Bleeding, Shock, and SoftTissue Injuries

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Bleeding, Shock, and Soft-Tissue Injuries
Unit 5 Illness and Injury
CHAPTER 10
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Bleeding, Shock, and Soft-Tissue Injuries

• Bleeding
• Shock
• Soft-Tissue Injuries
• Burns

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Bleeding

• The Heart
• Pumps blood with its nutrients and oxygen to the
  body
• The heart has four separate chambers.
• Right atrium
• Right ventricle
• Left atrium
• Left ventricle

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Bleeding

• The Heart

The flow of blood through the heart
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Bleeding

• Blood
• Carries oxygen and carbon dioxide
• Carries food to the tissue
• Carries wastes
• Carries hormones, water, salt, etc.
• Protects against disease

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Bleeding
Properties of blood
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Bleeding

• Blood
• Contains
• Red blood cells
• White blood cells
• Elements involved in forming blood clots
• Plasma

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Bleeding

• Blood Vessels
• Arteriescarry blood away from the heart.
• Veinsreturn blood to the heart.
• Capillarieswhere oxygen, nutrient, and waste
  exchange takes place.

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Bleeding

• General Considerations
• Body substance isolation (BSI) precautions
• Severity of blood loss
• Bodys normal response to bleeding

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Bleeding

• Types of External Bleeding

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Bleeding
Blood loss of about 1/2 liter
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Bleeding

• Controlling External Bleeding
• Direct pressure
• Elevation
• Pressure points
• Tourniquet (last resort)

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Bleeding
Apply direct pressure.
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Bleeding
Elevation
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Bleeding
Pressure dressing
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Bleeding
Pressure point (brachial artery)
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Bleeding
Pressure point (femoral artery)
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Bleeding
Tourniquet
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Bleeding

• Tourniquet
• Locate the site for the tourniquet
• Place a tourniquet pad on the site
• Apply the tourniquet
• Mark the time it was applied

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Bleeding

• Dressing and Bandaging
• Dressingsterile placed over a wound
• Bandageused to hold a dressing

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Bleeding
Dressings and bandages
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Bleeding
Improvised dressing and bandages
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Bleeding

• Rules for Dressing
• Control bleeding.
• Use sterile or clean materials.
• Cover the entire wound.
• Do not remove dressings.

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Bleeding

• Rules for Bandaging
• Do not bandage too tightly or too loosely.
• Do not leave loose ends.
• Always check pulse, motor function, and sensation
  in the limb receiving care.

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Bleeding
Forehead or ear
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Bleeding
Elbow or knee
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Bleeding
Forearm or leg
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Bleeding
Hand
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Bleeding
Shoulder
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Bleeding
Hip
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Bleeding

• Internal Bleeding
• Usually caused by blunt trauma
• Can be serious or minor
• Can lead to shock

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Bleeding

• Signs and symptoms of internal bleeding

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Bleeding
Estimating internal blood loss
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Bleeding

• Management of Internal Bleeding
• Perform a scene size-up.
• Take appropriate BSI precautions.
• Perform initial assessment.
• Loosen restrictive clothing.

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Bleeding

• Management of Internal Bleeding
• Provide care for shock.
• Nothing by mouth
• Reassure patient and keep patient calm.
• Oxygen per local protocol

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Shock

• Shock is the failure of the bodys circulatory
  system to provide enough oxygenated blood to all
  vital organs and tissues.

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Shock
The bodys attempt to solve the circulatory
problem may worsen the situation.
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Shock

• Types of Shock
• HypovolemicBlood or fluid loss
• HemorrhagicBlood loss
• CardiogenicHeart failure
• NeurogenicNervous system failure

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Shock

• Types of Shock
• AnaphylacticAllergic reaction
• PsychogenicFainting
• SepticInfection

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Shock

• Signs and Symptoms
• Weakness
• Nausea
• Thirst
• Dizziness
• Restlessness and fear

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Shock

• Signs and Symptoms
• Rapid, weak pulse
• Rapid, shallow respirations
• Mental status changes
• Pale, cool, moist skin

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Shock

• Preventing and Caring for Shock
• Perform a scene size-up.
• Take appropriate BSI precautions.
• Perform an initial assessment.
• Control external bleeding and splint suspected
  fractures.

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Shock

• Preventing and Caring for Shock
• Maintain the patients body heat.
• Properly position the patient.
• Nothing by mouth
• Monitor the patients vital signs.
• Oxygen by local protocol

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Shock
Properly position patient in shock.
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Soft-Tissue Injuries

• Soft tissue and underlying structures

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Soft-Tissue Injuries

• Closed wound
• injury in which the skin is not broken

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Soft-Tissue Injuries

• Open wound
• injury in which the skin is broken

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Soft-Tissue Injuries
Abrasions
Incision

• Types of open wounds

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Soft-Tissue Injuries
Punctures
Lacerations

• Types of open wounds

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Soft-Tissue Injuries

• Perforating, penetrating wound

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Soft-Tissue Injuries
Avulsions
Amputations

• Types of open wounds

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Soft-Tissue Injuries

• Crushing injuries

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Soft-Tissue Injuries
Care of Open Wounds
Expose the wound.
Clear the wound surface.
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Soft-Tissue Injuries
Care of Open Wounds
Control bleeding.
Treat for shock.
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Soft-Tissue Injuries
Care for an Impaled Object
Control bleeding.
Stabilize in place.
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Soft-Tissue Injuries

• Avulsions and Amputations
• Clear the surface of the wound.
• If there is an avulsion, gently fold the skin
  back to its normal position.
• Control bleeding.
• Use bulky pressure dressings.

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Soft-Tissue Injuries

• Avulsions and Amputations
• Save the avulsed or amputated part
• Wrap the part in a sterile dressing.
• Place it in a plastic bag.
• Keep the part cool.
• Do not place the avulsed or amputated part in
  water or in direct contact with ice.

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Soft-Tissue Injuries
Care for an Impaled Object in the Cheek
If all the way through, then remove.
Control bleeding.
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Soft-Tissue Injuries

• Eye Injuries

Flush foreign bodies from the eyes
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Soft-Tissue Injuries

• Eye Injuries

Care for burns to the eyes
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Soft-Tissue Injuries
Care for an Impaled Object in the Eye
Stabilize the object.
Cover both eyes.
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Soft-Tissue Injuries

• Penetrating Chest Wounds

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Soft-Tissue Injuries
Place an occlusive dressing on an open chest
wound.
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Soft-Tissue Injuries
Use an occlusive dressing on an open abdomen.
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Soft-Tissue Injuries
Cover with a bulky dressing or towel.
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Burns

• Classifications of Burns
• Heat (thermal) burns
• Chemical burns
• Electrical burns
• Lightning burns
• Light burns
• Radiation burns

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Burns
Categories of burns
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Burns
Categories of burns
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Burns

• Critical Burns
• Hands
• Feet
• Face
• Groin
• Buttocks

• Large burns
• Any burn that encircles a body part
• Burns to the airway
• Burns to pediatric and geriatric patients

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Burns

• Care of Burns
• Perform a scene size-up.
• Stop the burning process.
• Remove smoldering clothing and jewelry.
• Flush minor burns with cool water.

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Burns

• Care of Burns
• For major burns, do not flush.
• Cover the burn area with dry, sterile dressing.
• Care for shock.
• Oxygen per local protocol

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Summary

• Bleeding
• Shock
• Soft-Tissue Injuries
• Burns