ECare - Chapter 25 (Bleeding & Shock)

Question 1

patient assessment: identifying massive eternal bleeding

Answer 1

bleeding is addressed in C, after airway and breathing

Question 2

signs of shock

Answer 2

altered mental status, pale, cool, and clammy skin, nausea and vomiting, vital signs change (high pulse, high respiratory, BP drop)

Question 3

Patient Care: External Bleeding

Answer 3

direct pressure, elevation of a limb, hemostatic agent, tourniquet

Question 4

pressure dressing

Answer 4

bulky dressing held in position with a tightly wrapped bandage, which applies pressure to help control bleeding

Question 5

tourniquet

Answer 5

device used for bleeding control that constricts all blood flow to and from an extremity

Question 6

Controlling hemorrhage: extremities

Answer 6

direct pressure then tourniquet

Question 7

Controlling hemorrhage: trunk

Answer 7

direct pressure, then hemostatic dressing/bandage

Question 8

bleeding associated with musculoskeletal injury

Answer 8

use splinting

Question 9

air splints

Answer 9

pros: several wounds in extremities, venous and capillary bleeding
cons: high pressure bleeding (ex. injured artery)

Question 10

cold application

Answer 10

minimizes swelling and reduce bleeding by constricting blood vessels; don’t apply directly to skin and only for 20 minutes

Question 11

epistaxis

Answer 11

nosebleed

Question 12

stopping a nosebleed

Answer 12

1. patient sits down and leans forward
2. apply direct pressure to fleshy portion around nostrils
3. keep patient calm and quiet
4. do not let patient lean back
5. if patient gets unconscious place in recovery position

Question 13

signs of internal bleeding

Answer 13

1. injuries to body surface
2. bruising, swelling, tenderness over vital organs
3. painful, swollen deformed extremities
4. tender, rigid, distended abdomen
5. vomiting coffee grounds
6. dark, tarry stools, or bright red blood stool
7. shock

Question 14

patient care: internal bleeding

Answer 14

ABCs, oxygen, external bleeding (splint if possible internal bleeding in extremity), preserve body temperature, transport

Question 15

heady injury and bleeding

Answer 15

no pressure, let it flow

Question 16

how shock develops

Answer 16

1. heart fails as pump
2. blood volume is lost
3. blood vessels dilate

Question 17

compensated shock

Answer 17

body senses decrease in perfusion and attempts to compensate by maintaining perfusion

Question 18

signs of compensated shock

Answer 18

increased heart rate and respirations, pale, cool skin; increased capillary refill time for children

Question 19

decompensated shock

Answer 19

body can no longer compensate for low blood volume

Question 20

signs of decompensated shock

Answer 20

falling blood pressure

Question 21

hypovolemic/hemorrhagic shock

Answer 21

shock resulting from blood or fluid loss

Question 22

neurogenic shock

Answer 22

shock resulting from nerve paralysis due to dilation of blood vessels that increases volume of circulatory system

Question 23

cardiogenic shock

Answer 23

shock due to inadequate pumping action

Question 24

septic shock

Answer 24

dilation of vessels due to toxins in blood

Question 25

patient assessment: shock

Answer 25

1. altered mental status 2. pale, cool, and clammy skin 3. nausea and vomiting 4. vital signs change (higher pulse, higher respirations, low BP) 5. others: thirst, dilated pupils, and cyanosis

Question 26

on scene time for caring a trauma/shock patient

Answer 26

10 minutes

Question 27

patient care: shock

Answer 27

similar to trauma patient 1. maintain airway and get respiratory rate 2. control bleeding 3. use pelvic binding device if necessary 4. splint if not in shock 5. prevent loss of body heat 6. transport