WOUNDS, BLEEDING AND SHOCK

COMPONENTS OF THE CIRCULATORY SYSTEM Heart Blood Arteries Veins Capillaries

THE HEART It is located in the centre of the chest just beneath the breastbone It is approximately the size of a clenched fist It is a specialized pump It is constructed of muscle(myocardium), which gets it’s blood supply from the coronary arteries It consists of 4 chambers

HEART POSITION OF THE HEART WITHIN THE CHEST

AORTA FROM BODY TO LUNGS TO LUNGS FROM LUNGS FROM LUNGS LEFT ATRIUM RIGHT ATRIUM LEFT VENTRICLE RIGHT VENTRICLE

CORONARY ARTERIES OF THE HEART

BLOOD - COMPONENTS Plasma (liquid) Red blood cells (solid) White blood cells (solid) Platelets (solid)

FUNCTIONS OF BLOOD To carry oxygen and nutrients to the tissues of the body. To carry carbon di-oxide and waste products away from the tissues of the body.

ARTERIES Carotid Radial Femoral Brachial

PULSE Definition:- The wave of pressure caused by the distension and recoil of the Aorta.

SHOCK

SHOCK Definition:- Failure of the circulatory system to deliver sufficient oxygen and nutrients to the vital organs of the body.

SHOCK - TYPES Cardiogenic shock Psychogenic shock Anaphylactic shock Spinal shock Hemorrhagic shock

SIGNS AND SYMPTOMS Pale, cold, clammy skin Rapid weak pulse Thirst Weakness or fainting Nausea Rapid shallow breathing Delayed capillary refill Falling B.P. (late sign)

TREATMENT Maintain A,B,C’s. Position the patient correctly. Treat the cause if possible (e.g. external bleeding). Administer 100% O2. Loosen the clothing around the neck, chest and waist.

TREATMENT Elevate the legs (if no trauma). Prevent chilling. Monitor vital signs, pulse, respirations, BP, skin colour etc. Give nothing by mouth.

TYPES OF BLEEDING Arterial. Venous. Capillary.

CONTROLLING EXTERNAL BLEEDING Elevation Direct pressure Indirect pressure (brachial and femoral pressure points) Do not apply tourniquets!

WOUNDS Definition:-An injury caused by physical means that leads to damage of a body part. Open wounds. Closed wounds.

TYPES OF WOUNDS Contusion(bruise) Laceration Incision Puncture Shot Abrasion Amputation Avulsion

CARE OF AMPUTATED PARTS Place the part in a plastic bag to protect it from water. Lay the bag on top of a cold pack or iced water. Do not allow the part to come into direct contact with ice. Do not wash the amputated part. Label the bag with the persons name and the time of injury.

INTERNAL BLEEDING Bleeding within the body cavities may follow injury, such as a fracture or puncture wound, but can also occur spontaneously - e.g. Bleeding from a stomach ulcer.

TREATMENT OF INTERNAL BLEEDING Maintain A,B,C’s. Treat for shock. 100% Oxygen.

CONTUSION (BRUISE)

Deep Lacerations

INCISION

PUNCTURE

GUNSHOT

AVULSION

Abrasion ABRASION

AMPUTATION

Dressing And Bandaging

DRESSINGS Dressings are used to. Control bleeding. Stabilize a wound. Protect a wound. Prevent further risk of infection.

BANDAGES Bandages are used to. Maintain direct pressure. Hold a dressing in place.

RULES WHEN BANDAGING Explain exactly what you are going to do. Work in front of the casualty. Not too tight. Not too loose. Leave fingers and toes exposed. Regularly check circulation.

WOUNDS - TREATMENT Nosebleed. Eye injuries. Neck wounds. Chest and back wounds. Impaled objects.

WOUNDS - TREATMENT CLOSED ABDOMINAL WOUNDS OPEN ABDOMINAL WOUNDS GENITAL WOUNDS EXTREMITY WOUNDS GUNSHOT WOUNDS

CRUSH INJURIES

CRUSH INJURY Definition:- A crush injury results when the trunk or an extremity is trapped between heavy items.

EFFECT OF A CRUSH INJURY External bleeding. Internal bleeding:-internal organs are crushed and blood vessels are damaged. Inflammation:- contents of hollow organs leak. Muscle damage. Nerve damage. Musculoskeletal injuries.

HEART POSITION OF THE HEART WITHIN THE CHEST

CRUSH INJURY SYNDROME Circulation is cut off when an extremity is trapped. Oxygenated blood can not travel past the blockage to the extremity. Waste products and de-oxygenated blood can not be carried away from to the extremity. Toxins and potassium build up in the extremity.

CRUSH INJURY SYNDROME If an extremity which has been trapped for more than 10 minutes is released, one of two things may happen. Immediate cardiac arrest. Kidney failure.

TREATMENT OF CRUSH INJURY If the extremity is trapped for less than 10 minutes:- Scene safety, universal precautions. Primary survey - A,B,C’s. Release the casualty as quickly as possible. Control any external bleeding and cover any wounds.

TREATMENT OF CRUSH INJURY If the extremity is trapped for less than 10 minutes:- Secure and support any fractures. Treat for shock. Monitor vital signs, pulse, respirations, skin colour, skin temperature, pupils etc. Obtain patient history, S.A.M.P.L.E.

TREATMENT OF CRUSH INJURY If the extremity is trapped for more than 10 minutes:- Scene safety, universal precautions. Primary survey, A,B,C’s. Summon advanced life support. Obtain patient history, S.A.M.P.L.E. Treat for shock where possible. Do not release the casualty!