Chapter 25: Bleeding

What is the largest artery in the body?

The aorta

What is perfusion?

Circulation of blood within an organ or tissue to allow it to meet the cells’ current needs for oxygen, nutrients, and waste removal

What is a hemorrhage?

Bleeding

What is an adult’s normal total blood volume?

9-10 pints / 5 to 5.5 L

What is the maximum amount of blood loss the body can take?

20% of the total blood volume

What does arterial bleeding look like?

Oxygen rich and spurts in time with the pulse

What does venous bleeding usually look like?

Darker and can flow slowly or rapidly

What does capillary bleeding usually look like?

Dark red and oozes from the wound

How long does it take for minor bleeding to cease?

Approx 10 minutes

If a patient has hemophilia, what does it mean?

They lack one or more of the blood’s clotting factors

How much blood loss can a broken femur cause?

2 pints / 1 L

What are the proper names for bruising?

Contusion or ecchymosis

What does DCAP-BTLS stand for?

D: Deformities

C: Contusions

A: Abrasions

P: Punctures / penetrations

B: Burns

T: Tenderness

L: Lacerations

S: Swelling

Internal bleeding signs and symptoms?

Abdominal tenderness, guarding, rigidity, pain, distention, hematemesis (vomiting of blood), blood diarrhea, melena, or vomitus that resembles coffee grounds

What is hemoptysis?

The coughing up of bright red bloodW

What is a hematoma?

Mass of blood that has collected in the soft tissues beneath the skin, indicates bleeding into soft tissues and may be the result of a minor or severe injury

Signs and symptoms of internal bleeding in trauma

Hematemesis, melena, pain tenderness bruising guarding or swelling, broken ribs bruises over the lower part of the chest, rigid distended abdomen

Later signs of hypovolemic shock that suggest internal bleeding

Tachycardia, weakness, fainting, dizziness at rest, thirst, nausea, vomiting, cold moist clammy skin, shallow rapid breathing, dull eyes, slightly dilated pupils that are slow to respond to light, cap refill of over 2 seconds, weak rapid/thready pulse, dec bp, altered level of consciousness

According to the book, how far should you apply a tourniquet to the bleeding?

2-3 inches proximal to the bleeding

What type of gauze is preferred when packing a wound?

Hemostatic

What is a junctional tourniquet and how is it used?

It allows for compression of life-threatening bleeding in areas where standard tourniquet application isn’t possible (groin or axilla (armpit/underarm))

What is a pelvic binder?

A type of splint that may be indicated for a suspected unstable closed pelvic fracture

Stabilizes pelvic injuries

Specifically stops bleeding associated with a life-threatening open-book pelvic fracture

What is an open-book pelvic fracture?

Pelvic ring splits apart, looks like an open book

What can cause bleeding from the nose, ears, and/or mouth?

Basal skull fracture

Facial injuries

Sinusitis and infections

Use of nose drops or drugs

Expose to dry air that causes the mucosal membrane to dry out

High bp

Coagulation disorders/anticoagulant medication

Nose picking

Cancer