1. Chapter Bleeding and Shock Twenty-One

4. Review of Circulatory System

5. Perfusion Circulation of blood through an organ Hypoperfusion Inadequate circulation of blood through an organ K EY TERMS

6. E XTERNAL BLEEDING

7. Arterial Capillary Venous 3 Types of External Bleeding

8. Take BSI precautions when controlling bleeding.

11. Uncontrolled bleeding or significant blood loss leads to shock (hypoperfusion) and possibly death!

12. Emergency Care of External Bleeding

13. Direct Pressure

14. Elevation

15. Pressure Bandage

17. Pressure Point Brachial

18. Pressure Point Femoral

19. Supplemental Oxygen Since blood loss reduces perfusion and the supply of oxygen to the tissues, the use of supplemental oxygen is vital. Oxygen should be administered after bleeding has been controlled.

20. Supplemental Methods of Bleeding Control

21. Air Splinting

22. A tourniquet is a last resort.

23. Bleeding from the Nose, Ears, and Mouth

24. Managing a Simple Nosebleed

26. I NTERNAL BLEEDING

28. Consider mechanism of injury.

36. S HOCK (HYPOPERFUSION)

37. Signs of shock (hypoperfusion) appear LATE! Waiting for signs of shock to appear before recognizing and treating may result in the DEATH of your patient

46. Patient CARE Shock Emergency Care Steps

47. Tell new EMT-B that shock (hypoperfusion) should be recognized and managed in its early phase. They should never wait to see if the blood pressure drops to decide to manage the patient with suspected bleeding loss! This is especially true in pediatric patients, who have the ability to compensate in the absence of approximately 30% of their blood volume! P RECEPTOR P EARL

48. Use BSI. Maintain airway and administer oxygen.

49. Control external bleeding.

50. Apply pneumatic anti-shock garment if indicated. Elevate lower extremities 8–12 inches.

51. Prevent loss of body heat. Transport immediately.

53. R EVIEW QUESTIONS 1. What BSI precautions should be taken when dealing with a patient who is actively bleeding? 2. How is external bleeding controlled? 3. How is internal bleeding identified? 4. What are the stages of hypoperfusion?