1. Bleeding and Shock
Chapter 15

2. Blood Blood is the only tissue that flows throughout the body
Carries oxygen & nutrients to all parts of the body
Transports waste products back to the lungs, kidneys, and liver for disposal
Essential part of immune system
Crucial for fluid and temp balance
Hydraulic fluid for certain functions
Highway for hormonal messages
3 basic types of bleeding: arterial, venous, capillary

3. Bleeding Arterial Bleeding Venous Bleeding Capillary Bleeding
Issues bright red blood that spurts or pulses corresponding to heart beat
Venous Bleeding
Slower, less severe non-pulsing bleeding
Closer to surface, therefore easier to control
Capillary Bleeding
Slow & oozing blood
Blood clots rapidly
Greater risk of infection

4. Arterial Bleeding Most serious Punctured/severed artery
Bright red blood
Distinct spurts/pulses correspond to heart beat
Can lose large volume of blood in short period
Treatment:
Treat athlete for shock
Apply direct pressure; find and use pressure points
Activate EMS
Apply tourniquet if bleeding cannot be controlled by direct pressure or use of pressure points
Blood in arteries under high pressure
Can be fatal if not controlled promptly

6. Venous Bleeding Rupture of 1+ veins Less severe than arterial
Steady blood flow
Bluish-red blood
Easier to control
Treatment:
Direct pressure
Compression bandaging
Follow-up with doctor
Bluish-red b/c veins return oxygen-depleted blood to lungs
Easier to control b/c veins closer to surface
Body’s blood clotting mechanism more effective venous than arterial

7. Capillary Bleeding Slow Typically oozes Blood clots quickly
Risk of infection higher than with arterial or venous
Scratches
Minor cuts
Abrasions
Risk higher b/c slow
Show:

8. SHOCK Precursor to death
Occurs when the circulation system fails to send blood to all body parts
Prompt recognition, treatment, & control are crucial for survival
Characterized by:
Drop in blood pressure
Reduced blood circulation
Inadequate blood flow to tissues
Areas of body are deprived of oxygen because blood flow or blood volume is too low to meet the body’s needs
Eight main types of shock

9. Hemorrhagic Shock Respiratory Shock Loss of blood from an injury
Blood pressure falls and adequate oxygen is unavailable to body
Injury internal or external
Cause by severe blunt trauma or internal injuries (i.e. ruptured spleen)
Respiratory Shock
Lungs unable to supply enough oxygen to blood
Causes dypsnea and elevated respiratory rate
Caused by disease, illness, or pulmonary contusion (bruising of lungs)
Ruptured spleen…mono!
Dypsnea—difficulty breathing
Leads to collapse of cardiorespiratory system
Injuries involving high velocity cause pulmonary contusion

10. Cardiogenic Shock Neurogenic Shock
Caused by inadequate functioning of the heart
Heart sustains damage through disease, infection, or injury
Extremely rare in athletics
Athletes with previously undiagnosed heart defects or conditions
Neurogenic Shock
Loss of vascular control by the nervous system
Disruption of autonomic nervous system control over vasoconstriction
Veins & arteries immediately dilate, expands volume of circulatory system, reducing blood pressure
Neuorgenic: under normal conditions, ANS keeps muscle of veins and arteries partially contracted. At onset of shock, further constriction is signaled. Vascular muscles cannot maintain this contraction indefinitely. A number of factors can override ANS (increased fluid loss, central nervous system trauma, emotional shock).

11. Anaphylactic Shock
Caused by severe allergic reaction (exaggerated response by body’s immune system to what would otherwise be a harmless substance)
Reactions vary—itchy eyes and runny nose, to life-threatening response
Insect stings, medications, certain food and food additives

12. Metabolic Shock Psychogenic Shock Septic Shock
Occurs with severe loss of body fluids
Severe diarrhea, vomiting, or some disease
Severe dehydration
Psychogenic Shock
Physiological response to fear, stress, or emotional crisis
Causes person to faint
Sudden temporary dilation of blood vessels reduces normal blood volume to brain
Temporary
Septic Shock
Life-threatening reaction to severe infection
Body tissues and organs not get enough blood and oxygen
Vital organs may not function properly or fail completely
Medical emergency
Hospital care
Signs:
Fever
Elevated breathing
Elevated heart rate
Dizziness
Psychogenic: Temporary condition; will correct itself as soon as vascular control returns to normal; individual will regain consciousness
Septic: severe infections, germs make harmful toxins that can cause fluid to leak from blood vessels out into tissues. The toxins may also prevent the heart from beating strongly enough. Together, these reactions lower blood pressure. If blood pressure gets too low the body and its organs bbecome deprived or oxygen

13. Signs and Symptoms Restlessness and anxiety Weak and rapid pulse
Cold and clammy skin
Profuse sweating
Face that becomes pale and my eventually become cyanotic (blue) around the mouth
Shallow respirations
Dull, lusterless eyes with dilated pupils
Thirst
Nausea and vomiting
Blood pressure that falls gradually and steadily
Loss of consciousness

14. Treatment for Shock
Maintain a clear airway so breathing is not impaired
Control all bleeding
Elevate extremities 12 inches to help control swelling
Splint fractures and elevate if well stabilized
Avoid rough and excessive handling that my cause additional injury
Prevent loss of body heat; blanket should be placed under victim as well as on top

15. Treatment for Shock Keep victim in supine position
Do not give victim anything to eat or drink
Record vital signs (pulse, blood pressure, respiration rate) every 5 minutes
Constantly reassure victim; keeping victim calm minimizes effects of shock
Activate EMS; call 911 immediately
Person complaining of chest pain may be more comfortable in a semi-reclining position
Any ingestion bay cause choking or vomiting which can cause additional problems
Give vitals to EMS personnel