Bleeding And ShockAState出血与休克状态焦虑文档资料.ppt

Sources of External Bleeding,ArteriesVeinsCapillaries,Arterial Bleeding,Most serious/arteries are usually deep in the bodyRapid and profuse blood lossBright red/spurtsLess likely to clotMust use external means to stop blood flow,Venous Bleeding,Steady flow/bluish-redMay be profuseMore easily controlledVeins are closer to the body surfaceCan be serious,Capillary Bleeding,Easily controlledBlood oozesRoad rash,Blood Vessel Spasm,Severed arteriesArtery draws back into the tissueArtery constricts and slows bleedingPartially severed arteriesAssociated with greater blood lossExample:amputations,Definitions,Hemorrhage:Rapid blood lossAdult:1 quart may lead to shockChild:1 pint loss of bloodDressingA protective covering for a wound p.150BandageA material used to hold a dressing in place,Dressings,Used to control bleeding Prevents contaminationDressings should be:SterileLarger than the woundThick,soft,compressibleLint free(no cotton balls),Types of Dressings,Gauze padsAdhesive stripsTrauma dressingsImproviseDonut shaped,Dressings,ApplicationWash handsDressing should extend over edges of woundDo not touch dressing surface that is to be next to the woundPlace medications directly onto padCover with a bandageRemoval of DressingsSoak“stuck”dressing in warm water,Bandages Are Used For:,Holding dressings in placeApplying pressurePrevent or reduce swellingProvide support or stability,Application of Bandages,Leave toes and fingers exposed if possibleBandage too tight?Check for color,circulation,temperatureWrap towards the heartSmall end of bone to large end,Types of Bandages,Roller gauzeImprovisedTriangularCravatAdhesive/paper tapeAdhesive stripsP.150-152,Tourniquets,Rarely recommendedDamages nerves and vessels,Types of Wounds And Application of Bandages And Dressings Will Be Addressed Later,Someone Has Cut Their Leg:What Should You Do?(external bleeding/depends on severity),Call for help when necessaryProtect yourself from bodily fluidsExpose the woundApply sterile gauze pad(dressing)Apply constant,direct pressure for 10 minutes(dont peak),Cut Leg,If dressing becomes blood soaked do not remove dressing,add others over itAfter 10 minutes,if bleeding persistsapply pressure harder and over a wider area for 10 more minutes(seek help),Additional Options,Elevate limb above heart levelApply pressure at a pressure pointWhen bleeding stops:Apply pressure bandage(roller gauze)Wrap towards the heart,Problem Bleeders,HemophiliacsAspirin,When Not To Apply Direct Pressure,Protruding boneSkull fractureEmbedded objectMay use a donut shaped pad,Internal Bleeding,Look for abdominal:PainTendernessRigidityBruises,Internal Bleeding,Look for:Black stoolsBright red stoolsCough or vomit with bloodFractured ribs or bruises,Internal Bleeding:What To Do,Monitor ABCsLay on side if appropriate(expect vomiting)Treat for shockRaise legs 8-12 inches(if conscious)Cover victim Bruises:Ice,ace wrap,elevate,Shock,Occurs when the circulatory system failsResulting in inadequate blood flow to some part of the bodyA MAJOR CAUSE OF DEATH!,Shock#2,Always treat injured victims for shockShock:can be preventedcannot be reversed,Types of Shock,CardiogenicHeart fails to pump sufficient blood supply,Types of Shock,NeurogenicSpinal cord damageDrug overdoseVessels dilateBlood supply insufficient to fill vessels,Types of Shock#2,SepticResult of a bacterial infectionVessels lose ability to contract,Types of Shock#3,Hypovolemic(Fluid Loss)Most common typeBlood lossDehydration from vomiting,diarrhea or profuse sweating,Shock:What To Look For,Pale,cold,clammy skinAltered mental statusRapid breathing and pulseUnresponsivenessNausea and vomiting,Shock:What To Do,First,care for life threatening injuriesIf the face is red,raise the head,(injuries to upper half of body raise the upper half of body)If the face is pale,raise the tail.(injuries to lower half of body,raise the lower half of the body),Shock:What To Do#2,If conscious and appropriate,place victim on back,raising legs 8-12 inches EXCEPT those needing sitting position(listed on next slide)Cover victim,over and underDo not let victim eat or drinkMay suck on wet cloth,Shock:When To Place In A Half Sitting Position,Difficulty breathingHead injuries(when appropriate)StrokesChest injuriesPenetrating eye injuriesHeart attackUnconsciousness,Anaphylaxis or Anaphylactic Shock,Massive allergic reaction by the bodys immune system,Causes Of Anaphylactic Shock,MedicationsPenicillin and related drugs,aspirin,sulfa drugs,meds and alcoholFoods and food additivesMonosodium glutamate,peanutsPlant pollensBee stingsRadiographic dyes,Characteristics of Anaphylaxis,Usually comes on in minutes/Peaks in 15-30 minutesSensation of warmth Intense itching of soles of feet and palms of handsBreathing difficultiesTightness and swelling in throatCoughing,sneezing,wheezingTightness in chest,Characteristics of Anaphylaxis#2,Increased pulse rateSwollen face,tongue,mouthNausea and vomitingDizzinessBlue around lips and mouth,Anaphylaxis:What To Do,Check ABCsUse ice pack on bee stingInject epinephrine(dilates bronchioles)P.442(hopefully victim will have some)Inject in outside part of thigh,hold for 10 secondsMay need to repeatGet help immediately(float trip)Benedryl too slow for major emergency,but worth a try,