NURSING CARE OF BLEEDING NURSING CARE OF BLEEDING nursing care for bleeding

BLEEDING:

Hemorrhage or sever bleeding is the major cause of shock “Hypoperfusion”

This condition involves losing blood. This can occur internally (when blood leaks from blood vessels inside the body), externally through a natural opening (such as the vagina, mouth, or rectum), or externally through a break in the skin.

External bleeding:

There are three types of external bleeding

1- Arterial bleeding :

Usually bright red in color because of O2

In this type bleeding is more because it has hight blood pressure.

It is the most difficult  to control the bleeding

2- Venous bleeding:

Usually dark red because it has CO2  and waste product

It is easy to control bleeding except large vein like neck vein.

3- Capillary bleeding:

Usually slow because of the small size and pressure easily can be contaminated

Severity of External bleeding:-

Depend on blood loss according to age and physical size of patent

Adult              more           1000cc

Child              more            500cc

Infant             more            150cc

Controlling of External Bleeding:

It is the most important in management of shock

Control blood loss mean increase in perfusion

Guid line of controlling

external bleeding

1- Direct pressure

The most common and effective way

direct press to wound “ pressure dressing

Always check distal pulse to

make sure dressing is not light

2- Elevation

On injured extremity may be used at the some time of pressure dressing

It should be above the heart level gravity reduce blood pressure in extremity

->>>> slow bleeding

Pressure point:

       *Brachial artery

       *Femoral artery

3- splinting

Stabilizing fractures reduce injuries to tissues and vessels

4- Cold application

Ice – cold packs à  reduce  swelling cause constriction of blood vessels of blood vessels à minimize bleeding

“Never apply ice directly to skin”

5- Tourniquet

Or blood pressure cuff should be last choice

Only in life threatening emergency

Apply above the joint 5cm above wound

Internal Bleeding

Not seen , that cause internal bleeding very serious also it can be large a wound in short time .

Blunt trauma may lead to death .

Causes of blunt bleeding :-

                          * Falls

                       * RTA

                       * Auto-pedestrian collision

                       * Blast injuries

Signs of internal bleeding:

1- injuries to the surface of the body.

2-Bruising ,swelling , pain over vital signs.

3- Painful , swollen or deformed extremities.

4- Bleeding from mouth , rectum , vaginal .

5- Tender , rigid , distended abdomen

6- vomiting à bright red vomits

7- Dark ,tarry stool or bright red in stool

8- Mechanism of injury.

Nursing care for internal bleeding

•Maintain ABC provide support

•Administer high concentrated O2

•Control any external bleeding