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Bleeding and Shock CHAPTER 25 1.

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Presentation on theme: "Bleeding and Shock CHAPTER 25 1."— Presentation transcript:

1 Bleeding and Shock CHAPTER 25 1

2 Review of the Cardiovascular System
Vessels Blood Heart 1

3 Arterial System Carotid artery Brachial artery Radial artery
Femoral artery 1

4 The average adult has about 6 liters of blood in the body.

5 Venous System External jugular Inferior vena cava Femoral vein
Great saphenous 1

6 Perfusion: The process of delivering blood with oxygen and nutrients to the cells, and removing wastes. The skin condition is a good indicator of perfusion. 1

7 The Perfusion Process Artery Vein O2 and nutrients Waste products Cell

8 Shock 1

9 Any alteration in the body’s ability to deliver oxygenated blood to every organ is detrimental.

10 Hypoperfusion: The state that results when cells are not perfused adequately; oxygen and nutrients are not delivered and there is an inadequate removal of metabolic waste products. Widespread hypoperfusion results in shock. 1

11 General Causes of Shock
Pump failure Decrease in the heart’s ability to pump blood Container failure Circulatory system larger than the volume available Volume failure Decrease in available fluid volume 1

12 Hypovolemic shock: Hypoperfusion that results from inadequate volume.
Hemorrhagic shock is hypoperfusion caused only by bleeding. 1

13 Causes of Hypovolemic Shock
Dehydration Excessive vomiting Excessive diarrhea Blood loss Internal blood loss External blood loss 1

14 Assessing Shock 1

15 Subtle mental status changes, such as restlessness and anxiety, are the earliest signs of shock.

16 Severe blood loss leads to vasoconstriction of the blood vessels...
…and blood is diverted to the vital organs. 1

17 Assess capillary refill under normal room temperature conditions.

Decreased blood pressure is a late sign of shock. DON’T WAIT FOR THE BP TO DROP BEFORE TREATING! 1

19 Infants and children can maintain a normal BP until they have lost over half their blood volume!

20 Signs and Symptoms of Shock
Restlessness, anxiety, combativeness Increased heart rate Decreased CRT (infants & children only) Pale, cool, clammy skin Rapid and shallow breathing Thirst 1

21 Signs and Symptoms of Shock continued
Nausea, vomiting Decreasing level of consciousness Cyanotic skin color Low or decreasing blood pressure Sluggish pupils 1

22 Emergency Care for Shock

23 Treatment of Shock Appropriate BSI precautions Maintain an open airway
Gloves, eye wear, mask, and gown Maintain an open airway Provide 100% oxygen Control bleeding as much as possible Consider use of PASG (according to local protocol) 1

24 Treatment of Shock continued
Elevate patient’s legs Cover with blanket Splint suspected extremity fractures if time permits Transport immediately 1

25 Raising the legs will maximize delivery of oxygenated blood to the brain.

26 The best treatment for shock is rapid transportation.

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