controlling an external bleed
Look for debris or foreign body
45
Do you elevate pressure points?
NO Reduces applied pressure
46
What should you ask and check for while controlling external bleeding
Ask patient how it feels PMSC Check distal Pulse
47
What do you do in a last resort for external bleeding
Tourniquet for arterial bleeds where pressure doesn’t work No more distal pulse Note the time
48
Where do you place the tourniquet
2-3inches ABOVE (proximal) the bleed, above joint if needed
49
When do you do wound packing
When a tourniquet can’t be placed, compression doesn’t work Neck Shoulder Groin
50
What do you do when wound packing
Use hemostatic gauze Plain gauze LEAVE A PIECE OUT Apply compression with both hands
51
What are the 5 steps for wound packing
1. Open clothing over wound 2. Wipe away any pooled blood 3. Pack the wound with bleeding control gauze 4. Apply steady pressure with both hands directly on 5. PUSH DOWN AS HARD AS POSSIBKE
52
What is a puncture
Penetration of skin and underlying tissue
53
What is a skin bruise (ecchymosis)
Accumulation of blood within the skin closed wound
54
What is a laceration
Irregular jagged tear
55
What is an incision
Clean cut
56
What is a blister
Accumulation of fluid between epidermis and dermis
57
What is an avulsion
Complete separation of skin
58
What is an abrasion
Scraping away of layers of skin
59
What do you do with a mat burn
Clean the wound (soap and water) Polysporin triple action Non adherent Tape/hypafix Send athlete back
60
What do you do with an abrasion
Make sure nothing is inside Soap and water CLEAN FROM MIDDLE TO OUTER Dry it Sterile gauze Polysporin Bandage and secure Send back
61
What do you do with a blister
DONT POP Remove dirt Disinfect Polysporin Bandaid Tuf skin on bandaid Elastic tape AT tape
62
What do you do with an a laceration on face
Clean it Dry (Not fresh!!) put OPSITE Or Vaseline for extra layer CHECK FOR CONCUSSION, FRACTURE Send for sutures if needed
63
What is OPSITE
Forms a film designed to be a protective layer
64
How do you use steri strips
Control the bleeding Clean the wound Pull skin together (assistant) Use tough skin Gloves and tweezers Start in middle Alt directions
65
What if an athlete has sutures
Check for infection and how long they had them for
66
How long do hand sutures stay in
3-5 days
67
How long do stomach sutures stay in
7 days
68
How long do back sutures stay in
14 days
69
How long do ankle sutures stay in
10-14days
70
What do you do with an avulsion
PPE stop bleeding Sterile gauze Saline FIT SKIN BACK IN HOLE dress and bandage Sutures? Take 📸
71
What is irrigation
Using large amounts of soap and water or saline on a large cut to clean it all
72
What else do you check for with a head laceration
SKULL FRACTURE
73
What do you do if an athlete has an incision
Check post op Clean No infection ASSESS HEALING
74
What do you do with a puncture wound
Keep it in Consider tetanus and infection LOG CABIN w gauze 1/2 height of item
75
When can you remove an object that was punctured
Through the check and out No tongue Put gauze inside to bite on
76
What are CLASSIC signs of infection (6)
1. Increased pain around wound 2. Redness or warmth 3. Fever chills 4. Pus 5. Odor 6. Firmness or swellintn
77
What are secondary signs of infection (lower grade infection) (6)
1. Drainage from wound bed 2. Delayed healing 3. Discolouration 4. Odor 5. Fragility of wound bed 6. Wound breakdown/ enlargement
78
How do you prevent infections in an athlete
Check on it everyday Triple action antibiotic PREVENTION
79
What are the four goals of wound care
1. Facilitated hemostasis 2. Decrease tissue loss 3. Promote wound healing 4. Minimize scar formation
80
What are open wounds
Exposed body tissue in the base of the wound
81
What are closed wounds
Damage within blunt trauma
82
what is ecchymosis
common bruise- bleeding underneath skin
83
what is a hematoma
"cork" pooling of blood outside blood vessel -direct trauma -indirect post trauma muscle tissue
84
what is effusion
accumulation of fluid in-around a JOINT arthritis
85
what is an edema
accumulation of fluid in the interstitial space when capillaries leak fluid puffy, shiny, indents with pressure
86
what are characteristics of internal bleeding
you dont see it- SECOND ASSESSMENT difficult to assess difficult to control 911
87
what traumas can cause internal bleeding
traumatic injury -severe force -contact sports -non-compound fractures (closed fracture)
88
what non-traumatic injuries can cause internal bleeding
aneurism ruptures ectopic pregnancy ulceration
89
what are signs and symptoms of internal bleeding remember shock
rigid abdomen pain, tenderness, (ecchymosis) swelling (edema, hematoma, hemerthrosis) dizziness (blood loss= o2 loss) thirst restlessness weak shallow breathing clammy skin weak and rapid pulse PMSC look sick
90
how to treat internal bleeding
TREAT FOR SHOCK AND RECOGNIZE THE SYMPTOMS stop bleeding elevate legs if possible loose clothes vomit will happen ABC airway maintained O2 Blanket (SHOCK) VITALS VITALS VITALS
91
what is a nose bleed? caused by what?
epistaxis capillaries rupture local or systemic
92
what is an anterior epistaxis
internal bleeding out of nostril one nostril
93
what is posterior epistaxis (medical)
deep, bleeds to back of throat both nostrils
94
what can cause anterior epistaxis
local trauma anatomical issues inflammation FACIAL TRAUMA nasal sprays
95
what can cause posterior epistaxis
high BP vascular malformations cardiovascular disease bleeding disorder
96
how to treat for epistaxis
pinch nose (sterile gauze) and head flexion sit and rest calm them down dont blow! leave tampon in!! nasal sprays (check with cces for doping)
97
four steps for basic wound care
cleansing- saline disinfection- triple action poly (BZK for around wound) dressing- sterile non adherent bandage- secure, bigger and tape
98
who should not use polysporin
allergy to penicillin
99
what is ischemia
lack of adequate profusion (lack of oxygen) that causes lower than normal blood flow in the body
100
organ tolerance to ischemia for brain, heart and lungs
4-6mins ABCs!!
101
what are the effects of hemorrhage on the body
decrease blood volume decrease o2 transport low blood pressure high heart rate =HYPOVOLEMIC SHOCK
102
what is happening in the body during hypovolemic shock
loss of body fluids leads to decrease in hearts ability to pump sufficient blood to whole body
103
what are the three causes of hypovolemic shock
blood loss (internal or external) -CATCH EARLY IN SECOND ASSESMENT loss of fluid and electrolytes dehydration
104
what are ways for the body to lose fluid besides bleeding
severe burns excessive diarrhea excessive vomiting excessive sweating
105
what is the cycle of hypovolemic shock
1. decrease blood volume 2. decrease venous return 3. decrease stroke volume 4. decrease cardiac output 5. decrease tissue perfusion
106
what are the signs and symptoms of hypovolemic shock!!
anxiety clammy cool skin confusion no urine weakness, look sick palor skin rapid breathing sweating unconsciousness
107
what is class II hemorrhagic shock (compensation)
15-30% blood loss >100 bpm 20-30 breathing (thready) normal bp
108
what is class III hemorrhagic shock (decompensation)
30-40% blood loss >120 bpm 30-40 breathing (rapid) DECREASE bp
109
what is class IV hemorrhagic shock (decompensation)
>40% >140 bpm >35 breathing (shallow) BP DECREASED A LOT
110
What are the uses of compressive bandages
Decrease swelling Keep the joint warm Decrease movement Hold padding in place Sling and swaths Bleeding compression Fixate splints Hold ice
111
What are the principles of applying a compression bandage
Applied distal to proximal Injury in centre under herringbone PMSC before and after Remove at night
CATA 262 Ecare
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