chapter 26: bleeding

heart, brain, spinal tissue can go w/o blood for _

4-6 mins

lungs can go w/o blood for

15-20 mins

kidneys can go w/o blood for

45 mins

skeletal muscle can go w/o blood for

2-3 hrs

when do you have inc resistance to hypoperfusion

when temp <98.6F

compensated shock after _ blood lost

20%

decompensated shock after _ blood lost

30-40%

infants go into shock after _ mL of blood loss

100-200

arterial bleeding

brighter red, spurts in time w/ pulse (high flow in arteries → blood lost faster)

venous bleeding

dark red (low O2); more likely to clot spontaneously

capillary bleeding

dark red, oozes steadily + slow (superficial cuts); MOST likely to clot spontaneously

how long does it normally take for bleeding to stop on its own

10 mins

what causes bleeding to stop on its own

vasoconstriction (epinephrine), thrombocytes + clotting factors

internal bleeding S/S

swelling, distention, bleeding into chest cavity/lung → dyspnea + hemoptysis (coughing up blood), hematoma, ecchymosis (bruise), hematuria, hematemesis, melena, nonmenstraual vaginal bleeding

direct pressure

fingertip pressure (gloved hand), direct pressure w/ bulky dressing on top of impaled object

hemostatic agent

chemical compound that slows/stops bleeding by assisting w/ clot formation

types of hemostatic agents

granular, gauze impregnated w/ clay substance

tourniquet

should NOT be on a joint; should NOT be narrow material; place padding under tourniquet; should NOT have bandage over; should NOT be loosened until at hospital

splints (2)

air splints, rigid splints

air splints

can control internal/extneral bleeding associated w/ severe injuries

rigid splints

immobilize fractures, prevent further soft tissue damage

epistaxis/nosebleed

can usually be controlled by pinching nostrils tgt; have pt sit up + tilt head slightly forward (prevent from swallowing blood)

bleeding from nose/ears following head trauma can indicate

skull fracture

treatment for bleeding from nose/ears following head trauma

do NOT attempt to stop blood flow, loosely cover bleeding site w/ sterile gauze pad, target/halo shaped stain indicates CSF

emergency medical care for internal bleeding

keep pt calm, reassured, quiet (restless from compensated shock); treat for shock

what should you never use a tourniquet on

closed, internal, soft tissue injuries