EMS EMT_REF Trauma Part 1

EMS EMT_REF Trauma Part 1 - Bleeding and Shock Circulatory...

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Bleeding and Shock Circulatory (Cardiovascular) System Review Anatomy review Heart Arteries Capillaries Veins Blood Perfusion :circulation of blood through an organ Hypoperfusion is the inadequate circulation of blood through an organ. Inadequate tissue perfusion is shock. External Bleeding Body substance isolation Eye protection Gloves Gown Mask Hand washing following each run
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Types of external bleeding Arterial The blood spurts from the wound. The blood is bright, red, and oxygen rich. Venous The blood flows as a steady stream. The blood is dark and oxygen poor. Capillary The blood oozes from a capillary and is dark red in color. The bleeding often clots spontaneously. Severity General impression of the amount of blood loss. Signs and symptoms of shock (hypoperfusion) The sudden loss of one liter (1000 cc) of blood in the adult patient 1/2 liter (500 cc) of blood in the child 100-200 cc of the blood volume in an infant 30cc (1 ounce) in a newborn is serious. Uncontrolled bleeding or significant blood loss leads to shock (hypoperfusion) and possibly death.
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Emergency medical care of external bleeding Take body substance isolation precautions. Maintain airway/artificial ventilation. Bleeding control Apply direct pressure with a gloved hand directly on the point of bleeding. Elevation of a bleeding extremity Pressure Bandage Pressure points may be used in upper and lower extremities. Methods to control external bleeding if direct pressure fails Splints & Air-pressure splints Tourniquet is a last resort Bleeding from the nose, ears, & mouth Epistaxis (Simple Nosebleed) Place the patient in a sitting position leaning forward. Apply direct pressure by pinching the fleshy portion of the nostrils together. Skull Fracture/Head Injury May cause loss of blood or clear fluid from the nose and ears. Do not stop the flow of fluid. Head injury will not cause signs & symptoms of shock. Vital signs for serious head injury are just the opposite of shock If a patient with a serious head injury presents with signs & symptoms of shock/hypoperfusion look for other injury.
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Internal Bleeding Severity Mechanism of injury Clinical signs and symptoms Internal bleeding can result in severe blood loss with resultant shock (hypoperfusion) and subsequent death. Relationship to mechanism of injury Blunt trauma Falls Motorcycle crashes Pedestrian impacts Automobile collisions Blast injuries Signs and symptoms of internal bleeding Significant mechanism of injury Pain, tenderness, swelling or discoloration (bruising) of suspected site of injury Deformity Swelling, discoloration Bleeding from the mouth, rectum, vagina, or other orifice Tender, rigid, and/or distended abdomen Vomiting of bright red blood or dark coffee-ground-colored blood Dark, tarry stools or stools with bright red blood
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Capillary refill greater than 2 seconds-use with infant and child patients only Dilated pupils Nausea and vomiting Dropping blood pressure (late sign) Emergency medical care Take body substance isolation precautions. Maintain airway/artificial ventilation.
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This note was uploaded on 04/28/2008 for the course HSC HC26 taught by Professor W.lee during the Summer '08 term at Suffolk.

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EMS EMT_REF Trauma Part 1 - Bleeding and Shock Circulatory...

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