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Chapter 30
Trauma: Bleeding
45
Medical
Not Applicable
12/05/2016

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Term
Which of the following components is LEAST crucial to the continuous circulation of oxygenated blood throughout the body?
Definition
spleen
Term
The cardiac cycle begins with the onset of myocardial contraction and ends:
Definition
with the beginning of the next contraction
Term
Afterload is defined as the:
Definition
pressure in the aorta against which the left ventricle must pump.
Term
Which of the following two factors DIRECTLY affect cardiac output?
Definition
Stroke volume and HR
Term
Which of the following statements regarding blood flow is correct?
Definition
Ejection fraction is the percentage of blood that the heart pumps per contraction.
Term
Hemoglobin functions by:
Definition
binding to oxygen that is absorbed in the lungs and transporting it to the tissues.
Term
What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation?
Definition
platelets
Term
Perfusion is defined as:
Definition
the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands
Term
Which of the following organs or body systems requires a constant blood supply, regardless of external factors?
Definition
kidneys
Term
Which of the following organs can sustain the longest period of inadequate perfusion?
Definition
GI tract
Term
An organ or tissue that is considerably colder than 98.6°F is better able to resist damage from hypoperfusion because:
Definition
the body's metabolic rate is slower
Term
The amount of blood returned to the heart is called:
Definition
preload
Term
External bleeding would be the MOST difficult to control in a patient with a large laceration to the _____________ and a blood pressure of ______ mm Hg.
Definition
carotid artery, 100/70
Term
Patients with internal hemorrhage will benefit MOST from:
Definition
rapid transport
Term
What is the approximate total blood volume of a 150-pound male?
Definition
4.8 L
Term
The MOST significant factor that determines how well the body compensates for blood loss is:
Definition
the period of time over which the blood is lost
Term
Venous bleeding
Definition
is more likely to clot spontaneously than arterial bleeding.
Term
Which of the following factors would have the MOST negative effect on the body's process of hemostasis?
Definition
Anticoagulant use
Term
If you suspect internal bleeding during the primary assessment, you should:
Definition
keep the patient warm and administer oxygen.
Term
Hematochezia:
Definition
is the passage of stools that contain bright red blood.
Term
All of the following are common early signs or symptoms of nontraumatic internal hemorrhage in older patients, EXCEPT:
Definition
vomiting
Term
Most external hemorrhage can be controlled with a combination of:
Definition
direct pressure and pressure dressings
Term
What is "warm ischemic time"?
Definition
The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature
Term
Much of the bleeding associated with unsplinted fractures continues because:
Definition
bone ends will continue to move and destroy partially formed clots.
Term
When applying a tourniquet to control major external hemorrhage from an extremity injury, you should:
Definition
maintain direct pressure to the wound until the tourniquet has been fully applied.
Term
Agents such as Celox, HemCon, and QuikClot are used to:
Definition
promote hemostasis
Term
A patient with hemorrhagic shock would be expected to have:
Definition
flattened jugular veins
Term
Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock?
Definition
severe burns
Term
A trauma patient with suspected internal hemorrhage and inadequate breathing requires
Definition
ventilation assistance and rapid transport.
Term
A trauma patient with hypotension secondary to internal hemorrhage should receive IV fluid boluses in order to:
Definition
maintain the systolic blood pressure in a low normal range
Term
Which of the following types of medication would MOST likely reduce a patient's ability to compensate when in shock?
Definition
Calcium channel blockers
Term
Confusion, a sustained heart rate greater than 120 beats/min, and a respiratory rate of 32 breaths/min are MOST consistent with class ___ hemorrhage?
Definition
III
Term
A healthy adult can tolerate blood loss of up to ____ mL over a period of 15 to 20 minutes without any negative effects.
Definition
500
Term
The physiologic process of hemostasis is achieved through:
Definition
vasoconstriction and platelet aggregation
Term
In contrast to a patient with compensated shock, a patient with decompensated shock would be expected to present with:
Definition
mottled skin and dilated pupils.
Term
A fall in blood pressure and the resultant changes in plasma osmolality cause the release of:
Definition
aldosterone and antidiuretic hormone.
Term
Circulation of blood within an organ or tissue in adequate amounts to meet the cells' current needs is called:
Definition
perfusion
Term
Which of the following types of shock is caused by poor blood vessel function?
Definition
septic
Term
If you discover minor external bleeding during your primary assessment of a patient, you should:
Definition
make note of it and continue your assessment.
Term
The paramedic's MAIN goal in treating a patient with shock is to:
Definition
recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs
Term
Decompensated shock in the adult is characterized by:
Definition
a falling blood pressure
Term
Which of the following signs would you MOST likely observe in a patient with compensated shock?
Definition
anxiety or agitation
Term
You are treating a 20-year-old man with a large laceration involving the brachial artery. The patient is confused, is pale, and has weak peripheral pulses. Your initial attempts to control the bleeding have failed. You should
Definition
apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route.
Term
A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient's clinical presentation?
Definition
Bilateral femur fractures
Term
You have successfully controlled a large arterial hemorrhage from a 42-year-old man's leg with direct pressure and a pressure dressing. He is conscious, but restless. His blood pressure is 84/58 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min. You should:
Definition
administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route.
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