Bleeding Control Drill: Bleeding and Blood Loss

EMTB Bleeding Control Drill Session Reference: 1 Topic: Bleeding and Blood Loss Level of Instruction: 3 Time Required: 3 hours Materials:    • Chalkboard    • Cardiovascular system handouts...

      b. all cellular exchanges occur at this level

            1) oxygen/carbon dioxide

            2) nutrients/waste products

  4. Venules

      a. smallest branches connecting the capillaries to the veins

  5. Veins

      a. carry oxygen depleted blood back to the heart

           1) exception is pulmonary vein

      b. much lower pressure than arteries

      c. contain one-way valves to prevent back flow

      d. major veins

           1) superior vena cava

           2) inferior vena cava

           3) pulmonary

           4) jugular

B. Vascular Structures

  1. Tunica intima

       a. interior layer

       b. smooth to provide easy blood flow

  2. Tunica media

      a. middle, muscular layer

      b. controls the vessel size

  3. Tunica adventitia

      a. outer, fibrous layer

      b. maintains maximum vessel size

  4. Lumen

      a. interior opening or diameter


IV. Effects of Blood Loss (1-4)

A. Physiological responses

  1. Loss of blood volume

       a. body generally will not tolerate acute loss of 20% of volume

  2. Loss of blood solids

  3. Decreased oxygen level to the cells

  4. Decreased waste elimination

  5. Changes in vital signs

      a. increasing heart rate

      b. decreasing blood pressure


V. External Bleeding (1-5)

A. Types

  1. Arterial

      a. bright red in color

      b. spurting

  2. Venous

      a. dark maroon or blue in color

      b. steady flow

  3. Capillary

      a. oozing

B. Control of External Bleeding

  1. Direct pressure

  2. Pressure dressing

  3. Elevation - if no other injuries

  4. Reinforce pressure dressing - if not controlled

  5. Pressure point

       a. brachial artery

       b. femoral artery

  6. Tourniquet - last resort


VI. Internal Bleeding (1-6)

A. Causes

  1. Blunt trauma

       a. falls

       b. motor vehicle accidents

       c. auto-pedestrian collisions

       d. blast injuries

  2. Penetrating trauma

       a. gunshot wounds

       b. stab wounds

       c. impaled objects

  3. Medical history

       a. ulcers

B. Signs of Internal Bleeding

  1. Surface injuries may indicate underlying injuries

  2. Bruising, swelling or pain over vital organs

  3. Painful, swollen or deformed extremities

  4. Bleeding from body orifices

  5. Tender, rigid or distended abdomen

  6. Vomiting

      a. “coffee grounds”

      b. bright red

  7. Dark, tarry stools or bright red blood in stool

  8. Signs and symptoms of shock

      a. altered mental status

      b. pale, cool, clammy skin

      c. nausea and vomiting

      d. vital sign changes

            1) increased pulse

            2) increased respiration

            3) decreased blood pressure

  9. Thirst

  10. Dilated pupils

  11. Cyanosis

C. Treatment of Internal Bleeding

  1. Maintain airway, breathing and circulation

  2. High concentration oxygen

  3. Patient positioning

        a. supine with legs elevated 8 - 12 inches if no serious injuries

  4. PASG

  5. Splint fractures during transport

  6. Maintain body temperature

  7. Transport immediately




Review of the Vascular System Components and Functions

   • Solid and Liquid Components of Blood

   • Function of the Blood Supply

   • Vascular System Anatomy and Physiology

   • Effects of Blood Loss

   • External Bleeding

   • Internal Bleeding