Chapter 25 ebook Quiz, Chapter 25 Bleeding AAOS Emergency Care and Transportation of the Sick and Injured Eleventh Edition

aorta

largest artery in the body

the ______ ________ is the thickest chamber of the heart

left ventricle

several conditions that result in bleeding form the nose, ears or mouth

skull fracture facial injuries (direct blow to the nose) sinusitis, infections, nose drop use and abuse dried or cracked nasal mucosa intranasal use of street drugs (snorting) high blood pressure coagulation disorder digital trauma (sever nose picking)

capillaries

small tubes with the diameter of a single RBC that pass among all cells in body link arterioles and venules

arterioles

smaller blood vessels that connect arteries and capillaries

venules

smaller blood vessels that connect capillaries and veins

Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the:

spleen

Internal bleeding into a fractured extremity is MOST often controlled by:

splinting the extremity

When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should:

stop twisting the stick when the bleeding stops

When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should:

stop twisting the stick when the bleeding stops.

The severity of bleeding should be based on all of the following findings, EXCEPT:

systolic BP

tourniquet

the bleeding control method used when a wound continues to bleed despite the use of direct pressure and elevation; useful if a patient is bleeding severely from a partial or complete amputation (this helps control bleeding no cut it off)

Which part of the cardiovascular system is considered "a container"?

the blood vessels

veins

the blood vessels that carry blood from the tissues to the heart

Hypovolemic shock occurs when:

the body cannot compensate for rapid blood loss.

Hypovolemic shock occurs when:

the body cannot compensate for rapid fluid loss

perfusion

the circulation of blood within an organ or tissue in adequate amounts to meet the current needs of the cells

hemoptysis

the coughing up of blood

External bleeding from a vein is relatively easy to control because:

veins are under a lower pressure

P. M. S.

Pulse Motor skills sensory skills make sure you check before and after splinting

Which portion of the blood carries oxygen to and wastes away from body tissues?

RBCs

Hypoperfusion is another name for:

Shock.

Which part of the cardiovascular system is considered "a container"?

The blood vessels

Which of the following organs/body systems cannot tolerate lack of blood flow for more than a few minutes?

The heart and brain

An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost.

100 mL

The process of blood clotting and plugging the hole is called A. Conglomeration B. Configuration C. Coagulation D. Coalition

C

The term _______ means constantly adapting to changing conditions A. Perfusion B. Conduction C. Dynamic D. Autonomic

C

When using an air splint to control bleeding in the fractured extremity you should reassess the A. Airway B. Breathing C. Circulation in the injured extremity D. Fracture site

C

Which organ or organ system has the greatest tolerance for lack of perfusion (shock)?

GI system

Which of the following is a term for vomited blood?

Hematemesis

Most cases of external bleeding from an extremity can be controlled by:

applying local direct pressure

Which type of bleeding is characterized by a bright red color and spurting?

arterial

blood enters an organ or tissue by

arteries arterioles capillaries

The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the:

arterioles

An organ or tissue may be better able to resist damage from hypoperfusion if the:

body's temperature is considerably less than 98.6 F

arterial bleeding

bright red (because it's oxygenated blood) and spurts in time with the pulse

contusion/ecchymosis

bruise from an injury that causes bleeding beneath the skin without breaking the skin may not always be present at first

the function of the blood is to deliver nutrients to all of the body's

cells and tissues

early signs/symptoms of hypovolemic shock:

change in mental status (anxiety, restlessness, combativeness) non-trauma patients: weakness, faintness, dizziness on standing (important in older patients)

Perfusion is MOST accurately defined as the:

circulation of blood within an organ in adequate amounts to meet the organ's metabolic needs

Perfusion is MOST accurately defined as the:

circulation of blood within an organ in adequate amounts to meet the organ's metabolic needs.

perfusion

circulation of blood within an organ or tissue in adequate amounts to meet cells' current needs for O2, nutrients, and waste removal

What mechanism(s) does the body use to control bleeding?

clotting, coagulation, vasoconstriction

an organ or tissue that is considerably ____________ is much better able to resist damage from hypoperfusion.

colder

an organ or tissue that is considerably _____________is much better able to resist damage from hypoperfusion

colder

venules

very small thin-walled blood vessels

hematemesis

vomited blood

signs of serious internal bleeding

vomiting blood black tarry stools coughing up blood distended abdomen broken ribs

signs and symptoms of internal bleeding

vomiting of blood (may look like coffee grounds) melena (black foul smelling tarry stool) pain, tenderness, bruising, guarding or swelling broken ribs, bruises over the lower part of the chest, rigid distended abdomen

In older patients, the first indicator of nontraumatic internal bleeding may be:

weakness or dizziness

hypoperfusion (shock)

when circulatory system fails to provide sufficient circulation to maintain normal cellular functions (due to pump, container, or fluid failure)

How soon do cells in the brain and spinal cord start to die without constant perfusion?

within 4-6 minutes

internal bleeding commonly occurs as a result of high energy MOI

falls blast injuries automobile accidents penetrating trauma

In which of the following situations would external bleeding be the MOST difficult to control?

femoral artery laceration and a blood pressure of 140/90 mm Hg

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing:

gastrointestinal bleeding

Which of the following conditions might an EMT suspect as a possible cause for bleeding from the nose and mouth?

(all of the above): skull fracture, high BP, sinus infection

assessment: reassessment

- 5/15 minutes - high-flow O2 for external/internal bleeding - rapid transport if hypoperfusion - document how much blood loss occurred over what period of time

without adequate perfusion:

- CNS cells die after 4-6 minutes (no ability to regenerate) - lungs survive 15-20 minutes - kidneys damaged after 45 minutes - skeletal muscle deteriorates after 2-3 hours

blood clot formation depends on:

- blood stasis - changes in blood vessel wall - blood's ability to clot (affected by disease processes/medications) ANS directs blood away from other organs to heart/brain/lungs/kidneys in an emergency

arterial bleeding

- bright red - spurts in time with pulse - doesn't clot spontaneously difficult to control

capillary bleeding

- dark red - oozes slowly

venous bleeding

- darker red (O2 poor) - flows slowly or rapidly but doesn't spurt easier to control

tourniquet precautions

- do not apply directly over a joint - make sure it is secure and tightening - never use wire, rope, belt - consider placing padding underneath - never cover with bandage - do not loosen after application

treating facial injuries:

- do not apply excessive pressure and increase pressure on the brain skull: - loosely cover bleeding site with sterile gauze pad - wrap dressing loosely around head - watch out for CSF (halo shape draining)

signs of bleeding into chest cavity:

- dyspnea - tachycardia - hemoptysis (coughing up blood) - hypotension

MOI: internal bleeding

- high-energy MOI should increase index of suspicion - result of falls, blast injuries, MVCs, penetrating trauma - assess via DCAP-BTLS

bleeding tends to stop quickly within

10 minutes

issues that affect clotting:

- movement - disease - certain medications - removal of bandages - external environment - body temperature - hemophilia (makes all injuries, no matter how trivial, life-threatening)

severe external bleeding signs:

- poor general appearance - no response to external stimuli - signs of shock - significant amount of blood loss - rapid/ongoing blood loss - inability to control bleeding - association with MOI

three components of cardiovascular system:

- pump (heart) - container (blood vessels) - fluid (blood, bodily fluids)

assessment: scene size-up

- scene safety - standard precautions (bring multiple pairs of gloves) - ensure no fluid leaking from vehicle or energized power lines at MVC - number of patients - NOI/MOI (bloody emesis vs. upturned step stool) - ALS? - spinal immobilization?

reasons for bleeding from nose/ears/mouth:

- skull fracture - facial injuries (ex. direct blow to nose) - sinusitis, infection - nose drop use, abuse - dried/cracked nasal mucosa - intranasal use of street drugs - high BP - coagulation disorders - digital trauma

late signs/symptoms of hypovolemic shock:

- tachycardia - dizziness at rest - thirst - nausea and vomiting - cold, moist, clammy skin - shallow, rapid breathing - dull eyes - slightly dilated pupils, slow to respond to light - cap. refill time longer than 2 seconds (child, infants) - weak, thready pulse - decreasing BP - altered LOC

pressure dressings and/or splints

- use 4x4 gauze for small wounds and universal dressings for larger wounds - cover entire wound and stretch bandage tight enough - check for distal pulse after applying dressing

assessment: secondary assessment

- vitals (*look out for systolic < 100 mm Hg) - pain assessment - DCAP-BTLS for secondary injuries - detailed physical exam for isolated injuries - abdomen: feel all 4 quadrants - extremities: pulse, motor, sensory (PMS)

treatment of internal bleeding

-follow standard precautions -maintain airway w/ cervical spine immobilization (if needed) -administer high flow oxygen or artificial ventilation as -necessary -control all obvious external bleeding -consider pelvic compression device or splint -monitor and record patients vitals at least every 5 min -keep the patient warm -give nothing by mouth -provide prompt transport for all patients with sign an symptoms of shock

hemostatic agents come in two forms

-granular powder (which can be inserted into small wounds to create a tight seal) -gauze impregnated with a clay substance (which speeds blood clot formation) this can be packed into larger wounds to control hemorrhage

A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh.

1 L

how to apply a MAT tourniquet:

1. apply pressure over bleeding site; place tourniquet proximal to injury (axillary region of upper extremity OR groin of lower extremity) 2. click buckle into place, pull strap tight, turn tightening dial clockwise until pulses no longer palpable

assessment recap:

1. control bleeding 2. address ABCs 3. treat for shock 4. assess for DCAP-BLTS

how to control external bleeding:

1. direct, even pressure - use gloved fingertip/hand if no dressing available - never remove object from wound - apply pressure for 5 minutes without interruption - do not remove dressings, just add more 2. tourniquets - use if direct pressure doesn't control bleeding - apply until distal pulses are no longer palpable

how to apply a triangular bandage tourniquet:

1. fold triangular bandage until it is 4 inches wide, 6-8 inches thick 2. wrap bandage around extremity twice 3. place bandage proximal and tight 4. tie one knot 5. twist (using stick/rod) until bleeding has stopped 6. secure stick 7. write TK + exact time you applied it

controlling epistaxis (nosebleed)

1. position patient sitting forward; pinch fleshy part of nostrils together OR 1. apply pressure with a rolled gauze bandage between the upper lip and gum 2. apply ice over the nose, maintain pressure until bleeding is controlled - initiate prompt transport - assess/treat for shock

how to control internal bleeding:

1. standard precautions, maintain ABCs (O2), spinal immobilization, rapid transport 2. control obvious external bleeding and treat suspected internal bleeding via a splint 3. use pelvic compression device to splint internal bleeding in the pelvic region 4. monitor vital signs and keep the patient warm

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume.

20%

the body will not tolerate an acute blood loss of greater that _________ percent of blood volume

20%

In general, what is the maximum amount of acute blood loss the adult body can tolerate?

20% of the total body volume (1 liter)

what should be used for a direct pressure dressing

4 x 4 inch sterile gauze pads for small wounds and sterile universal dressings for larger wounds then cover the entire dressing with a bandage above and below the wound and stretch the bandage tight enough to control bleeding.

What is the approximate blood volume of an 80-kg adult male?

5.60 L

typical adult female blood volume

65ml of blood per kilogram of body weight 4 to 5 liters

typical adult male blood volume

70ml of blood per kilogram of body weight 5 to 6 liters

A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes: A. preparing for immediate transport. B. applying oxygen via nasal cannula. C. performing a focused physical exam. D. a detailed assessment of his abdomen.

A

A 70-year-old man is experiencing a severe nosebleed. When you arrive, you find him leaning over a basin, which contains an impressive amount of blood. He has a history of coronary artery disease, diabetes, and migraine headaches. His BP is 180/100 and his heart rate is 100 beats/min. Which of the following is the MOST likely contributing factor to his nosebleed? A. His blood pressure B. His history of diabetes C. The fact that he is elderly D. His heart rate of 100 beats/min

A

hematuria

blood in the urine

Bleeding from the nose following head trauma: A. is a sign of a skull fracture and should not be stopped. B. should be controlled by packing the nostril with gauze. C. should be assumed to be caused by a fractured septum. D. is usually due to hypertension caused by the head injury.

A

If bleeding continues after applying a pressure dressing should do all the following except A. Remove the dressing apply another sterile dressing B. Apply manual pressure through the dressing C. Add more gauze pads over the first dressing D. Secure both dressings tighter with a roller bandage

A

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: Select one: A. a tourniquet proximal to the injury. B. digital pressure to a proximal artery. C. a splint and elevate the extremity. D. additional sterile dressings.

A

In nontrauma patients, an early indicator of internal bleeding is: A. dizziness upon standing. B. a rapid, thready pulse. C. a decreasing blood pressure. D. rapid, shallow breathing.

A

In older patients, the first indicator of non-traumatic internal bleeding may be: Select one: A. weakness or dizziness. B. diaphoresis and pale skin. C. a heart rate over 120 beats/min. D. a low blood pressure.

A

In which of the following situations would external bleeding be the MOST difficult to control? A. femoral artery laceration and a blood pressure of 140/90 mm Hg B. jugular vein laceration and a systolic blood pressure of 90 mm Hg C. carotid artery laceration and a systolic blood pressure of 60 mm Hg D. antecubital vein laceration and a blood pressure of 138/92 mm Hg

A

The only arteries of the body that carry deoxygenated blood are the A. Pulmonary arteries B. Coronary arteries C. Femoral arteries D. Subclavian arteries

A

The severity of bleeding should be based on all of the following findings, EXCEPT: A. systolic blood pressure. B. poor general appearance. C. the mechanism of injury. D. clinical signs and symptoms.

A

The systemic veins function by: A. returning deoxygenated blood back to the heart. B. delivering oxygen-poor blood to the capillaries. C. returning oxygen-rich blood back to the left atrium. D. delivering deoxygenated blood to the capillaries.

A

What is the approximate blood volume of a 75-kg adult? A. 5.25 L B. 5.50 L C. 6.25 L D. 6.50 L

A

When applying a bandage to hold a dressing in place, stretch the bandage tight enough to control the bleeding but not so tight as to decrease _____ to the extremity. A. blood flow B. pulses C. oxygen D. CRTs

A

Which of the following sets of vital signs is LEAST indicative of internal bleeding? A. BP, 140/90 mm Hg; pulse rate, 58 beats/min; respirations, 8 breaths/min B. BP, 100/50 mm Hg; pulse rate, 120 beats/min; respirations, 24 breaths/min C. BP, 98/60 mm Hg; pulse rate, 110 beats/min; respirations, 28 breaths/min D. BP, 102/48 mm Hg; pulse rate, 100 beats/min; respirations, 22 breaths/min

A

Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? A. air splint B. vacuum splint C. sling and swathe D. cardboard splint

A

_______ is inadequate tissue perfusion A. Shock B. Hyperperfusion C. Hypertension D. Contraction

A

_______ shock is a condition in which low blood volume results in inadequate perfusion or even death A. Hypovolemic B. Metabolic C. Septic D. Psychogenic

A

Which of the following statements regarding the clotting of blood is correct?

A person taking blood thinners will experience slower blood clotting

Which of the following conditions might an EMT suspect as a possible cause for bleeding from the nose and mouth?

A skull fracture High blood pressure A sinus infection

Which section of the heart receives deoxygenated blood? Select one: A. Left B. Right C. Ventricles D. Atria

B

A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. You should: A. ensure the patient has a patent airway. B. control the bleeding with direct pressure. C. apply oxygen with a nonrebreathing mask. D. apply a tourniquet proximal to the wound.

B

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes: A. having the patient pinch his own nostrils and then lie supine. B. pinching the patient's nostrils and having him lean forward. C. placing a rolled 4″ × 4″ dressing between his lower lip and gum. D. packing both nostrils with gauze pads until the bleeding stops.

B

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: Select one: A. having the patient pinch his own nostrils and then lie supine. B. pinching the patient's nostrils and having him lean forward. C. packing both nostrils with gauze pads until the bleeding stops. D. placing a rolled 4² × 4² dressing between his lower lip and gum.

B

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: Select one: A. acute appendicitis. B. gastrointestinal bleeding. C. intrathoracic hemorrhaging. D. an aortic aneurysm.

B

A lack of one or more of the blood clotting factors is called A. A deficiency B. Hemophilia C. Platelet anomaly D. Anemia

B

An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost. A. 50 mL B. 100 mL C. 150 mL D. 200 mL

B

An organ or tissue may be better able to resist damage from hypoperfusion if the: A. body's demand for oxygen is markedly increased. B. body's temperature is considerably less than 98.6°F (37.0°C). C. systolic arterial blood pressure is at least 60 mm Hg. D. heart rate is maintained at more than 100 beats/min.

B

An organ or tissue that is considerably _______ is much better able to resist damage from hypoperfusion A. warmer B. colder C. younger D. older

B

Blood enters the left atrium from the A. Coronary arteries B. Lungs C. Vena cava D. Coronary veins

B

The first sign of hypovolemic shock is change in A. Respiration B. Heart rate C. Mental status D. Blood pressure

C

Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______. Select one: A. coagulation B. perfusion C. hemorrhage D. hypoperfusion

B

Controlling internal bleeding requires: A. applying a tourniquet. B. surgery in a hospital. C. positioning the patient in the sitting position. D. providing slow and considerate transport.

B

During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should: A. assess the quality of her pulse. B. repeat the primary assessment. C. perform a secondary assessment. D. begin assisting her ventilations.

B

Early signs and symptoms of intra-abdominal bleeding include: A. bruising only. B. pain and distention. C. widespread ecchymosis. D. significant hypotension.

B

Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: A. liver. B. spleen. C. pancreas. D. gallbladder.

B

Hypovolemic shock occurs when: A. the clotting ability of the blood is enhanced. B. the body cannot compensate for rapid blood loss. C. the patient's systolic blood pressure is less than 100 mm Hg. D. at least 10% of the patient's blood volume is lost.

B

If the typical adult loses more than 1L of blood, significant changes in vital signs, such as _____ will occur A. Decreased heart rate B. Increased respiratory rate C. Increased blood pressure D. All of the above

B

In older patients, the first indicator of nontraumatic internal bleeding may be: A. a low blood pressure. B. weakness or dizziness. C. a heart rate over 120 beats/min. D. diaphoresis and pale skin.

B

The _______ links the arteries and the venules. A. Aorta B. Capillaries C. Vena cava D. Valves

B

The ability of a person's cardiovascular system to compensate for blood loss is MOST related to: A. how fast his or her heart beats. B. how rapidly he or she bleeds. C. his or her baseline blood pressure. D. the part of the body injured.

B

The body will not tolerate an acute blood loss of greater than _______ of blood volume A. 10% B. 20% C. 30% D. 40%

B

The function of the blood is to _______ all of the body's cells and tissues A. Remove oxygen from B. Deliver nutrients to C. Carry waste products to D. All of the above

B

The quickest and MOST effective way to control external bleeding from an extremity is: A. a pressure bandage. B. direct pressure and elevation. C. a splint. D. a tourniquet.

B

The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the: A. venules. B. arterioles. C. vena cavae. D. capillary arteries.

B

When applying a tourniquet to an amputated arm, the EMT should: A. use the narrowest bandage possible. B. avoid applying the tourniquet over a joint. C. cover the tourniquet with a sterile bandage. D. use rope to ensure that the tourniquet is tight.

B

When caring for a patient with severe epistaxis, the MOST effective way to prevent aspiration of blood is to: A. insert a nasopharyngeal airway and lean the patient back. B. tilt the patient's head forward while he or she is leaning forward. C. place the patient supine with his or her head in the flexed position. D. tilt the patient's head forward while he or she is leaning backward.

B

When treating a patient with signs and symptoms of hypovolemic shock and no outward signs of bleeding always consider the possibility of bleeding into the A. thoracic cavity B. Abdomen C. Skull D. Chest

B

When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should: A. cover the tourniquet with a sterile dressing. B. stop twisting the stick when the bleeding stops. C. twist the stick until the radial pulse disappears. D. remove the tourniquet if the bleeding has stopped.

B

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: A. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. B. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. C. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. D. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.

B

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: Select one: A. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. B. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. C. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. D. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.

B

Which of the following is NOT a component of the cardiovascular system? A. Heart B. Lungs C. Venules D. Plasma

B

Which of the following statements regarding hemophilia is correct? A. Hemophilia is defined as a total lack of platelets. B. Patients with hemophilia may bleed spontaneously. C. Hemophiliacs take aspirin to enhance blood clotting. D. Approximately 25% of the population has hemophilia.

B

Which of the following statements regarding hemophilia is correct? Select one: A. Hemophiliacs take aspirin to enhance blood clotting. B. Patients with hemophilia may bleed spontaneously. C. Approximately 25% of the population has hemophilia. D. Hemophilia is defined as a total lack of platelets.

B

Which organ or organ system has the greatest tolerance for lack of perfusion (shock)? Select one: A. Brain B. Gastrointestinal system C. Skeletal muscle D. Kidneys

B

You are dispatched to a store in the downtown mall for an arm injury. When you arrive, you are directed to a small stock room where you find a teenaged girl holding a blood-soaked cloth tightly onto her left forearm. You notice blood droplets high up the wall and on the floor several feet from where she is sitting. "I was opening a shipment with a box-cutter," she says, her skin noticeable pale. "And it slipped and cut my arm." What type of bleeding should you anticipate? A. You should suspect heavy venous bleeding. B. She most likely has arterial bleed. C. Internal bleeding is probably causing her skin to appear pale. D. Very sharp blades usually only cause capillary bleeding.

B

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that: A. the patient may be significantly hypertensive. B. the patient is at risk for vomiting and aspiration. C. a detailed exam is needed to determine the cause. D. many medications interfere with blood clotting.

B

You respond to a 33-year-old man who was hit in the ear by a line drive during a softball game. He is complaining of a severe headache, ringing in the ears, and dizziness. He has blood draining from his ear. Why would you not apply pressure to control bleeding? A. It should be collected to be re-infused at the hospital. B. It could collect within the head and increase the pressure on the brain. C. It is contaminated. D. You could fracture the skull with the pressure needed to staunch the flow of blood.

B

You should consider bleeding to be serious if all of the following conditions are present except A. Blood loss is rapid B. There is no mechanism of injury C. The patient has a poor general appearance D. Assessment reveals signs and symptoms of shock

B

________ is the circulation of blood within an organ or tissue in adequate amounts to meet the cells current need for oxygen nutrients and waste removal A. Anatomy B. Perfusion C. Physiology D. Conduction

B

A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should: A. apply direct pressure to the wound. B. place the patient on 100% oxygen. C. follow appropriate standard precautions. D. perform a rapid head-to-toe assessment.

C

A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh. A. 250 mL B. 500 mL C. 1 L D. 2 L

C

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: Select one: A. perform a secondary assessment. B. apply a nonrebreathing mask. C. assist the patient's ventilations. D. obtain baseline vital signs.

C

As red blood cells begin to clump together to form a clot, __________ reinforces the clumped red blood cells. A. fibrin B. plasma C. fibrinogen D. plasminogen

C

Blood contains all of the following except A. White blood cells B. Plasma C. Cerebrospinal fluid D. Platelets

C

Blood enters the right atrium from the A. Coronary arteries B. Lungs C. Vena cava D. Coronary veins

C

Blood leaves each chamber of a normal heart through a A. Vein B. Artery C. One way valve D. Capillary

C

Hypoperfusion is another name for: A. hypoxemia. B. cyanosis. C. shock. D. cellular death.

C

Hypovolemic shock occurs when: Select one: A. the clotting ability of the blood is enhanced. B. the patient's systolic blood pressure is less than 100 mm Hg. C. the body cannot compensate for rapid blood loss. D. at least 10% of the patient's blood volume is lost.

C

If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply: A. additional sterile dressings. B. a splint and elevate the extremity. C. a tourniquet proximal to the injury. D. digital pressure to a proximal artery.

C

Perfusion is MOST accurately defined as: A. the removal of adequate amounts of carbon dioxide during exhalation. B. the intake of adequate amounts of oxygen during the inhalation phase. C. circulation of blood within an organ with sufficient amounts of oxygen. D. the production of carbon dioxide, which accumulates at the cellular level.

C

Significant blood loss demands your immediate attention as soon as the _______ has been managed A. Fracture B. Extraction C. Airway D. None of the above

C

The _______ only requires a minimal blood supply when at rest A. Lungs B. Kidneys C. Muscles D. Heart

C

You and your partner respond to a patient who has had his hand nearly severed by a drill press. As you approach, you note that the patient is pale and there appears to be a lot of blood on the floor. The wound continues to bleed copiously. After applying a tourniquet, you write ______ and _______ on a piece of adhesive tape and apply it to the patient's forehead. A. the patient's name; tourniquet location B. your last name; unit number C. the letters "TK"; the exact time applied D. the date and time; estimated amount of blood loss

C

You respond to a 25-year-old man who has cut his arm with a circular saw. The bleeding appears to be a bright red and spurting. The patient is alert and oriented and converses with you freely. He appears to be stable at this point. What is your first step of controlling his bleeding? A. Direct pressure B. Maintain the airway C. Standard precautions D. Elevation

C

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: A. acute appendicitis. B. intrathoracic hemorrhaging. C. an aortic aneurysm. D. gastrointestinal bleeding.

D

A man involved in a motorcycle crash has multiple abrasions and lacerations. Which of the following injuries has the HIGHEST treatment priority? A. Widespread abrasions to the back with pinkish ooze B. 3" laceration to the forehead with dark red, flowing blood C. Laceration to the forearm with obvious debris in the wound D. 1" laceration to the thigh with spurting, bright red blood

D

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: A. obtain baseline vital signs. B. apply a nonrebreathing mask. C. perform a secondary assessment. D. assist the patient's ventilations.

D

At the arterial end of the capillaries, the muscles dilate and constrict in response to conditions such as A. Fright B. A specific need for oxygen C. A need to dispose of metabolic wastes D. All the of above

D

Blood stasis, changes in the vessel wall, and certain medications affect the: A. systolic blood pressure exclusively. B. white blood cell's ability to fight infection. C. ability of red blood cells to carry oxygen. D. ability of the blood to effectively clot.

D

Even though the body is very efficient at controlling bleeding on it's own it may fail in situations such as A. When medication interferes with normal clotting B. When damage to the vessel maybe so large that a clot cannot completely block the hole C. When only part of the vessel is cut preventing it from constricting D. All of the above

D

Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Select one: A. liver. B. pancreas. C. gallbladder. D. spleen.

D

Gastrointestinal bleeding should be suspected if a patient presents with: A. dyspnea. B. hematuria. C. hemoptysis. D. hematemesis.

D

If applying a dressing to control the bleeding of a patient's arm, the EMT should ________. Select one: A. apply direct pressure first B. use large or small gauze pads or dressings depending upon the size of the wound C. cover the entire wound, above and below, with the dressing D. All of these answers are correct.

D

Internal bleeding into a fractured extremity is MOST often controlled by: Select one: A. applying chemical ice pack. B. applying a tourniquet. C. keeping the patient warm. D. splinting the extremity.

D

Most cases of external bleeding from an extremity can be controlled by: A. elevating the injured extremity. B. packing the wound with gauze. C. compressing a pressure point. D. applying local direct pressure.

D

Nontraumatic internal bleeding may be caused by an A. Ulcer B. Ruptured ectopic pregnancy C. Aneurysm D. All of the above

D

Perfusion is MOST accurately defined as the: A. effective transfer of oxygen from the venules across the systemic capillary membrane walls. B. ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure. C. effective removal of carbon dioxide and other metabolic waste products from the body's cells. D. circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.

D

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. A. 5% B. 10% C. 15% D. 20%

D

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. Select one: A. 10% B. 5% C. 15% D. 20%

D

Signs and symptoms of internal bleeding in both trauma and medical patients include A. hematemesis B. melena C. hemoptysis D. all of the above

D

The _______ is the thickest chamber of the heart A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle

D

The brain and spinal cord usually cannot go for more than _______ minutes without perfusion or the nerve cells will be permanently damaged A. 30 -45 B. 12-20 C. 8-10 D. 4-6

D

The cardiovascular system consists of A. A pump B. A container C. Fluid D. All of the above

D

The most common symptom of internal bleeding is: A. bruising around the abdomen. B. distention of the abdomen. C. rigidity of the abdomen. D. acute abdominal pain.

D

The severity of bleeding should be based on all of the following findings, EXCEPT: Select one: A. clinical signs and symptoms. B. poor general appearance. C. the mechanism of injury. D. systolic blood pressure.

D

What mechanism(s) does the body use to control bleeding? Select one: A. Clotting B. Coagulation C. Vasoconstriction D. All of these answers are correct.

D

When caring for a patient with internal bleeding, the EMT must first: A. ensure a patent airway. B. obtain baseline vital signs. C. control any external bleeding. D. take appropriate standard precautions.

D

Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body? A. an effectively pumping heart B. an intact system of blood vessels C. adequate blood in the vasculature D. the filtering of blood cells in the spleen

D

Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding? Select one: A. The patient has not eaten in 24 hours. B. The patient had a stroke 5 years prior. C. The patient has a history of hypertension. D. The patient takes rivaroxaban (Xeralto).

D

Which of the following organs can tolerate inadequate perfusion for up to 2 hours? A. brain B. heart C. kidneys D. skeletal muscle

D

Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? Select one: A. Vacuum splint B. Sling and swathe C. Cardboard splint D. Air splint

D

Which of the following statements regarding the clotting of blood is correct? A. Venous and capillary blood typically does not clot spontaneously. B. Bleeding begins to clot when the end of a damaged vessel dilates. C. Direct contact with the environment prevents blood from clotting. D. A person taking aspirin will experience slower blood clotting.

D

Which portion of the blood carries oxygen to and wastes away from body tissues? Select one: A. Platelets B. Plasma C. White blood cells D. Red blood cells

D

You and your partner respond to a patient who has had his hand nearly severed by a drill press. As you approach, you note that the patient is pale and there appears to be a lot of blood on the floor. The wound continues to bleed copiously. In the above call, when applying the tourniquet you know you must be sure to: A. use the narrowest bandage possible to minimize the area restricted. B. cover the tourniquet with a bandage. C. never pad underneath the tourniquet. D. not loosen the tourniquet after you have applied it.

D

You are called to a playground for an 8-year-old girl who has an uncontrolled nosebleed. The child is crying and will not to talk to you. The babysitter and other children present did not witness any trauma, but there is a bump on the temporal portion of the girl's head. The babysitter does state that the girl has had a cold for several days but can give you no further information on her medical history. What could be the possible cause(s) of the bleeding? A. A skull fracture B. Sinusitis C. Coagulation disorder D. All of the above

D

deformities, contusions, abrasions, punctures/penetrations, burns, tenderness, lacerations and swelling

DCAP-BTLS

artery

a blood vessel consisting of three layers of tissue and smooth muscle that carries blood away from the heart.

contusion

a bruise from an injury that causes bleeding beneath the skin without breaking the skin; also called ecchymosis

ecchymosis

a buildup of blood beneath the skin that produces a characteristic blue or black discoloration as the result of an injury; also see contusion

hemostatic agent

a chemical compound that slows or stops bleeding by assisting with clot formation (primarily utilized in military medicine to stop profuse bleeding)

hypovolemic shock

a condition in which low blood volume due to massive internal or external bleeding or extensive loss of body water, results in inadequate perfusion

hypoperfusion

a condition in which the circulatory system fails to provide sufficient circulation to maintain normal cellular function; also called shock

shock

a condition in which the circulatory system fails to provide sufficient circulation to maintain normal cellular functions; also called hypoperfusion BP less than 100 mm Hg systolic

Pelvic binder

a device to splint the bony pelvis to reduce hemorrhage from bone ends, venous disruption and pain (reduce the width of pelvic ring injuries)

hemophilia

a hereditary condition in which the patient lacks one or more of the bloods normal clotting factors

open-book pelvic fracture

a life-threatening fracture of the pelvis caused by a force that displaces one or both sides of the pelvis laterally and posteriorly

hematoma

a mass of blood that has collected within damaged tissues beneath the skin or in a body cavity

expistaxis

a nosebleed

Which of the following statements regarding the clotting of blood is correct?

a person taking blood thinners will experience slower blood clotting

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply:

a tourniquet proximal to the injury

Which of the following would be the first sign of hypovolemic shock?

anxiety

when treating a patient with signs and symptoms of hypovolemic shock and no outward signs of bleeding, always consider the possibility of bleeding into the:

abdomen

when treating a patient with signs and symptoms of hypovolemic shock and not outward signs of bleeding always consider the possibility of bleeding into the

abdomen

Blood stasis, changes in the vessel wall, and certain medications affect the:

ability of the blood to effectively clot

the most common symptom of internal abdominal bleeding is

acute abdominal pain

the most common symptom of internal abdominal bleeding is:

acute abdominal pain

assessment: primary assessment

address external bleeding before ABCs - use tourniquet if direct pressure doesn't stop bleeding B: assess for tachypnea C: assess skin color (moist, cool, grey skin = perfusion problem), for tachycardia, weak pulse

the automatic nervous system monitors these needs

adjust blood flow automatically redirects blood to vital organs adapts to maintain homeostasis and perfusion

You determine that your patient is experiencing internal bleeding. What should you do first?

administer O2

amount of blood in body

adults: - 70 mL (males) - 65 mL (females) *cannot tolerate acute blood loss of more than 20% (2 pints/1 liter) children: - much less blood volume - can lose only 3-6 oz and show significant symptoms

Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding?

air splint

splint

air: acts like a pressure dressing applied to an entire extremity rigid: immobilizes fractures and reduces pain/further damage

life threatening external bleeding demands your immediate attention even before the __________ has been managed

airway

hemostatic agents

any chemical compound that slows/stops bleeding by assisting with clot formation - granular powder (for small wounds) - gauze with clay substance (for larger wounds) must be used when direct pressure is ineffective or when tourniquet placement is impossible

A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should:

apply a compression device around his pelvis

A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should:

apply a compression device around his pelvis.

What should you do first to control external bleeding in an extremity?

apply direct pressure

If applying a dressing to control the bleeding of a patient's arm, the EMT should ________.

apply direct pressure first, use large or small gauze pads or dressings depending on the size of the wound, and cover the entire wound above/below with the dressing

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:

assist the patient's ventilations

melena

black, foul smelling tarry stool that contains digested blood

hemorrhage

bleeding

hemorrhage

bleeding treatment based on patient's presentation and MOI, before ABCs severity depends on how quickly and how much blood is being lost

hematoma

bleeding into soft tissues; result of a minor OR severe injury

nature of illness for internal bleeding

bleeding ulcers bleeding from the colon ruptured ectopic pregnancy aneurysm

common causes of non-traumatic internal bleeding

bleeding ulcers, bleeding from the colon, ruptured ectopic pregnancy, aneurysms

heart

cannot tolerate disruption of blood flow for more than a few minutes

the ______________ links the arterioles and the venules

capillaries

NOI: internal bleeding

common causes: - bleeding ulcers (vomiting of blood, bloody diarrhea) - bleeding from the colon - ruptured ectopic pregnancy - aneurysms - severe femur, pelvic fractures (*older patients) common in older patients

A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. You should:

control the bleeding with direct pressure

A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. You should:

control the bleeding with direct pressure.

capillary bleeding

dark red, oozes from a would steadily but slowly

venous bleeding

darker red ( because its de-oxygenated blood) flows slowly or rapidly

methods to control external bleeding

direct local pressure pressure dressing tourniquet splinting device

bleeding will never stop if an effective clot does not form unless the injured blood vessel is completely cut off from the main blood supply by

direct pressure or tourniquet

older patients signs of non-traumatic internal bleeding

dizziness faintness weakness

In nontrauma patients, an early indicator of internal bleeding is:

dizziness upon standing

tourniquet precautions

do not apply over a joint make sure its tightened securely never use wire, rope, a belt or other narrow material use wide padding underneath (if possible) never cover with a bandage do not loosen once applied (mark the time it was applied)

Gastrointestinal bleeding should be suspected if a patient presents with:

hematemesis

Which of the following is a term for vomited blood?

hematemesis

signs and symptoms of internal bleeding in both trauma and medical patients include:

hematemesis

The ability of a person's cardiovascular system to compensate for blood loss is MOST related to:

how rapidly he or she bleeds

The condition in which low blood volume results in inadequate perfusion is called what?

hypovolemic shock

signs of significant blood loss

increased heart rate (pulse) increased respiratory rate decreased blood pressure (hypotension) (1 liter of blood)

if the typical adult loses more than 1 L of blood, significant changes in vital signs, such as _______________ will occur.

increased respiratory rate

blood enters the right atrium from the

inferior and superior vena cava

Bleeding from the nose following head trauma:

is a sign of a skull fracture and should not be stopped.

Bleeding from the nose following head trauma:

is a sign of skull fracture and should not be stopped

never remove an object from a protruding wound unless

it is in the cheek and blocking the patients airway

treatment of a bleeding skull fracture

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 (look for cerebrospinal fluid in the draining blood)

You are assessing a patient who is bleeding from the ear, which gives you a high index of suspicion that he has a skull fracture. How should you address this?

loosely cover the site

hypovolemic shock

low blood volume due to massive internal or external bleeding results in inadequate perfusion

blood enters the left atrium from the

lungs

without adequate perfusion

lungs can only survive 15 to 20 minutes kidneys can be damaged after 45 minutes skeletal muscle evidence of injury after 2-3 hours gastrointestinal can tolerate slightly longer periods

treatment of external bleeding

make sure there is an open airway provide high flow oxygen control bleeding direct even pressure pressure dressings / splints tourniquets

broken ribs, bruises over the lower part of the chest or rigid distended abdomen

may indicate spleen or liver laceration. referred pain in right should for liver or left should for spleen

several types of tourniquets

mechanical advantage tourniquet (MAT) combat application tourniquet (CAT) ratcheting medical tourniquet (RMT) special weapons and tactics tourniquet (SWAT-T)

which of the following inhibits the body's ability to control bleeding

medication that interferes with normal clotting

the first sign of hypovolemic shock is a change in:

mental status

signs/symptoms of internal bleeding:

mild: - hematemesis (vomiting of blood) - melena (blood in stool) - pain, tenderness, bruising, guarding, swelling - bruises over lower chest (broken ribs) - rigid, distended abdomen (lacerated spleen, liver) severe: - bleeding from mouth, rectum - hematuria

the ___________________ only require a minimal blood supply when at rest

muscles

vasoconstriction

narrowing of a blood vessel, such as with hypoperfusion or cold extremities

blood leaves each chamber of a normal heart through a

one-way valve

blood leaves each chamber of a normal heart through a(n):

one-way valve

Early signs and symptoms of intra-abdominal bleeding include:

pain and distention

signs and symptoms of a closed fracture that is bleeding

pain, tenderness, bruising, guarding or swelling

Which of the following statements regarding hemophilia is correct?

patients with hemophilia may bleed spontaneously

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes:

pinching the patient's nostrils and having him lean forward

After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should:

place additional dressings over the wound

signs and symptoms of hypovolemic shock

rapid, weak pulse low blood pressure changes in mental status cool, clammy skin cyanosis

Which of the following are they key to the formation of blood clots?

platelets

A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes:

preparing for immediate transport

A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes:

preparing for immediate transport.

coagulation

process clot formation

The cardiovascular system consists of three parts

pump (heart) container ( blood vessels that reach the cells of the body) fluid ( blood and body fluids)

which of the following is NOT a factor in the formation of blood clots?

pumping function of the heart (IS: blood stasis, ability of blood to clot, & changes to the walls of blood vessels)

for a patient with suspected internal bleeding you should assess circulation by checking the pulse for

rate and quality

the cells of the central nervous system do NOT have the capacity to

regenerate

During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should:

repeat the primary assessment

During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should:

repeat the primary assessment.

assessment: history taking

responsive trauma with isolated injury/limited MOI: - SAMPLE > important Q: blood thinners? (aspirin, Coumadin, Xarelto, Pradaxa, Eliquis, Plavix) unresponsive: - ask family for any information

The systemic veins function by:

returning deoxygenated blood back to the body

Which section of the heart receives deoxygenated blood?

right

Hypoperfusion is another name for:

shock

Which condition is likely when signs of hypotension; tachycardia; and cool, clammy skin are found?

shock

_________________________is inadequate tissue perfusion

shock

conditions to consider bleeding serious

significant MOI, poor general appearance, signs and symptoms of shock, obvious significant blood loss, rapid blood loss, uncontrollable bleeding

Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body?

the filtering of blood cells in the spleen

coagulation

the formation of clots to plug openings in injured blood vessels and stop blood flow

Which of the following organs/body systems cannot tolerate lack of blood flow for more than a few minutes?

the heart and brain

aorta

the main artery that receives blood from the left ventricle and delivers blood to all the other arteries that carry blood to the tissues of the body

vasoconstriction

the narrowing of a blood vessel, such as with hypoperfusion or cold extremities

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that:

the patient is at risk for vomiting and aspiration

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that:

the patient is at risk for vomiting and aspiration.

When encountering a suspected bleeding emergency, the most pertinent finding during the SAMPLE history phase of assessment would be that ________.

the patient states that she takes blood-thinner medications

Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding?

the patient takes rivaroxaban (Xarelto)

capillaries

the small blood vessels that connect arterioles and venules; various substance pass through these walls into and out of the interstitial fluid and then onto the cells. (small tubes that are about the same diameter as a single red blood cell)

arterioles

the smallest branches of arteries leading to the vast network of capillaries

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that:

the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released

blood thinners

these are prescribed for patients with a history of stroke, pulmonary embolism or heart attack. (always ask the patient if they are on them)

Air splint

this acts like a pressure dressing applied to an entire extremity rather than to a small ocal area (use approved clean or disposable valve stems when inflating)

intra-abdominal bleeding

this causes pain and distention

internal bleeding

this is any bleeding that occurs in a cavity or space inside the body and is not easily detected (falls, blast injuries and motor vehicle crashes), nose bleeds, ectopic pregnancies, gastrointestinal, dialysis shunt)

pelvic sling

this is designed to prevent over and under compression to the pelvic area

right side of the heart

this side circulates blood from the body to the lungs

left side of the heart

this side circulates oxygen-rich blood from the lungs to the rest of the body

cardiovascular system

this system circulates blood to the body's cells and tissues, delivering oxygen and nutrients and carrying away metabolic waste products (heart , arteries, veins, capillaries)

automatic nervous system

this system monitors the body's needs and adjust the blood flow by constriction or dilating blood vessels as required.

rigid splints

this will help immobilize fractures as well as reduce pain and further damage to soft tissues.

tourniquet

useful if a patient has substantial bleeding from an extremity injury sold types: - mechanical advantage (MAT) - combat application (CAT) - ratcheting medical (RMT) - special weapons and tactics (SWAT-T) other forms: - triangular bandage - blood pressure cuff (left inflated)