Chapter 3 Bleeding and Shock Nabeel AlMawajdeh RN'Mcs

1
Chapter 3 Bleeding and Shock
Nabeel Al-Mawajdeh
RN.Mcs
2
Definitions

• Bleeding (haemorrhage) is abnormal internal or
  
• external loss of blood.
• Homeostasis tendency of the body to maintain a
  
• steady and normal internal environment.
• Shock is inadequate tissues perfusion and is a
  
• considered a transition between homeostasis
  and
• death.
• Nabeel Al-Mawajdeh RN.Mcs

3
Types of External Bleeding

• Arterial Bleeding
• Bright red in color.
• Rapid and profuse, spurting with each heart beat.
• Difficult to control.
• Venous Bleeding
• Dark red.
• Steady flow.
• Easy to control.
• Capillary Bleeding
• Color of blood between dark red and bright red.
• Slow and oozing.
• Very easy to control.
• Nabeel Al-Mawajdeh RN.Mcs

4
External Bleeding

• Signs symptoms
• Spurting/steady flowing or oozing blood.
• Bright red or dark blood.
• Separated or displacement of body part or tissue.
• Signs of shock (hypo perfusion)
• Nabeel Al-Mawajdeh RN.Mcs

5
Emergency Care of External Bleeding

• Assure patent airway.
• Assess the ABCs.
• Control bleeding
• a. Direct pressure (most common and
  effective)
• b. Elevation.
• c. Pressure point.
• d. Splints (using inflatable or air
  splint)
• e. Blood pressure cuff.
• f. Tourniquet (is a last resort)
• Nabeel Al-Mawajdeh RN.Mcs

6
Emergency Care of External Bleeding (Contd)

• Apply dressing and bandage.
• Do not remove impaled objects unless impaled in
  cheek and airway is compromised by the object.
  Secure impaled objects in place.
• Treat for shock if necessary.
• Transport the victim to the nearest hospital.
• Nabeel Al-Mawajdeh RN.Mcs

7
Internal Bleeding

• Signs symptoms
• Injuries to the surface of the body, which
  indicate underlying injuries.
• Bruising, swelling, or pain over vital organs.
• Painful, swollen, or deformed extremities.
• Bleeding from mouth, rectum, vagina, ear, or
  other part.
• A tender, rigid, or distended abdomen.
• Nabeel Al-Mawajdeh RN.Mcs

8
Emergency Care Internal Bleeding (Contd)

• Maintain the ABCs and provide support as needed.
• Administer high- concentration oxygen by
  non-rebreather mask.
• Control any external bleeding.
• Provide prompt transport to an appropriate
  medical facility.
• Nabeel Al-Mawajdeh RN.Mcs

9
Shock

• Signs symptoms
• Altered mental status.
• Shallow/rapid breathing.
• Restlessness/anxiety.
• Cool/clammy, pale skin.
• Weak rapid pulse.
• Decreasing blood pressure.
• Dilated pupils.
• Nabeel Al-Mawajdeh RN.Mcs

10
Classifications of Shock

• Hypovolemic shock (hypo perfusion)
• Cardiogenic shock.
• Anaphylactic shock.
• Neurogenic shock.
• Septic shock.
• Nabeel Al-Mawajdeh RN.Mcs

11
General Emergency Care of Shock

• Assure patent airway.
• Maintain the ABCs Administer high- concentration
  oxygen.
• Control bleeding.
• Give nothing by mouth.
• Administer IV fluids.
• Elevate lower extremities, if no
  contraindications.
• Splint fractures.
• Prevent heat loss.
• Transport the victim immediately.
• Nabeel Al-Mawajdeh RN.Mcs

12

• The End
• Nabeel Al-Mawajdeh RN.Mcs