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12 Cards in this Set
- Front
- Back
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Classification of hemorrhages |
Arterial Venous Capillary Primary Reactionary Secondary Revealed Concealed Concealed revealed Acute Chronic Acute on chronic |
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What is primary, reactionary and secondary hemo |
Primary: Occurs at time of injury or during surgery Reactionary: Occurs withing 24 hours after surgery or 4 to 6 hours after injury Secondary: Occurs 14 days after surgery |
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Classification of hemorrhagic shock |
Class 1: <15% blood loss(<750ml) with normal signs Class 2: 15 to 30% blood loss(750-1000ml) with pallor, tachycardia, thirst Class 3: 30-40% loss(1000-2000ml) with hypotension, oliguria, confusion Class 4: >40% loss(>2000ml) with anuria, unconsciousness, hypotension, MODS |
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Clinical features of hemorrhages |
Air hunger Dry skin Goose flesh appearance Oliguria Rapid thready pulse, hypotension Cold clammy skin Tachycardia, tachypnea Pallor, thirst, cyanosis |
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Signs that blood loss significant |
Pulse>100bpm SBP<100mmHg DBP drop on sitting or standing >10mmHg Pallor/sweating Shock index(PR/BP>1 cardiac index) |
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Estimating blood loss |
Clot size of a clenched fist is 500ml Closed tibial fracture 500 to 1500ml Fractured femur: 500 to 2000ml Rain's factor: total amount of blood loss= total difference in swab weight × 1.5 or 2 |
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Complications of hemorrhages |
Acute kidney injury Sepsis GIT mucosal ischemia Metabolic acidosis Hypoxic effect Cardiac depression Liver cell dysfunction Hypovolemic shock Interstitial edema, AV shunting lungs, ARDS |
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Treatment |
Stop the blood loss Replace the lost blood |
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How can blood loss be stopped? 4 p's |
Packing Pressure Position and rest Operative procedures |
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Blood transfusion indications |
>15% blood loss following trauma Prophylaxis prior to surgery During major surgery(abdominopelvic, hepatobiliary, thoracic) Following burns Septicemia ITP, hemophilias Chronic anemia- packed blood |
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How can you improve iron excretion in a patient receiving blood transfusion |
IV Desferrioxamine |
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Complications of blood transfusions |
Immediate: Acute febrile non hemolytic reactions Allergic reactions Acute hemolytic reactions Infections Congestive cardiac failure, pulmonary edema Transfusion related acute lung injury Delayed: TTP Thrombophlebitis Iron overload Hemochromatosis Citrate intoxication causing bradycardia and hyplcalcemia |
