MOD E Tech 34 Wounds & Bleeding

Question 1

Wounds & Bleeding

what is a wound

Answer 1

• A wound is a break in the continuity of tissues; it frequently includes a break in the surface of the skin or mucous membrane (an open wound) making it exposed to infection.” (IHCD, BTM 3rd Ed)
• Management of wounds centres on:
• Control of bleeding • Prevention of infection
• Prevention of further complications

Question 2

Types of Wound

Answer 2

• Contusion
• Laceration
• Incision
• Puncture
• Gunshot

Question 3

Bleeding & Blood Loss

Types of bleeding

describe

Answer 3

Types of bleeding:

1.External

2.Internal

1.External Bleeding – can be seen at source and may be:

• Arterial (spurts to the pulse rate)
• Venous (constant flow)
• Capillary (oozes to the wound surface)

Question 4

External Bleeding

Answer 4

Question 5

Bleeding and Blood Loss

Answer 5

Question 6

Internal Bleeding

Look for:

“blood on the floor and four more”

list

Answer 6

Look for:

“blood on the floor and four more”

1. External
2. Chest
3. Abdomen
4. Pelvis

5Long bones

Question 7

Describe the characteristics of blood appearing from damage to the following organs:

1. Lungs
2. Stomach
3. Kidneys
4. Large Intestine
5. Brain

Answer 7

Question 8

Blood Loss

Answer 8

It is the percentage of blood loss that is of importance in the development of the clinical picture.

A small amount of haemorrhage in a child may be of serious significance whereas a similar volume lost by an adult may be of no consequence

To assess blood loss look out for blood lost:

• In body tissues • On the patient’s clothing
• On the floor • In wound dressings etc..

Question 9

Blood loss in injuries

Answer 9

Question 10

Blood loss associated with musculoskeletal injuries

Answer 10

Question 11

Factors Affecting Bleeding

Bear in mind the:

Answer 11

Bear in mind the:

• Depth, type and size of wound
• Size of the blood vessel
• Duration of bleeding - ? anticoagulants
• Position of the injury
• Age or size of the patient
• Seriousness of scalp wounds

Question 12

•Identify, in writing, the clinical consequences of bleeding and state how observation of the patient assists in assessing the severity of their condition.

Answer 12

Answer 13

Signs of shock

Question 14

Management

Bleeding and Blood Loss

Answer 14

Because blood can spurt or splash, use appropriate BSI precautions.

Question 15

Management of External Bleeding

Answer 15

Effective management may be achieved by:

• ABC
• Controlling any catastrophic haemorrhage
• Inspecting for foreign bodies or debris
• Applying direct pressure
• Elevating the injured area
• Placing the patient in a position of rest
• Dressing wounds
• Immobilising the injured area
• Re-checking wound dressings for effectiveness
• Observing for control of bleeding and impairment of circulation - ? Tourniquet if exsanguinating/catastrophic haemorrhage
• Treating for shock

Question 16

Wound Dressings

Should be:

Answer 16

Should be:

• Large enough to completely cover the injury
• Sterile
• Absorbent, non-adherent material
• Applied to provide sufficient pressure to control bleeding

Question 17

exposed bowel

Answer 17

• Cover exposed bowel with warmed dressings soaked in a crystalloid solution
• Do Not attempt to push organs back into the abdomen

Question 18

Foreign Bodies Wound Dressings

Answer 18

• Construct a built up dressing of sterile pads around the wound
• Cover and seal with a large wound dressing to provide indirect pressure without disturbing the foreign body
• Secure long objects to prevent their movement

Question 19

Management of Internal Bleeding

Answer 19

Effective management may be achieved by:

• Ensuring an open airway
• Providing oxygen therapy
• Assessing the pulse and acting on your assessment
• Positioning the patient appropriately for their injuries and level of consciousness
• Elevating the lower limbs

Loosening restrictive clothing

• Anticipating vomiting and giving nothing by mouth
• Moving the patient as little as possible
• Keeping constant observation of pulse, respiration, level of consciousness
• Observing closely for signs of shock
• Consider pain relief

Question 20

Amputations

Answer 20

• Wrap in sterile gauze, moistened
• Seal in plastic bag
• Place on ice if possible
• Never directly onto ice
• Dress stump with moist dressings
• Pain relief

Question 21

Briefly describe the following terms:

• Contusion
• Epistaxis
• Haematemesis
• Haematoma
• Haematuria
• Haemoptysis
• Haemorrhage
• Hyphaema
• Melaena

Answer 21

Question 22

Terminology

• Contusion
• Epistaxis
• Haematemesis
• Haematoma

Haematuria

• Haemoptysis
• Haemorrhage
• Hyphaema
• Melaena

Answer 22

•Haemorrhage

Bleeding

•Hyphaema

Blood in the anterior chamber of the eye

•Melaena

Blood contained in the faeces