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Bleeding and Shock ¤ Lesson Objective: Identify the types of bleeding and their treatments.

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Presentation on theme: "Bleeding and Shock ¤ Lesson Objective: Identify the types of bleeding and their treatments."— Presentation transcript:

1

2 Bleeding and Shock ¤ Lesson Objective: Identify the types of bleeding and their treatments

3 OVERVIEW ¤ Anatomy and Physiology ¤ External Bleeding ¤ Internal Bleeding ¤ Anatomy and Physiology ¤ External Bleeding ¤ Internal Bleeding

4 Anatomy and Physiology ¤ Container ¥Heart ¥Arteries ¥Arterioles ¥Capillaries ¥Venules ¥Veins ¤ Container ¥Heart ¥Arteries ¥Arterioles ¥Capillaries ¥Venules ¥Veins

5 Anatomy and Physiology ¤ Contents ¥Blood ¥Six liters ¤ Contents ¥Blood ¥Six liters

6 Anatomy Review ¤ Perfusion ¥Circulation of blood through an organ structure ¥Delivers oxygen and nutrients and removes waste products ¤ Perfusion ¥Circulation of blood through an organ structure ¥Delivers oxygen and nutrients and removes waste products

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8 Problems occur when Inadequate circulation of blood through an organ Inadequate circulation of blood through an organ

9 HypoperfusionHypoperfusion Organs susceptible ¤ Heart ¤ Brain and spinal cord ¤ Kidneys Inadequate perfusion results in shock Organs susceptible ¤ Heart ¤ Brain and spinal cord ¤ Kidneys Inadequate perfusion results in shock

10 External Bleeding Significant blood loss ¥1 liter - adult ¥1/2 liter - child ¥100 to 200 ml - infant Result may be HYPOVOLEMIC shock Significant blood loss ¥1 liter - adult ¥1/2 liter - child ¥100 to 200 ml - infant Result may be HYPOVOLEMIC shock

11 Types of Bleeding Arterial ¤ Bright red and spurts ¤ Difficult to controlArterial ¤ Bright red and spurts ¤ Difficult to control

12 Types of Bleeding Venous ¤ Darker and flows steady ¤ More easily managedCapillary ¤ Dark red and oozes ¤ Often clots spontaneouslyVenous ¤ Darker and flows steady ¤ More easily managedCapillary ¤ Dark red and oozes ¤ Often clots spontaneously

13 Controlling External Bleeding ¤ Airway / Breathing ¤ Bleeding Control ¤ Airway / Breathing ¤ Bleeding Control

14 Bleeding Control Direct local pressure Most effective Direct local pressure Most effective

15 Bleeding Control Direct local pressure ¤ Pressure dressings ¤ Additional dressings Direct local pressure ¤ Pressure dressings ¤ Additional dressings

16 Bleeding Control Elevation ¤ Use with direct pressure ¤ As little as 6 inchesSplints ¤ Reduces motion of bone ¤ Control of bleedingElevation ¤ Use with direct pressure ¤ As little as 6 inchesSplints ¤ Reduces motion of bone ¤ Control of bleeding

17 Bleeding Control ¤ Proximal Arterial Pressure ¥Rarely stops bleeding completely ¥Pulse points ¤ Proximal Arterial Pressure ¥Rarely stops bleeding completely ¥Pulse points

18 Tourniquet ¤ Last resort – when a limb is unsalvageable ¤ Can cause permanent damage ¤ Procedures ¥Bandage 4 inches wide and 6 to 8 layers deep ¥Wrap around extremity twice at a point proximal to bleeding but as distal on the extremity as possible ¤ Last resort – when a limb is unsalvageable ¤ Can cause permanent damage ¤ Procedures ¥Bandage 4 inches wide and 6 to 8 layers deep ¥Wrap around extremity twice at a point proximal to bleeding but as distal on the extremity as possible

19 TourniquetTourniquet ¤ Tie a knot and insert stick ¤ Twist until bleeding stops ¤ Secure stick or rod in position ¤ Write TK and time applied on forehead ¤ Document use of tourniquet and time applied ¤ May use BP cuff ¤ Tie a knot and insert stick ¤ Twist until bleeding stops ¤ Secure stick or rod in position ¤ Write TK and time applied on forehead ¤ Document use of tourniquet and time applied ¤ May use BP cuff

20 Precautions with the use of a Tourniquet

21 PrecautionsPrecautions ¤ Use a wide bandage and secure tightly ¤ Never use wire, rope, or belt ¤ Do not remove or loosen once applied ¤ Leave in open view ¤ Do not apply over joint ¤ Use a wide bandage and secure tightly ¤ Never use wire, rope, or belt ¤ Do not remove or loosen once applied ¤ Leave in open view ¤ Do not apply over joint

22 Special Areas - nose, ears, or mouth ¤ Potential Causes ¥Injured skull ¥Facial trauma ¥Digital trauma ¤ Potential Causes ¥Injured skull ¥Facial trauma ¥Digital trauma

23 Special Areas - nose, ears, or mouth ¤ Potential Causes (cont.) ¥Sinusitis, or other URI infections ¥Hypertension ¥Coagulation disorders ¤ Potential Causes (cont.) ¥Sinusitis, or other URI infections ¥Hypertension ¥Coagulation disorders

24 Treatment Skull FX ¤ Do not stop blood flow ¤ Loose, dry sterile dressing ¤ Wrap dressing loosely around head ¤ Do not stop blood flow ¤ Loose, dry sterile dressing ¤ Wrap dressing loosely around head

25 Treatment for epistaxis (nose bleed)

26 ¤ Place in sitting position, leaning forward ¤ Apply direct pressure by pinching nostrils together, or ¤ Gauze between upper lip and gum ¤ Ice over nose ¤ Keep patient calm and quiet ¤ Place in sitting position, leaning forward ¤ Apply direct pressure by pinching nostrils together, or ¤ Gauze between upper lip and gum ¤ Ice over nose ¤ Keep patient calm and quiet

27 Internal Bleeding ¤ Severity ¥Hypovolemic shock ¥Bleeding may be concealed ¤ Severity ¥Hypovolemic shock ¥Bleeding may be concealed

28 Internal Bleeding Severity ¤ Broken bones - serious internal bleeding ¥Local swelling ¥BruisingSeverity ¤ Broken bones - serious internal bleeding ¥Local swelling ¥Bruising

29 Mechanism of Injury ¤ Blunt trauma ¥Falls ¥Motorcycle crashes, pedestrian impacts, automobile collisions ¤ Blunt trauma ¥Falls ¥Motorcycle crashes, pedestrian impacts, automobile collisions

30 Mechanism of Injury Blunt trauma cont... ¥Blast injuries ¥Look for contusions, abrasions, deformity, impact marks, and swelling ¤ PenetratingtraumaKnife orgunshot ¤ Penetrating trauma- Knife or gunshot ¥Blast injuries ¥Look for contusions, abrasions, deformity, impact marks, and swelling ¤ PenetratingtraumaKnife orgunshot ¤ Penetrating trauma- Knife or gunshot

31 S & S of Internal Bleeding ¤ Pain, tenderness, swelling, or discoloration ¤ Bleeding from mouth, rectum, or vagina ¤ Pain, tenderness, swelling, or discoloration ¤ Bleeding from mouth, rectum, or vagina

32 S & S of Internal Bleeding ¤ Hematuria ¤ Hematemesis ¤ Melena ¤ Hematuria ¤ Hematemesis ¤ Melena

33 S&S Internal Bleeding ¤ Hemoptysis ¤ Pain, tenderness, bruising, or swelling around injured site ¤ Hemoptysis ¤ Pain, tenderness, bruising, or swelling around injured site

34 S&S Internal Bleeding ¤ Broken ribs, bruises over lower chest, tender, rigid, or distended abdomen ¥Lacerated spleen or liver ¥Referred pain ¤ Broken ribs, bruises over lower chest, tender, rigid, or distended abdomen ¥Lacerated spleen or liver ¥Referred pain

35 Late S & S of hypovolemic shock ¤ Anxiety, restlessness, combativeness, or altered mental status ¤ Weakness, faintness, or dizziness ¤ Anxiety, restlessness, combativeness, or altered mental status ¤ Weakness, faintness, or dizziness

36 Late S & S of hypovolemic shock ¤ Thirst ¤ Shallow, rapid breathing ¤ Rapid weak pulse ¤ Pale, cool, clammy skin ¤ Thirst ¤ Shallow, rapid breathing ¤ Rapid weak pulse ¤ Pale, cool, clammy skin

37 S & S of Hypovolemic Shock ¤ Rapid pulse (early sign) ¤ Capillary refill greater than 2 seconds ¤ Dropping blood pressure (late sign) ¤ Nausea and vomiting ¤ Rapid pulse (early sign) ¤ Capillary refill greater than 2 seconds ¤ Dropping blood pressure (late sign) ¤ Nausea and vomiting

38 Treatment ¤ Basic life support ¤ Airway/ Breathing/ Circulation ¤ Treat internal and external bleeding ¤ Treat uncontrolled hypovolaemic shock ¤ Basic life support ¤ Airway/ Breathing/ Circulation ¤ Treat internal and external bleeding ¤ Treat uncontrolled hypovolaemic shock

39 Treatment ¤ Vitals at least every 10 minutes ¤ Elevate legs ¤ Immediate fluid/blood replacement ¤ Vitals at least every 10 minutes ¤ Elevate legs ¤ Immediate fluid/blood replacement

40 QUESTIONS?

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