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Presentation on theme: "LESSON 16 BLEEDING AND SHOCK."— Presentation transcript:


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

3 Trauma Overview Frequently results in bleeding and shock, and other injuries Trauma care by EMRs includes a range of specific care skills The National Trauma Triage Protocol guides where to transport trauma patients With significant forces, increased risk for injuries to multiple organs Multi-trauma patients at greater risk for developing shock Suspect multi-system trauma in any patient subjected to significant external forces

4 Anatomy and Physiology Review
Arteries: carry oxygenated blood to body Veins: carry deoxygenated blood back to heart Capillaries: exchange nutrients, oxygen and carbon dioxide between blood and tissue cells Perfusion: adequate flow of blood to body tissues Pulmonary artery: carries deoxygenated blood to lungs Pulmonary veins: carry oxygenated blood back to heart

5 Bleeding Risk of infectious disease from contact with patient’s blood or body fluids Follow standard precautions Serious injury may prevent effective clotting Significant blood loss will cause shock and possibly death Bleeding may be external or internal  either can result in severe blood loss Difficult to estimate how much blood a patient has lost  pay close attention to signs and symptoms

6 Types of External Bleeding

7 Assessing External Bleeding
Perform standard assessment Estimate severity of blood loss, based on patient’s signs and symptoms and your general impression Assess patient for shock

8 Skill: Controlling External Bleeding

9 Place sterile dressing on wound
Apply direct pressure with gloved hand

10 After 5 minutes re-evaluate bleeding
If needed, put another dressing on top of first and keep applying pressure

11 If needed, apply pressure bandage
If appropriate, treat for shock

12 Tourniquet Tourniquet use carries high risk of complications
Should only be used as extreme last resort by rescuers trained in its use

13 Internal Bleeding

14 Internal Bleeding Commonly occurs with blunt trauma
Suspect based on mechanism of injury Internal organs may be injured Bleeding is concealed Can cause shock and be life-threatening Long bone fractures and pelvic fractures may cause serious internal bleeding Cannot control internal bleeding

15 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

16 Emergency Care for Internal Bleeding
Perform standard patient care Manage any external bleeding Position patient lying on back Keep patient from becoming chilled or overheated Limit movement of deformed extremity Treat for shock Administer high-flow oxygen

17 Shock

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


20 Shock Progressive and may occur slowly or quickly
Body attempts to compensate by increasing heart and breathing rates With continued reduced perfusion, body can no longer compensate and vital organs begin to fail Definitive treatment is critical Transport patient for treatment as soon as possible Consider possibility of shock in any serious injury or illness

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

22 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)

23 Emergency Care for Shock
Perform standard patient care Prevent further blood loss Put patient in shock position

24 Emergency Care for Shock (continued)
Position patient on back and raise feet inches (unless spinal or pelvic injury) Maintain normal body temperature

25 Emergency Care for Shock (continued)
Do not give patient anything to eat or drink Provide care for specific injuries Administer high-flow oxygen if available Monitor patient’s breathing and vital signs every 5 minutes


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