bleeding.ppt
- 1. Anatomy of the Cardiovascular System • The cardiovascular system is responsible for supplying and maintaining adequate blood supply flow. • Consists of three parts: – Heart (pump) – Blood vessels (container) – Blood and body fluids (fluids)
- 2. The Heart Right Side Left Side
- 3. Blood Vessels • Arteries • Arterioles • Capillaries • Venules • Veins
- 4. Blood • Contains: – Red blood cells – White blood cells – Platelets – Plasma
- 5. Perfusion (1 of 2) • Circulation within tissues in adequate amounts to meet the cells’ needs for oxygen, nutrients, and waste removal • Some tissues and organs need a constant supply of blood while others can survive on very little when at rest.
- 6. Perfusion (2 of 2) • The heart demands a constant supply of blood. • The brain and spinal cord can survive for 4 to 6 minutes without perfusion. • The kidneys may survive 45 minutes. • The skeletal muscles may last 2 hours.
- 7. External Bleeding • Hemorrhage = bleeding • Body cannot tolerate greater than 20% blood loss. • Blood loss of 1 L can be dangerous in adults; in children, loss of 100-200 mL is serious.
- 8. The Significance of Bleeding • The body will not tolerate an acute blood loss of greater than 20% of the blood volume. • In the typical adult, 20% is 1 liter or 2 pints. • A 1-year-old infant typically has 800 mL. A loss of 200 mL is significant.
- 9. Conditions With Possible Serious Bleeding • Significant mechanism of injury • Poor general appearance of patient • Assessment reveals signs of shock • Significant amount of blood loss noted • Blood loss is rapid. • You cannot control external bleeding.
- 10. Characteristics of Bleeding (1 of 2) • Arterial – Blood is bright red and spurts. • Venous – Blood is dark red and does not spurt. • Capillary – Blood oozes out and is controlled easily.
- 11. Characteristics of Bleeding (2 of 2)
- 12. Blood Clotting • Bleeding normally stops within 10 minutes. • Some medications interfere with clotting. • Some injuries will be unable to clot. • Patients with hemophilia lack clotting factors.
- 13. Controlling External Bleeding • Follow BSI precautions. • Ensure patient has an open airway and adequate breathing. • Provide oxygen if necessary. • There are several methods to control bleeding.
- 14. Direct Pressure and Elevation • Direct pressure is the most common and effective way to control bleeding. • Apply pressure with gloved finger or hand. • Elevating a bleeding extremity often stops venous bleeding. • Use both direct pressure and elevation whenever possible. • Apply a pressure dressing.
- 15. Pressure Points • If bleeding continues, apply pressure on pressure point. • Pressure points are located where a blood vessel lies near a bone. • Be familiar with the location of pressure points.
- 16. Location of Pressure Points
- 17. Splints • Splints can help control bleeding associated with a fracture. • Air splints can be used to control bleeding of soft-tissue injuries.
- 18. Applying a Tourniquet • Fold a triangular bandage into 4˝ cravat. • Wrap the bandage. • Use a stick as a handle to twist and secure the stick. • Write “TK” and time. Place on patient.
- 19. Tourniquet Precautions • Place as close to injury as possible, but not over joint. • Never use narrow material. • Use wide padding under the tourniquet. • Never cover a tourniquet with a bandage. • Do not loosen the tourniquet once applied.
- 20. Bleeding from the Nose, Ears, and Mouth • Causes: – Skull fractures – Facial injuries – Sinusitis – High blood pressure – Coagulation disorders – Digital trauma
- 21. Controlling a Nosebleed • Follow BSI precautions. • Help the patient sit and lean forward. • Apply direct pressure by pinching the patient’s nostrils. – Or place a piece of gauze bandage under the patient’s upper lip and gum. • Apply ice over the nose. • Provide transport.
- 22. Bleeding from Skull Fractures • Do not attempt to stop the blood flow. • Loosely cover bleeding site with sterile gauze. • If cerebrospinal fluid is present, a target (or halo) sign will be apparent.
- 23. Internal Bleeding • Internal bleeding may not be readily apparent. • Assess patient’s: – Mechanism of injury – Nature of illness
- 24. Signs and Symptoms of Internal Bleeding (1 of 2) • Ecchymosis: Bruising • Hematoma: Bleeding beneath the skin • Hematemesis: Blood in vomit • Melena: Black, tarry stool
- 25. Signs and Symptoms of Internal Bleeding (2 of 2) • Hemoptysis: Coughing up blood • Pain, tenderness, bruising, guarding, or swelling • Broken ribs, bruises over the lower chest, or rigid, distended abdomen
- 26. Signs of Hypoperfusion • Change in mental status • Tachycardia • Weakness • Thirst • Nausea or vomiting • Cold, moist skin • Shallow, rapid breathing • Dull eyes • Dilated pupils • Weak, rapid pulse • Decreased blood pressure • Altered level of consciousness
- 27. Emergency Medical Care • Follow BSI precautions. • Maintain airway and administer oxygen. • Control external bleeding and care for any internal bleeding. • Monitor and record vital signs. • Elevate legs and keep patient warm. • Transport immediately.