Chapter 26: Bleeding

Key Topics

• Structure and Function of the Circulatory System
• Significance and Characteristics of Bleeding
• Importance of Personal Protective Equipment (PPE)
• Characteristics of External vs. Internal Bleeding
• Patient Assessment for Bleeding
• Methodologies for Controlling Bleeding

Circulatory System

• Components: Heart, blood vessels, blood, and body fluids.
• Functions:
  • Circulates blood to deliver oxygen/nutrients and remove waste
  • Supplies adequate blood flow

Heart

• Requires rich blood supply
• Divided into two pumps:
  • Atrium (upper chamber)
  • Ventricles (lower chamber)
• Blood exits via one-way valves

Blood Vessels

• Types:
  • Arteries, arterioles, capillaries, venules, and veins
  • Capillaries allow exchange of oxygen/nutrients and waste

Blood Components

• Red Blood Cells: Oxygen transportation
• White Blood Cells: Fight infection
• Platelets: Blood clot formation
• Plasma: Liquid part

Clot Formation

• Factors:
  • Blood stasis, changes in vessel walls, blood's clotting ability

Autonomic Nervous System

• Monitors body needs, adjusts blood flow
• Redirects blood in emergencies
• Maintains homeostasis

Perfusion

• Definition: Blood circulation within organs or tissues
• Requires adequate speed for nutrients exchange and clot prevention
• Some organs need constant supply, others require less

External Bleeding

• Definition: Visible hemorrhage
• Significance:
  • Blood loss >20% is critical
  • Significant blood loss affects heart rate, respiration, and blood pressure

Characteristics

• Arterial: Bright red, spurts with pulse
• Venous: Dark red, steady flow
• Capillary: Dark red, oozes slowly

Clotting Process

• Occurs within 10 minutes
• Involves vasoconstriction and clot formation

Internal Bleeding

• Harder to detect, serious risk
• Causes: Stomach ulcers, lacerated liver, broken bones
• Symptoms: Pain, swelling, distention, hematoma
• Non-traumatic causes: Ulcers, ectopic pregnancy, aneurysms

Patient Assessment

• Scene Size-Up: Check hazards, consider spinal immobilization
• Primary Assessment: Address life-threatening bleeding
• ABCs: Airway, Breathing, Circulation assessment
• Transport Decision: Rapid transport if needed
• History: Chief complaint, SAMPLE history

Methods to Control Bleeding

• Direct Pressure
• Pressure Dressings/Splints
• Tourniquets
• Hemostatic Dressings/Wound Packing

Direct Pressure

• Most effective for external bleeding
• Hold pressure for at least 5 minutes

Tourniquets

• Use for substantial uncontrolled extremity bleeding

Hemostatic Dressings

• Promote clot formation, used with direct pressure

Special Cases

• Nose/Ear/Mouth Bleeding: May indicate skull fracture or other conditions
• Epistaxis (Nosebleed): Pinch nostrils, lean forward to prevent aspiration

Conclusion

• Understanding of bleeding and appropriate interventions is crucial for patient survival.
• Use PPE, assess quickly, decide on transport urgency, and apply appropriate bleeding control methods.