cardiovascular system:
circulate blood to cells and tissues
deliver … and …
carry away … products
oxygen; nutrients; metabolic waste
three parts for cardio system:
- … (heart)
- … (blood vessels)
- .. (blood and body fluids)
pump; container; fluid
the heart needs a rich and well-distributed blood supply works as two paired pumps: ... chamber (...) ... chamber (...) blood leaves each chamber through a ...
upper; atrium
lower; ventricle
one-way valve
types of blood vessels:
…: carry blood away from the heart
…: connect the arteries and capillaries
…: link arterioles and venules
…: empty into the veins
….: carry blood from the tissues to the heart
arteries; arterioles capillaries venules veins
oxygen and nutrients pass from the … into the …, and waste and carbon dioxide diffuse into the …
capillaries; cells; capillaries
blood contains: ... blood cells ... blood cells ...: form blood clots ...: fluid portion of the blood
red blood cells
white blood cells
platelets
plasma
blood clot formation depends on several factors:
blood …
changes in the …
blood’s ability to …
stasis; blood vessel walls; clot
autonomic nervous system:
monitors the body’s … and adjusts … by constricting/dilating blood vessels
automatically redirects blood to the …, …, …, and … in an emergency
adapts to maintain homeostasis and perfusion
if the system fails to provide sufficient circulation for every body part to perform its function, … results
needs; blood flow; heart; brain; lungs; kidneys; shock
.. is the circulation of blood within an organ or tissue to meet the cells’ needs for oxygen, nutrients, and waste removal–> blood flow must be … enough to maintain adequate circulation and … enough to allow cells time to exchange ox and nutrients for CO2 and other waste products
perfusion; fast; slow
some tissues need a constant supply of blood, while others can survive with very little. all organs and organ systems are dependent on … to function properly. death of an organ system can quickly lead to death of the patient
adequate perfusion
… means bleeding
with serious external bleeding, it may be difficult to estimate the amount of blood loss:
blood will look different on …
it is important to estimate the amount of external blood loss
hemorrhage;
different surfaces ;
body will not tolerate a blood loss greater than …% of blood volume
changes in vital signs may occur with significant blood loss:
increase in … rate
increase in … rate
decrease in …
20; heart; respiratory; blood pressure
how well people compensate for blood loss is related to how ….–> an adult can comfortably donate … unit (… mL) of blood over 15 to 20 minute–> if a similar blood loos occurs in a much shorter time, the person may rapidly develop symptoms of …
consider age and preexisting health
rapidly they bleed; 1; 500; hypovolemic shock
arterial bleeding: pressure causes blood to … and makes bleeding difficult to control. typically …red (rich in ox) and spurts in time with the pulse
venous bleeding: …red (low in ox) , does not spurt and is easier to manage, can be profuse and life-threatening
spurt; brighter; dark;
capillary bleeding: bleeding from damaged …, dark red, oozes … but …
more likely to clot spontaneously than arterial blood
capillary vessels; steadily; slowly
bleeding tends to stop rather quickly, within about … minutes, in response to internal mechanisms and exposure to air
when the skin is broken, blood flows rapidly from the open vessel
the cut ends of the vessel begin to … (…), reducing the amount of bleeding
then a clot forms (…)
bleeding will never stop if a clot does not form, unless the injured vessel is completely cut off from the main blood supply by direct pressure or a tourniquet
10; narrow; vasoconstriction; coagulation
hemophilia:
patient lacks …
bleeding may occur …
all injuries, no matter how trivial, are potentially serious
patients should be transported immediately
blood-clotting factors; spontaneously
internal bleeding:
bleeding in a … or … inside the body
can be very serious because it is not easy to detect immediately–> injury or damage to internal organs commonly results in …
can cause … shock
cavity; space; extensive internal bleeding; hypovolemic
possible conditions causing internal bleeding:
…
lacerated …
ruptured …
broken …, especially the ribs or femur
…
often, the only signs of internal bleeding are … or …
stomach ulcer liver spleen bones pelvic fracture contusion; ecchymosis
MOI for internal bleeding:
high-energy MOI should increase your … for serious unseen injuries
internal bleeding is possible whenever the MOI suggests that severe forces affected the body
look for DCAP-BTLS or any other signs of injury
index of suspicion
bleeding is not always caused by trauma nontraumatic causes include: .... ... from ... ruptured ... ... it is not as important for you to know the specific organ involved as it is to recognize that the patient is in shock and respond appropriately
bleeding ulcers
bleeding; colon
ectopic pregnancy
aneurysms
signs and symptoms of internal bleeding:
… (most common)
… in the area of …
…
bleeding into the chest cavity/lung may cause …, …, …, and …
….: a mass of blood in the soft tissues beneath the skin
…: a contusion, or ecchymosis
bleeding from any …–> bright red bleeding from the mouth/rectum, hematuria, nonmenstrual vaginal bleeding
pain swelling; bleeding distension dyspnea; tachycardia; hypotension; hemoptysis hematoma body opening
signs and symptoms of internal bleeding:
…: vomited blood, bright red/dark red, coffee-grounds appearance
….: black, foul-smelling, tarry stool with digested blood
pain, tenderness, bruising, guarding, or swelling (possible closed fracture)
…; bruises over the lower part of the chest; or a rigid, distended abdomen (possible lacerated spleen or liver)
… (hypovolemic shock): change in mental status, such as anxiety, restlessness, or combativeness; weakness, faintness, or dizziness on standing, changes in skin color/pallor (pale skin)
hematemesis
melena
broken ribs
hypoperfusion
determine transport priority--> signs that imply rapid transport: ... or ... ... weak ... .. skin
tachycardia; tachypnea
low blood pressure
pulse
clammy
communication and documentation:
recognize, estimate, and report the amount of … and how … or over what period of time it occurred
communicate all relevant information to the staff at the receiving hospital. document all injuries, the care provided, and the patient’s response
blood loss; rapidly
several methods are available to control external bleeding:
- …, … and …
- … and/or …
- …
direct, even pressure; elevation;
pressure dressings; splints
tourniquets
direct pressure:
the most effective way to control external bleeding
pressure stops the …. and permits normal … to occur
apply pressure with your gloved fingertip or hand over the top of a sterile dressing
for an object protruding from the wound, apply … to … the object in place, and apply pressure as best you can
hold uninterrupted pressure for at least … mins
flow of blood; coagulation; bulky dressings; stabilize; 5
pressure dressing:
firmly wrap a sterile, self-adhering roller bandage around the entire wound
stretch the bandage … enough to control bleeding–> you should still be able to palpate a … on the injured extremity after applying the dressing
right; distal pulse
pressure dressing contd:
do not remove a dressing until a … has evaluated the patient: apply … through the dressing
add more dressings over the first
physician; additional pressure
hemostatic agents:
any chemical compound that … or … bleeding by assisting with … formation
can be used with direct pressure when direct pressure alone is ineffective
two forms:
…
… impregnated with a … substance
slows; stops; clot; granular powder; gauze; clay substance
the tourniquet is useful if a patient has substantial bleeding from an … injury that cannot be controlled with direct pressure
if a commercial tourniquet is unavailable, you can create a tourniquet using a … bandage and a …/…
extremity; triangular bandage; stick; rod
tourniquet:
observe the following precautions:
- do not apply a tourniquet directly over any …
- always place the tourniquet … to the injury
- make sure the tourniquet is tightened securely
- never use wire, rope, a belt, or any other narrow material
- place … under the tourniquet to protect the tissues and help with arterial compression
- never cover a tourniquet with a …
- do not loosen the tourniquet after you have applied it
- record the exact … the tourniquet was applied
joint proximal padding bandage time
… can control internal/external bleeding associated with severe injuries; act as a pressure dressing applied to an extremity; immobilize fractures and act like a pressure dressing applied to an entire extremity rather than to a small, local area
…: will help immobilize fractures, reduce pain, prevent further damage to soft-tissue injuries
air splints; rigid splints
once the splint is applied, monitor … and … and … function in the distal extremity
pulse; motor; sensory
bleeding from the nose, ears, and mouth caused by several conditions: ... ... injuries ..., ..., ... or ... .... ... ...
skull fracture facial sinusitis; infections; dried or cracked nasal mucosa high blood pressure coagulation disorders digital trauma
… (nosebleed) is a common emergency–> occasionally can cause enough blood loss to send a patient into shock, can usually be controlled by .. together
epistaxis; pinching the nostrils
epistaxis contd:
the blood you see may only be a small part of the total blood loss–> much of the blood may pass … into the stomach as the patient swallows
a person who swallows a large amount of blood may become … and start … (may be confused with internal bleeding)
most nontraumatic nosebleeds occur from sites in the …, the tissue dividing the nostrils
down the throat
nauseated; vomiting;
septum
bleeding from the nose or ears following a head injury:
may indicate a …
may be difficult to control
do not attempt to …. –> applying excessive pressure to the injury may force the blood leaking through the ear or nose to collect within the head. loosely cover the bleeding site with a sterile gauze pad to collect the blood and help keep contaminants away from the site.
apply light compression by wrapping the dressing loosely around the head
a target or halo-shaped stain may occur on the dressing if blood or drainage contains …
skull fracture
stop blood flow
cerebrospinal fluid
Internal bleeding:
usually requires surgery or other hospital interventions
keep the patient calm, reassured, and as still and quiet as possible
provide .
maintain …
… the injured extremity (usually with an air splint)
never use a … to control the bleeding from closed, internal, soft-tissue injuries
body temperature
splint
tourniquet