Bleeding and Shock

A sudden loss of __________ of blood in a 7-year-old child is considered serious. - 200 cc - 300 cc - 400 cc - 500 cc

500 cc

When is it inappropriate to use elevation to assist in bleeding control? - As you apply direct pressure - While trying to bandage an extremity - If you suspect musculoskeletal injuries - When a patient is found lying down

If you suspect musculoskeletal injuries

Decompensated shock

Occurs when the body can no longer compensate for low blood volume or lack of perfusion. Late signs such as decreasing blood pressure become evident

Compensated shock

Occurs when the patient is developing shock but the body is still able to maintain perfusion

Perfusion

The supply of oxygen to, and removal of wastes from, the cells and tissues of the body as a result of the flow of blood through the capillaries

After controlling bleeding from an extremity using a bandaged pressure dressing, be sure to: - loosen the tourniquet - check the distal pulse - apply a hemostatic dressing - administer oxygen by nasal cannula

check the distal pulse

When a patient cuts a blood vessel, the body attempts to protect the patient even before a bandage is applied. The body's natural responses to bleeding are constriction of the injured blood vessel and: - perfusion - hypoperfusion - compensation - clotting

clotting

Your 46-yer-old male patient is in shock, yet his body is still able to maintain perfusion to his vital organs, and his systolic BP is still 120 mmHg. This is often referred to as __________ shock. - compensated - decompensated - delayed - constricted

compensated

When you suspect that a patient is in shock, additional signs may include any of the following except: - thirst - dilated pupils - cyanosis around the lips and nail beds - flushed, warm skin

flushed, warm skin

You are treating a 58-year-old male whose throat was slashed by an attacker standing behind him during a street hold-up. When a large bleeding vein in the necks sucks in an air bubble, or embolism, this can cause: - an evisceration - heart stoppage - infection - severe bleeding

heart stopping

Elevation is used to assist in minor/moderate bleeding control for all of the following reasons except that it: - slows bleeding - raises the limb above the heart - helps to reduce blood pressure in the limb - speeds up the pulse rate

speeds up the pulse rate

A 39-year-old female, who was dressing the mannequins in a clothing store display, fell through the store window and has sustained a large cut. Blood is flowing from her forehead. What method of bleeding control should you use? - A tourniquet will need to be applied to control the bleeding - Direct pressure with a dressing and bandage should work - Apply cold directly to the wound right away - Lower the patient's head below her heart, and the bleeding will stop

Direct pressure with a dressing and bandage should work

A sudden loss of __________ of blood in a 33-year-old adult is considered serious. - 250 cc - 500 cc - 600 cc - 1,000 cc

1,000 cc

A sudden loss of __________ of blood in a 1-year-old infant is considered serious. - 25 cc - 50 cc - 100 cc - 150 cc

150 cc

Which of the following is not an example of a penetrating trauma? - A blast injury - A gunshot wound - A knife wound - An ice pick wound

A blast injury

Pressure dressing

A bulky dressing held in position with a tightly wrapped bandage, which applies pressure to help control bleeding

Tourniquet

A device used for bleeding control that constricts all blood flow to and from an extremity

Finding arterial bleeding quickly is very important in assessing a patient such as the one described in the previous question [The blood has several functions. Carrying substances such as hormones, salt, and enzymes that control the body's functions is referred to as: regulation]. Which statement about arterial bleeding is correct? - Clot formation takes place rapidly - Arterial bleeding is often rapid and profuse - Arterial bleeding is the least difficult type of bleeding to control - Arterial bleeding causes the blood pressure to rise

Arterial bleeding is often rapid and profuse

Capillary bleeding

Bleeding that is characterized by a slow, oozing flow of blood

Arterial bleeding

Bleeding that is characterized by bright red blood and is rapid, profuse, and difficult to control

Venous bleeding

Bleeding that is characterized by dark red color or maroon blood and a steady, easy-to-control flow

Hemorrhage

Bleeding, especially severe bleeding

You are treating a 45-year-old female patient who has sustained considerable blood loss after slicing her hand while preparing food. She states that she feels nauseated. What is causing the symptom of feeling nauseated? - Blood is diverted from the digestive system - Blood rushes rapidly to the digestive system - Shock increases the production of digestive juices - The patient has swallowed a large amount of blood

Blood is diverted from the digestive system

Neurogenic shock

Hypoperfusion due to nerve paralysis (sometimes caused by spinal cord injuries) resulting in the dilation of blood vessels that increases the volume of the circulatory system beyond the point at which it can be filled

Why is administration of supplemental oxygen an important treatment for the trauma patient? - It enhances blood clotting - It improves oxygenation of the tissues - It constricts the blood vessels - it is important for all of these reasons

It improves oxygenation of the tissues

You are going to use an air splint to manage the bleeding on the lower leg of a 22-year-old male patient. Which of the following is true about the use of an air splint? - It is effective for controlling venous and capillary bleeding - It should be used only if there is no suspected bone injury - It is most effective for controlling arterial bleeding - It should be used before other manual methods of bleeding control

It is effective for controlling venous and capillary bleeding

Which of the following is not a guideline for supplementing bleeding control with cold application? - Wrap the ice pack in a cloth or towel - Pour ice chips directly into the open skin - Do not leave the cold pack in place for more than 20 minutes - Place the amputated part into a sterile cool container

Pour ice chips directly into the open skin

Cardiogenic shock

Shock brought on not by blood loss but by the heart's inadequate pumping action

Hemorrhagic shock

Shock resulting from blood loss

Hypovolemic shock

Shock resulting from blood or fluid loss

Your 26-year-old male patient was stabbed multiple times in a bar fight. Police are on the scene, and it is now safe for you to begin your assessment and treatment. The use of __________ is essential whenever bleeding is discovered or simply anticipated. - full protective gear - Standard Precautions - universal isolation precautions - Tyvek overalls

Standard Precautions

Hemostatic agents

Substances applied as dressing, gauze, or bandages to open wounds to stop bleeding

Shock

The body's inability to adequately circulate blood to the body's cells in order to supply them with oxygen and nutrients; a life-threatening condition

Hypoperfusion

The body's inability to adequately circulate blood to the body's cells to supply them with oxygen and nutrients

A 28-year-old male patient fell off the roof of a two-story house and landed on a pile of firewood. You suspect that he has sustained an injury that is causing internal bleeding. Internal bleeding may be signaled by all of the following except: - painful, swollen, or deformed extremities - signs and symptoms of shock - bright red blood in the stool - a laceration to the forearm

a laceration to the forearm

The patient in the previous question [You are treating a 45-year-old female patient who has sustained considerable blood loss after slicing her hand while preparing food. She states that she feels nauseated. What is causing the symptom of feeling nauseated? Blood is diverted from the digestive system] has a drop in her systolic blood pressure. This is: - an early sign of shock - an early sign of shock in a child - always present in shock - a late sign of shock

a late sign of shock

You are treating a 29-year-old female factory worker who was involved in an accident in which a machine has amputated her right forearm. Bleeding from a clean-edged amputation is usually cared for initially with: - a pressure dressing - cold application - a tourniquet - an air splint

a pressure dressing

Your 20-year-old female patient fell off her mountain bike and has a head injury. If you note bleeding or leakage of cerebrospinal fluid (CSF) from the patient's ears or nose, you should: - apply direct pressure to the skull - apply direct pressure to the ears and nose - apply cold packs to the ears and nose - allow the drainage to flow freely

allow the drainage to flow freely

You suspect that your patient may be going into shock. Shock may develop as a result of all of the following except: - pump failure - lost blood volume - dilated blood vessels - an injury to the head

an injury to the head

You are treating a 59-year-old female patient who called the ambulance because her nose has been bleeding for quite a while. To stop or control a nosebleed, try each of the following except: - having the patient sit down and lean forward - applying direct pressure to the fleshy portion around the nostrils - keeping the patient calm and quiet - applying cold packs to the bridge of the nose and face

applying cold packs to the bridge of the nose and face

You are treating a 58-year-old male who has had a nosebleed for the last hour. The medical term for a nosebleed is: - hemorrhage - epistaxis - epihemorrhage - nostrium

epistaxis

The leading cause of internal injuries and bleeding is: - blunt trauma - penetrating trauma - auto collisions - large lacerations

blunt trauma

After interviewing a 52-year-old male patient, you suspect that he may have internal bleeding. Signs of internal bleeding include all of the following except: - vomiting and coffee-ground-like substance - bradycardia and a flushed face - dark, tarry stools - a tender, rigid, or distended abdomen

bradycardia and a flushed face

Your 35-year-old male patient has severe bleeding from a large laceration on his right forearm. You tried direct pressure, and it did not work. A blood pressure cuff: - can be used as a tourniquet if it is inflated to 70 mmHg - should never be used for bleeding control - can be used as a temporary tourniquet if it is inflated to 150 mmHg - should always be used to control arterial bleeding

can be used as a temporary tourniquet if it is inflated to 150 mmHg

Your 22-year-old male patient has a large area of road rash from sliding along the highway when he laid down his motorcycle. Bleeding described as oozing is usually a result of ___________ bleeding. - arterial - venous - capillary - bronchiole

capillary

Your patient with severe internal bleeding is struggling to deal with the blood loss. When the body has lost the battle to maintain perfusion to the organ systems and the systolic BP begins to drop, the patient is experiencing __________ shock. - delayed - compensated - decompensated - reversible

decompensated

Early signs of shock that are actually the body's compensating mechanisms include all of the following except: - increased heart rate - increased respirations - pale, cool skin - decreased capillary refill time in children

decreased capillary refill time in children

When attempting to control a deep laceration across the entire right buttock of a 22-year-old ski racer, you note that the cut goes down to the bone and will not stop bleeding. The best treatment would be to utilize __________ while beginning to transport the patient be MEDEVAC to the regional trauma center. - elevation of the wound - hemostatic gauze into the wound - ice packs into the wound - a commercial tourniquet

hemostatic gauze into the wound

Because of internal bleeding, the patient is developing inadequate tissue perfusion. This condition is referred to as: - hyperperfusion - hypoxia - hypoperfusion - hypotension

hypoperfusion

The type of shock that is most commonly seen by EMTs is __________ shock. - cardiogenic - septic - neurogenic - hypovolemic

hypovolemic

The pulse of the patient in the previous question [You are treating a 45-year-old female patient who has sustained considerable blood loss after slicing her hand while preparing food. She states that she feels nauseated. What is causing the symptom of feeling nauseated? Blood is diverted from the digestive system] will likely? - decrease - be absent - increase - be irregular

increase

You are treating a 22-year-old male who has a deep laceration that is continuing to bleed. Use of direct pressure may not be effective if the wound: - was caused by an impaled object - was accompanied by spinal injury - is at the distal end of a limb - involves a profusely bleeding artery

involves a profusely bleeding artery

The patient has already bled through a smile pile of gauze pads. You will be applying some additional sterile pads to the injury. The initial layer of dressing should not be removed from a bleeding wound because it: - can become a biohazard - takes too long to remove - is a necessary part of clot formation - may increase the chance of infection

is a necessary part of clot formation

Cells and tissues of the brain, spinal cord, and ___________ are the most sensitive to inadequate perfusion. - kidneys - lungs - stomach - heart

kidneys

Your patient is a 9-year-old male who fell off his skateboard and has numerous injuries to both of his legs. You should be especially careful when evaluating pediatric patients for shock because children: - cannot be administered oxygen at low flow rates - may display few signs until a large percentage of blood volume is lost - can decompensate for blood loss very quickly - may exhibit erratic capillary refill times

may display few signs until a large percentage of blood volume is lost

EMTs often encounter patients who are in shock. Which of the following types of shock is rarely seen in the field by the EMT? - cardiogenic - neurogenic - hypovolemic - hemorrhagic

neurogenic

Your patient was involved in an automobile crash, and it took all night to find her vehicle. She is unable to move her lower extremities, and you suspect that she is in shock. Shock caused by the failure of the nervous system to control the diameter of blood vessels is called __________ shock. - hypovolemic - cardiogenic - neurogenic - reversible

neurogenic

You have decided that the most appropriate method of bleeding control for your patient is to apply a tourniquet. Once a tourniquet is in place, it must: - not be removed or loosened unless ordered by medical direction - be covered immediately to prevent accidental removal - be loosened every 15 minutes to dislodge clots - be packed in ice and a pressure dressing

not be removed or loosened unless ordered by medical direction

Rough-edged amputations, usually produced by crushing or tearing injuries: - are easily controlled by a pressure bandage - tend to stop bleeding on their own - often bleed very heavily - constrict quickly to control bleeding

often bleed very heavily

The most common mechanism of shock for a heart attack patient is: - vasoconstriction - fluid loss - pump failure - vasodilation

pump failure

The blood has several functions. Carrying substances such as hormones, salt, and enzymes that control the body's functions is referred to as: - transportation - nutrition - regulation - excretion

regulation

You are treating a 28-year-old female who sustained several deep lacerations when she fell off her scooter and was thrown into a guardrail. The most common and effective way to control severe external extremity bleeding is by: - cold application - elevation - tourniquet - direct pressure

tourniquet

Blood that has been depleted of oxygen and loaded with carbon dioxide and other wastes empties into the ___________, which carry it back to the heart. - arteries - veins - capillaries - tissues

veins

Your 38-year-old female patient has sustained an injury to her right lower leg. There is a steady flow of dark red or maroon blood, which is most likely a result of __________ bleeding. - arterial - venous - capillary - pulmonary

venous

The major methods that are used to control external extremity bleeding include all of the following except: - direct pressure - hemolytic dressing - tourniquet - vessel clamps

vessel clamps

You are treating a 19-year-old female who experienced a series of lacerations. Your assessment of external bleeding includes all of the following except: - estimating the amount of blood lost to predict potential shock - waiting for signs and symptoms of shock to appear before beginning treatment - prioritizing bleeding patients properly - identifying during the primary assessment any bleeding that must be treated

waiting for signs and symptoms of shock to appear before beginning treatment