Emt Mod. 5 Ch. 27

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Arteries

blood vessels that carry rich blood away from the heart

Capillaries

smallest blood vessel; brings nutrients and oxygen to the tissues and absorbs carbon dioxide and waste products

Veins

blood vessels that carry waste containing blood from the tissues back to the heart

Blood`s functions:Transportation of gases

Blood carries inhaled oxygen from the lungsto the bodys cells. It carries carbon dioxide from the body cells back to the lungs where it is then exhaled.

Blood`s functions:nutrition

Circulates nutrients from the intestines or storage tissues(ex. fatty tissue, the liver, and muscle cells) to the other body cells.

Blood`s functions: Excretion

Carries wate product from the cells to organs, such as the kidneys that excrete them from the body.

Blood`s functions: Protection

Carries antibodies and white blood cells. Contains platelets and clotting factors that work to control bleeding from damaged blood vessels by forming blood clots.

Blood`s functions: Regulations

Carries substances that control the body`s functions. Ex. hormones, water, salt, enzymes, and chemicals. Regulates body temp by carrying body heat to the lungs and skin surface.

Perfusion

Circulation of blood through tissues or the passage of fluids through vessels of an organ

Hypoperfusion(shock)

Inability of the body to adequately circulate blood to the body's cell to supply them with Oxygen and remove waste.

Hemorrhage

excessive bleeding

Arterial bleeding

Bleeding from an artery, which is characterized by bright red blood and as rapid, profuse, and difficult to control.

Venous Bleeding

Bleeding from a vein, which is characterized by dark red or maroon blood and as a steady flow, easy to control.

Capillary Bleeding

Bleeding from the capillaries, which is characterized by a slow oozing flow of blood.

Blood What determines the severity of the patients bleeding?

Speed and amount of blood lost in relation to the patients physical size.

Blood loss severity in adults?

1 liter or 1,000cc

Blood loss severity in children?

500cc or half a liter

Signs of shock: Altered mental status

Altered mental status occurs because the brain is not recieving enough oxygen....

Signs of shock: Pale, cool, and clammy skin

Blood is quickly directed away from the skin to such organs as the brain and heart. CHildren may exhibit caplillary refill times greater than 2 sec.

Signs of shock: anaphylactic and neurologic

skin is typically warm, flushed, and dry because the circulatory system has lost the ability to constrict blood vessels.

Signs of shock: nausea and vomiting

Blood is diverted from the digestive system in and effort to keep blood perfusing the organs.

Signs of shock: Vital sign changes

Pulse and respiration will be the first to change.
Pulse will increase in anattempt to pump more blood.
Respiration also increase in an attempt to increase the amount of oxygen in the blood.Blood pressure drop indicates a state of serious life threatening shock.
narrowing of the pressure may also occur. (diff. between systolic and diastolic pressure will decrease.)

hemostatic agent

Substances applied as powders, dressigns, gauze, or bandages to open wounds to stop bleeding.

What are the 4 major methods of controlling external bleeding?

Direct Pressure
Elevation
Hemostatic Agent
Tourniquet

What is direct pressure?

Most common way to control external bleeding to a wound.

Pressure dressing

A bulky dressing held in position with a tightly wrapped bandage to apply pressure to help control bleeding.

Should a dressing ever be removed? Why?

No. Because removing the dressing can damage the blood clot that is just forming. May also cause possible pulmonary embolism.

What is the quickest way to control external bleeding?

Applying direct pressure

Elevation

Applied during direct pressure application. Keeping injury site above heart level helps decrease the speed of bleeding.

What are the 2 forms of hemostatic agents?

Hemostatic dressing and Hemstatic gauze wraps

Tourniquet

Device that constrict all flow of blood to and from an extremity.

Where should a tourniquet be placed in reference to the bleeding wound.

2 inches above the bleeding wound.

What are the other methods of bleeding control?

Splinting, Cold application, Pneumatic Anti-Shock Garment

Splinting

Bleeding associated with a musculoskeletal injury may be controlled by proper splinting of the injury. Ex. Air splint may be used to control internal/external bleeding.

Cold application

minimizes swelling and constricts blood vessels (to reduce bleeding). Reduces pain at injury site. Causes frostbite when left for more than 20min or against skin.

Pneumatic Anti-Shock Garment(PASG)

Controls external bleeding from the lower extremities by direct pressure. Useful in providing indirect pressure to help control internal bleeding in the pelvic and abdominal cavities.

Another name for nosebleeds?

Epitaxis

Causes of nosebleeds(epitaxis):

High blood pressure(hypertension), Rupurted capillaries in the nose due to hypertension, sinus infection, digital trauma(nose picking)

Steps to stop nosebleed

1. Sit leaning forward
2.Apply direct pressure to fleshy portion of the nose
3.keep calm
4.Refrain from leaning backwards
5. In case of unconciousness or inability to maintain airway. Place in recovery postion.(on their side). Suction as needed

Reasons why internal bleeding is serious

Large quantity of blood loss in a short period of time due to internal organ and blood vessel damage.
Blood loss cannot be seen
Severe internal blood loss may even occur due to extremity damage

Mechanism of blunt trauma:

Falls
Motor Vehicle Accident(MVA)
Motorcross crashes
Blast Injuries

Mechanism of penatrating trauma:

Gunshot wounds
Stab wounds from a knife, ice pick, screwdriver, or similar object
Impaled Objects

Signs of internal bleeding:

1.Injuries to the surface of the body.(Could indicate underlying injuries)
2.brusing, swelling, or pain over vital organs
3. Painful, swollen, or deformed extremities
4.Bleeding from the mouth, rectum, vagina, or other body orifice
5.A tender, rigid, or distended abdomen
6. Vomiting a coffe ground like substance or bright red vomitus. Signifies the prescence of blood
7.Dark, tarry stools or bright red blood in the stool
8. Signs and symptoms of shock.

What are the 3 components of the circulatory system?

The heart, blood vessels, and blood.

3 reason why shock may develop?

heart fails as a pump, Blood volume is lost, Blood vessels dialate creating a vascular container capacity that is too great to be filled by the available blood

What are the 3 catergories of shock severity?

Compensated, Decompensated, Irreversible

Compensated Shock

The early stage of shock, in which the body can still compensate for blood loss. Noticeable effects are Increased heart rate, Increased respirations, Redirection of blood to the vital organs). Pale, cool skin, and increased capillary refill time in infants.

Decompensated Shock

Occurs when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident.

Irreversible Shock

When the body has lost the battle to maintain perfusion to vital organs. Even if adequate vital signs return, the patient may die days later due to organ failure. Liver and kidney cell damage.

what are the 3 major types of shock?

Hypovolemic shock, cardiogenic shock, neurogenic shock

Hypovolemic shock

Highly common. Shock resulting from blood or fluid loss

hemorrhagic shock

shock resulting from blood loss

Cardiogenic shock

Shock, or lack of perfusion, brought on not by blood loss, but by inadequate pumping action of the heart. It is often the result of a heart attack or congestive heart failure. Always check for low blood pressure and possible lower extremity edema

neurogenic Shock

Uncontrolled dilation of blood vessels due to nerve paralysis caused by spinal cord injuries.Rarely seen. Also caused by anaphylactic reaction or spesis(massive infection)

Signs of shock:

Altered mental status: Hypoxia
Pale, Cool, Clammy Skin: Inadequate tissue perfusion
Nausea and Vomiting: Blood diverted from the GI tract
Vital Sign Changes:
-Increase pulse
-Increased Respiration
-Low blood pressure
-Other signs: dialated pupils, cyanosis around lips an nail beds

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