Chapter 27 - Bleeding and Shock

Blood that has been depleted of oxygen and loaded with carbon dioxide and other wastes empties into the , which carry it back to the heart?

Veins

Cells and tissues of the brain, spinal cord, and _ are the most sensitive to inadequate perfusion?

Kidneys

Your 26 year old male patient was stabbed multiple times in a bar fight. Police are on the scene, and it is now safe for you to begin your assessment and treatment. The use of _ is essential whenever bleeding is discovered or simply anticipated?

Standard precaution

The blood has several functions. Carrying substances such as hormones, salt, and enzymes that control the body's function is referred to as:

Regulation

Finding arterial bleeding quickly is very important in assessing a patient such as the one described in question 3. Which statement about arterial bleeding is correct?

Arterial bleeding is often rapid and profuse

Your 38 year old female patient has sustained an injury to her right lower leg. There is a steady flow of dark red maroon blood, which is most likely a result of _ bleeding?

Venous

Your 22 year old male patient has a large area of road rash from sliding along in the highway when he laid down his motorcycle. Bleeding described as oozing is usually a result of bleeding?

Capillary

You are treating a 58 year old male whose throat was slashed by an attacker standing behind him during a street hold up. When a large bleeding vein in the neck sucks in an air bubble, or embolism, this can cause:

Heart stoppage

A sudden loss of _ of blood in a 33 year old adult is considered serious:

1,000 cc

A sudden loss of of blood in a 7 year old child is considered serious:

500 cc

A sudden loss of __of blood in a 1 year old infant is considered serious:

150 cc

When a patient cuts a blood vessel, the body attempts to protect the patient even before a bandage is applied. The body's natural response to bleeding are constriction of the injured blood vessel and:

Clotting

You are treating a 19 year old female who experienced a series of lacerations. Your assessment of external bleeding includes all of the following except:

Waiting for signs and symptoms of shock to appear before beginning treatment

The major methods that are used to control external extremity bleeding include all of the following except:

Vessel clamps

Why is administration of supplemental oxygen an important treatment for trauma patient?

It improves oxygenation of the tissues

You are treating a 28 year old female who sustained several deep lacerations when she fell off her scooter and was thrown into a guardrail. The most common and effective way to control severe external extremity bleeding is by:

Tourniquet

The patient has already bled through a small pile of gauze pads. You will be applying some additional sterile pads to the injury. The initial layer of dressing should not be removed from a bleeding wound because it:

Is a necessary part of clot formation

After controlling bleeding from an extremity using a bandaged pressure dressing, be sure to:

Check the distal pulse

Elevation is used to assist in minor/moderate bleeding control for all of the following reasons except that it:

Speeds up the pulse rate

When is it inappropriate to use elevation to assist in bleeding control?

If you suspect musculoskeletal injuries

A 39 year old female, who was dressing the mannequins in a clotting store display, fell through the store window and has sustained a large cut. Blood is flowing from her forehead. What method of bleeding control should you use?

Direct pressure with a dressing and bandage should work

You are treating a 22 year old male who has a deep laceration that is continuing to bleed. Use of direct pressure may not be effective if the wound:

Involves a profusely bleeding artery

You are going to use an air splint to manage the bleeding on the lower leg of a 22 year old male patient. Which of the following is true about the use of an air splint?

It is effective for controlling venous and capillary bleeding

Which of the following is not a guideline for supplemental bleeding control with cold application?

Pour ice chips directly into the open skin

When attempting to control a deep laceration across the entire right buttock of a 22 year old ski racer, you note that the cut goes down to the bone and will not stop bleeding. The best treatment would be to utilize __ while beginning to transport the patient by MEDEVAC to the regional trauma center:

Hemostatic gauze into wound

Your are treating a 29 year old female factory worker who was involved in an accident in which a machine has amputated her right forearm. Bleeding from a clean- edged amputation is usually cared for initially with:

A pressure dressing

Rough-edged amputations, usually produced by crushing or tearing injuries:

Often bleed very heavily

You have decided that the most appropriate method of bleeding control for your patient is to apply a tourniquet. Once a tourniquet is in place, it must:

Not be removed or loosen unless ordered by medical direction

Your 35 year old male patient has severe bleeding from a large laceration on his right forearm. You tired direct pressure, and it did not work. A blood pressure cuff:

Can be used as a temporary tourniquet if it is inflated to 150 mmHg

Your 20 year old female patient fell off her mountain bike and has a head injury. If you note bleeding or leakage of cerebrospinal fluid (CSF) from the patient's ears and nose, you should:

Allow the drainage to flow freely

You treating a 58 year old male who has had a nosebleed for the last hour. The medical term for nosebleed is:

Epistaxis

You are treating a 59 year old female patient who called the ambulance because her nose has been bleeding for quite a while. To stop or control a nose bleed, try each of the following except:

Applying cold packs to the bridge of the nose and face

The leading cause of internal injuries and bleeding is:

Blunt trauma

Which of the following is not an example of a penetrating trauma?

A blast injury

After interviewing a 52 year old male patient, you suspect that he may have internal bleeding. Signs of internal bleeding include all of the following except:

Bradycardia and a flushed face

A 28 year old male patient fell off the roof of a two story house and landed on a pile of firewood. You suspect that he has sustained an injury that is caused internal bleeding. Internal bleeding may be signaled by all of the following except:

A laceration to the forearm

Because if internal bleeding, the patient is developing inadequate tissue perfusion. This condition is referred to as:

Hypoperfusion

You suspect that your patient may be going into shock. Shock may develop as a result of all of the following except:

An injury to the head

The type of shock that is most commonly seen by EMTs is_ shock?

Hypovolemic

The most common mechanism of shock for a heart attack patient is:

Pump failure

Your patient was involved in an automobile crash, and it took all night to find her vehicle. She is unable to move her lower extremities, and you suspect that she is in shock. Shock caused by the failure of the nervous system to control the diameter of blood vessels is called shock?

Neurogenic

Your 46 year old male patient is in shock, yet his body is still able to maintain perfusion to his vital organs, and his systolic BP is still 120 mmHg. This is often referred to as _ shock?

Compensated

Early signs of shock that are actually the body's compensating mechanism include all of the following except:

Decreased capillary refill time in children

Your patient with severe internal bleeding is struggling to deal with the blood loss. When the body has lost the battle to maintain perfusion to the organ systems and systolic BP begins to drop, the patient is experiencing _shock?

Decompensated

You are treating a 45 year old female patient who has sustained considerable blood loss after slicing her hand while preparing food. She she states that she feels nauseated. What is causing this symptom of feeling nauseated?

Blood is diverted from the digestive system

The pulse of the patient in question 45 will likely:

Increase

The patient in question 45 has a drop in her systolic blood pressure. This is:

A late sign of shock

When you suspect that a patient is in shock, additional signs may include any of the following except:

Flushed, warm skin

Your patient is a 9 year old male who fell off his skateboard and has numerous injuries to both of his legs. You should be especially careful when evaluating pediatric patients for shock because children:

May display few signs until a large percentage of blood volume is lost

EMTs often encounter patients who are in shock. Which of the following types of shock is rarely seen in the field by the EMT:

Neurogenic shock