Tanvi Patel Ms.Alogna MRT / 45B 5/6/12 Chapter 13 Objectives: 1. The heart is the pump of the circulatory system.

It has four chambers; 2 atria on top which receive blood and 2 ventricles on the bottom that pump the blood to the lungs or to the body. The blood travels in pipes called arteries, veins, and capillaries. Arteries carry blood away from the heart. Then they branch out into capillaries that supply oxygenated blood to different parts of the body. The deoxygenated blood is returned to capillaries which join together into veins. The blood in these pipes consists of 4 parts, red blood cells that carry oxygen and carbon dioxide, white blood cells that fight diseases, platelets that help form clots, and plasma which is the fluid part of the blood. 2. The two most common places to look for a pulse at the neck (carotid) and wrist (radial). To locate the pulse, place two fingers lightly on the larynx and slide fingers off to one side. Or, for the radial pulse, slide two fingers on the base of the thumb. 3. Pump failure causes shock because inadequate pumping will create a back up of blood in vessels of the lungs. Pipe failure causes shock because when blood pools in the capillaries, vital organs are deprived of blood. Fluid loss results in shock because as the amount of fluid lessens, the heart must work harder, eventually causing the heart to cease. 4. Pipe failure can cause anaphylactic shock, psychogenic shock, and spinal shock. 5. S&S of Shock confusion, restlessness, anxiety; cold, clammy, sweaty, pale skin; rapid breathing; rapid, weak pulse; increased capillary refill time; nausea and vomiting, weakness or fainting, thirst. 6. Shock treatment: First position patient correctly, maintain the patients ABCs, traet the cause of shock if possible. Then maintain the patients body temperature by placing blankets under and over the patient. Make sure the patients doesnt eat or drink anything and assist with other treatments such as oxygen. Arrange prompt transport. 7. Follow general treatment. Keep patient quiet and help them if need to move and provide reassurance. Provide high flow oxygen as soon as available. 8. Provide general treatment, assist with an epi-pen if required and allowed. If there is a spinal injury, make sure to stabilize neck and head. 9. Follow general treatment. Dont let the patients move and ask them to keep quiet. 10. To control external blood loss, apply direct pressure, elevate the body part, or apply a tourniquet if permitted and if available. 11. Only use a tourniquet if direct pressure and elevation do not work and if blood loss can lead to death. 12. For the femoral pressure point, position patient on their back and kneel next to their hips, facing the head, on the opposite side of the injury. Find the pelvis and pace the little finger of your hand closest to the injured leg along the anterior crest on the injured side. Rotate your arm down firmly into the groin area. For the brachial pressure point, position the patients arm so the elbow is bent at a 90 degree angle and hold the upper arm away from the patients body. Gently slap the inside of the biceps with your fingers halfway between the shoulder and the elbow to push the biceps out of the way. Slide your fingers up to push the biceps away. Then squeeze you hand down on the humerus.

13. Soft injury wounds a. Puncture: is a wound caused by a sharp object that penetrates the skin b. Laceration is a cut or slice. c. Avulsion is tearing away of body tissue. d. Amputation is a whole body part torn away from the body. 14. Any amputated part should be located and placed in a clean plastic bag, kept cool and taken with the patient to the hospital for possible reattachment. Use ice pack to keep part cool but do not allow it to touch part directly. 15. The major principles are, control bleeding, prevent further contamination, immobilize injured part, and stabilize any impaled objects. 16. Dressings are placed directly on the wound to control bleeding and prevent further contamination. Bandages are used to hold dressings in place. 17. It is important to use standard precautions when dealing with soft-tissue injuries. These injuries almost always involve some amount of blood. Blood can transmit many life threatening diseases. To protect yourself and other patients, be sure to take precautions. 18. a. Face and Scalp: Apply direct pressure and dress and bandage the wound. If there is a chance skull fracture and signs are visible, do not apply pressure, loosely wrap around the head and stabilize spine b. Nosebleeds: have patient sit down and tilt head forward, pinch both nostrils together for 5 minutes, if nosebleed doesnt go away take patient to hospital. c. Eye injuries: If there is a laceration cover entire eye with dry gauze pad and have the patient lie on their back. Arrange for transport to an appropriate medical facility. If there is a small object in the eye, flush out with saline solution. If an object is impaled in the eye, immobilize the object by covering the eye with a cup and dressings. Cover both eyes. d. Neck wounds: Use direct pressure to control bleeding and dress neck and bandage. Then stabilize the neck and head. e. Chest and Back wounds: If lung is punctured, first cover any open chest wound with airtight material (occlusive dressing). Administer oxygen, monitor ABCs. f. Impaled objects: Apply stabilizing dressing and arrange for immediate prompt transport. If the object is too big, may have to call specialists to cut closer to the objects to make transport possible. g. Closed Abdominal wounds: Place patient on their back and elevate legs 6. Use blankets to conserve body heat. h. Open Abdominal wounds: apply sterile dressing to the wound, maintain the patients body temperature, place patient on their back with legs elevated and administer oxygen as soon as possible. i. Genital wounds: Apply direct pressure, dress and bandage. j. Extremity wounds: apply dry sterile dressing and bandage. Elevate injured area and splint injured extremities. k. Gunshot wounds: Open airway and establish ventilation and circulation. Apply direct pressure, dress and bandage wound. Examine patient to make sure all wounds are addressed. Treat for shock symptoms, administer oxygen, and arrange for immediate prompt transport. l. Bites: Control bleeding and dress and bandage wound.

19. You can tell the seriousness of a burn by its depth because the deeper the burn goes, the more damage it has done to the skin. When the skin is reddened and causes the patient pain, it is most likely only the outermost layers. On the other hand, if the patient can feel no pain, the pain receptors have been damaged and this is extremely dangerous. 20. The extent of the burns can also tell you how serious the burns are because the more spread out the burn is, the more it has been able to damage different parts of the body, making it worse. 21. Signs, Symptoms, complications, and treatments a. Thermal: S&S blisters, swelling, red skin, very painful. Treatment cool skin, cover it with a dry, sterile dressing or burn sheet, make sure not to break blisters and arrange for transport. b. Respiratory: S&S burns around face, singed nose hairs, soot in the mouth and nose, difficulty breathing, pain while breathing, unconsciousness because of a fire. Treatment administer oxygen, arrange for prompt transport and watch patient, be ready to perform CPR. c. Chemical: S&S chemicals around the patient and burn marks. Treatment remove as much chemical as possible, may have to ask to remove clothing, flush contaminated skin with abundant amounts of water for at least 10 minutes (flush eyes for 20 minutes), cover with dry, sterile dressing and arrange for prompt transport. d. Electrical: S&S irregularities in cardiac rhythm, entry and exit wounds. Treatment make sure not it contact with electricity, cover and dress wound, arrange for prompt transport, and monitor ABCs. 22. With multi-system trauma, be alert for all types of injuries, make sure to do full and thorough patient assessment, and treat life threatening injuries first.