Bleeding
What are the three roles of blood in the body?
1. protects against disease
2. maintains body temp
3. transports O2, nutrients, and waste
What three conditions must be present to maintain normal blood flow with adequate o2?
1. heart functioning properly
2. adequate amounts of blood volume
3. intact blood vessels that can regulate blood flow
What is the most common cause of shock?
hypovolemic
What is the difference between the dermis and the epidermis?
epidermis = barrier for bacteria and organisms, regulates body temp
dermis = contains nerves, sweat, oil glands, blood vessels
What is the highest temperature your sin can take?
113 degrees
What three organs does blood get shunted to in a hemorrhagic emergency?
heart, kidneys, brain
What are the stages of shock?
1. pre shock / compensated shock - body's compensation to vital organs needing blood
2. uncompensated shock - vital organs are maintained
3. reperfusion - tissues without O2 get O2 from vital organs
4. multiple organ failure
5. death
How do you treat anaphylactic shock?
epinephrine
What are the four types of open wounds?
abrasions, lacerations, punctures, avulsions/amputations
Explain the three degrees of burns.
first degree - superficial: skin on top is red; turns white when touched, mild pain & swelling, HAIR IS STILL PRESENT, heals quick without scars
second degree - partial thickness: some blisters; wet/dry skin, may or may not be painful, swelling, weeping fluids, HAIR IS GONE, longer healing with possible scars
third degree - full thickness: all the way through the layers of skin; no pain or extremely painful, skin is leathery/waxy/gray/charred, purple color, NO CAP REFILL, scarring, up to 6 months to heal
Explain the difference between arterial and venous bleeding.
arterial = bright red blood, spurting out off wound, rapid, and harder to control
venous = dark red almost brown blood, slower, steady rate
What are the bodys responses to a severe illness or injury?
1. hormone response to constrict vessels and increase HR to increase cardiac output
2. urine output decreases and thirst is signaled
3. catecholamines are released for fight or flight
4. respiratory rate increases to offset metabolic acidosis (increased CO2 in blood)
5. mental status changes due to low o2
What are three types of shock?
hypovolemic, obstructive, distributive (anaphylactic, neurogenic, septic), cardiogenic, hypoglycemic/metabolic, psychogenic, respiratory
When would you need stitches for a wound?
if you can't approximate the edges, if its a facial wound, if its over 1/2 inch long, if its over 1/4 inch deep
What are key signs of respiratory involvement in burns?
burns around mouth, nose, or face
airway closure from swelling
hoarse voice
circumferential burns around chest
What are the steps for caring for external bleeding?
1. body substance isolation (PPE)
2. expose wound
3. place sterile gauze over wound
4. direct pressure; add additional gauze
5. elevate above heart unless fx is suspected
6. pressure at pressure point
7. tourniquet or hemostatic agent
8. place roller gauze on once bleeding has stopped
What is the cycle of shock?
1. blood/fluid loss - heart rate and respiratory rate increases because it needs more o2
2. vital organs need o2 so blood vessels in non-vital organs constrict which causes these tissues to start dying which leads to blood being returned to extremities 3. vital organs are now left without o2 blood, the brain is affected which decreases LOC which leads to more tissue death and the cycle continues
How do you treat shock?
treat cause of shock
maintain body temp (check vitals)
if face is red raise the head; if face is pale raise the tail
When would you seek medical attention for a closed wound?
if there is significant pain, they cannot move the body part, or extreme force present
What is the rule of 9s?
every area of your body is 9%
- head = 9%
- 1 arm front and back = 9%
- chest = 9%
- upper back = 9%
- lower back = 9%
- front of 1 leg = 9%
- back of 1 leg = 9%
- genitals = 1%
What are some signs and symptoms of hemorrhage?
ecchymosis, tender/swollen/hardened tissue, anxiety/restlessness, rapid breathing, rapid heart rate, pale/cool/clamy skin, nausea, hematuria, declining LOC, shock
late signs of internal hemorrhage = dizziness, headache, seizures, swelling, pain in extremities or abdomen, Kehrs sign, McBurneys point, hematemesis, hemoptysis, fresh blood in stool (hematochezia)
What are the symptoms of shock?
anxious, irritability, lower body temp, rapid breathing, elevated pulse, pale/clammy skin, diaphoresis
late signs = listlessness, confusion, irregular breathing, decreased BP, rapid & irregular pulse, nausea & vomiting, low body temp, changes in LOC, dilated pupils
What are the red flags for recognizing shock?
urine output is less than 0.5 mL/kg/h - kidney function
lactate is greater than 3 mmol/L - hypoxic tissues which leads to sepsis
base deficit is less than -4 mEq/L - arterial gases get in blood
PaCO2 is less than 32 mm Hg - partial pressure of CO2 which means there is increased CO2 in blood
How would you care for an amputated body part?
control the bleeding and care for the wound
wrap severed part in a moist, sterile dressing and place in a plastic bag to seal it
place sealed bag in another bag or container with ice slurry
give the bag to EMS with the patients name, date, time, and place
What is considered a critical burn?
burns around face or any burns causing dyspnea
burns to head, neck, genitals, hands or feet, or covering more than 1 body part
2nd or 3rd degree burns to children or elderly
electrical, chemical, or explosion burns
hot grease, flames, or melted material