Bleeding
Bleeding (Basic)
Information Covered:
- Pathophysiology
- Type of Traumatic Bleeding
- Internal
- External
- Arterial
- Bright red bleeding “spurting”
- Difficult to control, due to size of vessels, volume of blood, and pressure that blood is pushed through arteries
- As blood pressure drops, amount of spurting blood drops
- Venous
- Darker red blood can vary from slow to severe stream, depending on size of vein
- Can be difficult to control, but easier to control than arterial bleeds
- Bleeding can be profuse and life-threatening
- Capillary – blood oozes from wound
- Usually easy to control or stop without intervention
- Clots spontaneously
- Severity – Related to
- Volume of blood loss
- Rate of blood loss
- Age and pre-existing health of patient
- Physiological Response to Bleeding
- Clotting and clotting disorders
- Factors that affect clotting
- Movement of injured area
- Body temperature
- Medications
- Removal of bandages
- Localized vasoconstriction
- Type of Traumatic Bleeding
- General Assessment
- Mechanism of Injury
- Primary Survey
- Identify and manage life threats related to bleeding
- Mental status
- Physical Exam
- Blood pressure is not a reliable indicator of early shock
- Lung sounds
- Peripheral perfusion
- Skin parameters
- History – Pre-Existing Illnesses
- Pediatric Considerations
- Vital sign variations
- Total fluid volume less than adults
- Geriatric Considerations
- Management Strategies
- Body Substance Isolation
- Airway Patency – May be obstructed if unconscious
- Oxygenation and Ventilation
- Pulse oximetry
- Apply oxygen
- Internal and External Bleeding Control
- External bleeding
- Direct pressure
- application of even pressure to an open injury that includes the area just proximal and distal to the injury
- using a gloved hand and dressings, the wound is covered and firm pressure applied until bleeding is controlled
- usually effective in capillary and minor venous bleeding
- in cases of heavier bleeding or major wounds, multiple dressings may be necessary; do not remove existing dressings but apply additional dressings on top of existing dressings in cases of continuing hemorrhage
- Splints
- soft
- rigid
- traction splint
- pressure splints
- Tourniquet – if severe bleeding is not controlled by direct pressure
- Signs and symptoms – bleeding may not slow after much blood loss
- some patients may be quiet and calm due to excessive blood loss
- the amount of blood at the scene does not always estimating the amount of blood loss by the size of a blood pool or the amount on clothing is not accurate
- assess for signs and symptoms of shock
- Direct pressure
- Internal bleeding
- Definition/description
- any bleeding in a cavity or space inside the body.
- internal bleeding can be severe and life threatening.
- may initially go undetected without proper assessment (mechanism of injury, signs, and symptoms)
- Signs and symptoms
- guarding, tenderness, deformity, discoloration of the affected area
- coughing up blood, blood in urine, rectal bleeding
- abdominal tenderness, guarding, rigidity, distention
- bleeding from a body orifice.
- signs of shock
- Definition/description
- External bleeding
- Stabilize Body Temperature
- Psychological Support
- Transport Considerations
- Trauma center
- Aeromedical transport
- ALS mutual aid
Content Creator: Josh Renolds
CAPCE Course Number: 20-EMTP-F3-2103
Total CE Hours: 1
Level: Basic
NJ Course Number: 1279253604365
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.