ch 26 bleeding overview

These flashcards cover vocabulary related to the circulatory system and specific medical conditions regarding blood and bleeding.

Aorta

Main artery that receives blood from the left ventricle and delivers it to all the other arteries that carry blood to the tissues of the body.

Arterioles

The smallest branches of arteries leading to the vast network of capillaries.

Artery

A blood vessel, consisting of three layers of tissue and smooth muscle that carries blood away from the heart.

Capillaries

Small blood vessels that connect arterioles and venules; various substances pass through capillary walls into and out of the interstitial fluid.

• diameter of a single red blood cell

Coagulation

The formation of clots to plug openings in injured blood vessels and stop blood flow.

Contusion

A bruise from an injury that causes bleeding beneath the skin without breaking the skin.

Ecchymosis

Build-up of blood beneath the skin that produces a characteristic blue or black discoloration as a result of an injury.

Epistaxis

Nosebleed.

Hematemesis

Vomited blood.

Hematoma

Massive blood collected with damaged tissue beneath the skin or in a body cavity.

Hematuria

Blood in the urine.

Hemophilia

A hereditary condition in which the person lacks one or more of the blood's normal clotting factors.

Hemorrhage

Bleeding.

Hemostatic dressing

A dressing impregnated with a chemical compound that slows or stops bleeding by assisting with clot formation.

Hypoperfusion

A condition in which the circulatory system fails to provide sufficient circulation to obtain normal cellular functions; also called shock.

Hypovolemic shock

A condition in which low blood volume results in inadequate perfusion.

Junctional tourniquet

A device that provides proximal compression of severe bleeding near the axial or inguinal junction of the torso.

Melena

Black, foul-smelling, tarry stool containing digested blood.

Open-book pelvic fracture

Fracture of the pelvis caused by force that displaces one or both sides of the pelvis laterally and posteriorly.

Pelvic binder

A device to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption, and pain.

Perfusion

Circulation of blood within an organ or tissue in adequate amounts to meet those current needs.

Shock

A condition in which the circulatory system fails to provide sufficient circulation to maintain normal cellular functions.

Tourniquet

A bleeding control method used when a wound continues to bleed despite the use of direct pressure.

Veins

Blood vessels that carry blood from the tissues to the heart.

Venules

Very small thin-walled blood vessels.

Hemoptysis

coughing of bright red blood

The cardiovascular system contains three main parts

•  working pump(heart)

•  a container (blood vessels)

• Fluid (oxygen-carrying blood)

Hypoperfusion or shock occurs when what doesnt occur?

Shock happens when one of these three is not working properly and the cardiovascular system fails to provide adequate perfusion

• Heart

• Blood vessels

• blood

Ask the patient WHAT if they take what kind of medication that can hinder bleeding control.

 ask if they're taking any blood thinners like aspirin or warfarin as these are blood-thinners

The method to control bleeding, in order, are:

• Direct pressure

• Pressure Dressing

• Tourniquet

• Splinting device

Blood flows out of the heart and into the ___, 

Aorta

Arteries become smaller the more distal its from the heart, what connect the arteries and capillaries together?

 The arterioles connect the arteries and capillaries together

Platelets are the key to the formation of blood clots.  

blood clots are an important response from the body to control blood loss. 

 the blood's ability to clot depends on several factors

• blood stasis

•  changes in the blood vessel wall such as a wound

•  and the blood's ability to clot which can be affected by disease processes or medications

The autonomic nervous system monitors the body's needs and adjust the blood flow by constricting or dilating blood vessels as required, what is the emergency response the ANS does?

• during an emergency the autonomic nervous system automatically we direct blood away from the organs to the heart brain lungs and kidneys

 Notes: if blood volume is significantly diminished and there is insufficient circulation for everybody part the performance function then shock will occur

Critical organs and corresponding organ systems: The Heart

 cardiovascular system

Critical organs and corresponding organ systems: Brain

Central nervous system

Critical organs and corresponding organ systems: The Lungs

 respiratory system

Critical organs and corresponding organ systems: Kidneys

 Renal system

The typical adult male body contains approximately __ 

70 mL of blood per kilo of body weight

The typical adult female body contains approximately __ 

65 mL of blood per kilo of body weight

The typical 1 year old body contains approximately __ 

27 oz (800 mL approximate)

Children will show significant symptoms of blood loss after losing ___ ____

3 to 6 oz (100 to 200 mL) 

• For scaling, its like half a soda can

The adult body will not tolerate a blood loss greater than ________

20% of blood volume, so about 1 L

Serious conditions that come with bleeding:

• Significant MOI

• Patient has a poor general appearance and is calm.

• Signs and symptoms of shock

• Significant blood loss

• Rapid blood loss 

• Uncontrollable bleeding

Characteristic of External Bleeding: Arterial

• Pressure causes blood to spurt and makes bleeding difficult to control.

• Typically brighter red and spurts in time with the pulse

Characteristic of External Bleeding: Venous

• Dark red, flows slowly or rapidly depending on the size of the vein

• Does not spurt and is easier to manage

Characteristic of External Bleeding: Capillary

• Bleeding from damaged capillary vessels

• Dark red, oozes steadily but slowly

On its own, bleeding tends to stop after __ _____.

10 minutes

For patients with hemophilia:

• Bleeding may occur spontaneously.

• All injuries, no matter how trivial, are potentially serious.

• Patients should be transported immediately.

Internal bleeding is very serious because it is not easy to detect immediately

• For organs, laceration or ruptures can quickly develop into hypovolemic shock

• Broken bones can cause life threatening hemorrhage

Possible conditions causing internal bleeding:

• Stomach ulcer 

• Lacerated liver 

• Ruptured spleen 

• Broken bones

What is D in DCAP-BTLS

Deformities: Any abnormal or misshapen parts of the body, such as a broken bone that is at an extreme angle

What is C in DCAP-BTLS

Contusions: Bruises, which are discolorations caused by bleeding under the skin. 

What is A in DCAP-BTLS

Abrasions: Scrapes or scratches where the outermost layer of skin is removed. 

What is P in DCAP-BTLS

Punctures/Penetrations: Wounds made by an object piercing the skin, like a stab wound. 

What is B in DCAP-BTLS

Burns: Injuries caused by heat, chemicals, electricity, or radiation. 

What is T in DCAP-BTLS

Tenderness: Pain or discomfort that occurs when a specific area is touched. 

What is L in DCAP-BTLS

Lacerations: Cuts or tears in the skin. 

What is S in DCAP-BTLS

Swelling: An abnormal enlargement of a body part. 

Internal bleeding is possible whenever the MOI suggests that severe forces affected the body.

• Blunt trauma

• Penetrating trauma

High-energy MOI should increase what?

Should increase your index of suspicion for serious unseen injuries

Nontraumatic causes include:

• Bleeding ulcers

• Bleeding from colon

• Ruptured ectopic pregnancy

• Aneurysms

Signs and Symptoms of Internal Bleeding pt 1

• Pain (most common) 

• Abdominal distension

• Hematuria

• Swelling in the area of bleeding

• Dyspnea, tachycardia, hypotensio

• Hematemesis

• Bruising

Signs and Symptoms of Internal Bleeding pt 2

• Hematoma

• Bleeding from any body opening

• Hematemesis

• Melena

• Pain, tenderness, bruising, guarding, or swelling

• Broken ribs

• Bruises over the lower part of the chest

• Rigid, distended abdomen

What are signs that imply rapid transport?

• Tachycardia or tachypnea

• Low blood pressure

• Weak pulse

• Clammy skin

Blood thinners meds are common for patients with a history of

• Stroke

• Pulmonary embolism

• Or MCI

Common blood thinners:

• Aspirin

• Clopidogrel (Plavix)

• Ticagrelor (Brilinta

Anticoagulants:

• Warfarin (Coumadin)

• Rivaroxaban (Xarelto)

• Dabigatran (Pradaxa)

• Apixaban (Eliquis)

If bleeding a present at the nose and a skull fracture is suspected, you should:

 place a gauze pad Loosely under the nose

Bleeding from the nose is present and a skull fracture is not suspected, you should:

pinch both nostrils together for 15 minutes. If the patient is awake and has a patent Airway, place the gauze pad inside the upper lip against the gum.