Bleeding and Shock

Lesson 12

12-1

Bleeding
External or internal bleeding common with trauma patients Control bleeding quickly to prevent shock

12-2

Bleeding, continued
Risk of infectious disease from contact with the patients blood or body fluids Follow standard precautions Serious injury may prevent effective clotting Significant blood loss will cause shock and possibly death

12-3

Types of External Bleeding

Assessing External Bleeding

Perform the standard assessment Estimate severity of blood loss Assess the patient for shock

12-5

Skill:
Bleeding Control

12-6

Place sterile dressing on wound. Apply direct pressure with hand.

12-7

If needed, put another dressing on top of first.

12-8

Apply roller bandage.

12-9

Tourniquet
Used rarely as an extreme last resort A life or limb decision Use a wide band just above the wound; tighten only enough to stop bleeding Record time of application Once applied, do not loosen or remove Do not cover

12-10

Internal Bleeding

12-11

Internal Bleeding
Commonly occurs with blunt trauma Suspect based on the mechanism of injury Bleeding is concealed Causes shock and is life threatening Cannot control internal bleeding

12-12

Signs and Symptoms of Internal Bleeding

Discolored, tender, swollen or hard skin, rigid abdomen Absence of distal pulse Increased respiratory and pulse rates Pale, cool, moist skin Nausea and vomiting Thirst Mental status changes Bleeding from body orifices
12-13

Care for Internal Bleeding

Perform standard patient care Manage any external bleeding Keep patient in a position of comfort Keep patient warm Limit movement of a deformed extremity Treat for shock Administer high-flow oxygen

12-14

Shock

12-15

12-16

Shock (Hypoperfusion)
Results from the inadequate delivery of oxygenated blood to body tissues May result from any condition involving: Failure of the heart to provide oxygenated blood (pump failure) Abnormal dilation of the vessels (pipe failure) Blood volume loss (fluid failure)

12-17

Causes of Shock
Severe bleeding Severe burns Heart failure Heart attack Head or spinal injuries Allergic reactions Dehydration Electrocution Serious infection Extreme emotional reactions (temporary/less dangerous)

12-18

Signs and Symptoms of Shock

Restlessness, anxiety Extreme thirst Rapid, weak pulse Rapid, shallow respirations Mental status changes Pale, cool, moist skin Decreased blood pressure (late sign)

12-19

Emergency Care for Shock

Perform standard patient care Prevent further blood loss Put patient in shock position

12-20

Have patient lie on back and raise legs 8 12 inches Loosen any tight clothing Maintain normal body temperature

12-21

Care for Shock continued

Do not give the patient anything to eat or drink. Provide care for specific injuries. Administer high-flow oxygen if available Monitor the patients breathing and vital signs every 5 minutes