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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 26

Bleeding

Learning objectives (11)

  1. Describe the characteristics of external bleeding, including the identification of the following types of bleeding: arterial, venous, and capillary — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  2. Describe the general structure of the circulatory system and the function of its parts, including the heart, arteries, veins, and capillaries — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  3. Discuss hypovolemic shock as a result of bleeding, including the signs of shock — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  4. Discuss internal bleeding in terms of the different mechanisms of injury (MOIs) and their associated internal bleeding sources — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  5. Explain how to assess a patient with external or internal bleeding, including the physical examination, vital signs, and the use of monitoring devices — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  6. Explain how to conduct a primary assessment, including identification of life threats beyond bleeding, ensuring a patent airway, and making a transport decision — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  7. Explain how to determine the nature of the illness (NOI) for internal bleeding, including identifying possible traumatic and nontraumatic sources — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  8. Explain the emergency medical care of the patient with external bleeding — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  9. Explain the importance of following standard precautions when treating a patient with external bleeding — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  10. Explain the significance of bleeding caused by blunt force trauma, including the importance of perfusion — Knowledge/skills objective (printed page 933); confirm wording in your course copy.
  11. Identify the signs and symptoms of internal bleeding — Knowledge/skills objective (printed page 933); confirm wording in your course copy.

Vocabulary (12)

Hemorrhage
The loss of blood from the circulatory system, internally or externally.
External bleeding
Visible blood loss outside the body — controlled with direct pressure, dressings, and as needed, tourniquets.
Internal bleeding
Bleeding into a body cavity or tissue, often without external signs; recognized by mechanism plus signs of shock.
Arterial bleeding
Bright red blood under high pressure, often pulsatile or spurting; high-risk for rapid blood loss.
Venous bleeding
Darker red blood with steady, non-pulsatile flow.
Capillary bleeding
Slow, even oozing of blood — typical of abrasions; usually self-limiting.
Hemostasis
The body's natural process of stopping bleeding through vasoconstriction, platelet plug, and clot formation.
Direct pressure
Firm, continuous compression applied directly over a bleeding wound — the first and most important bleeding-control step.
Tourniquet
A constricting band applied to a limb proximal to a wound to control life-threatening extremity bleeding when direct pressure fails.
Hemostatic dressing
Gauze impregnated with a clot-promoting agent (e.g., QuikClot, Combat Gauze) used for severe bleeding, especially junctional sites where tourniquets cannot be applied.
Pressure dressing
A bandage applied with sufficient force to maintain compression over a wound after initial bleeding control.
Class I–IV hemorrhage
ATLS classification of blood loss — Class I (<15%), Class II (15–30%), Class III (30–40%), Class IV (>40%) — used to anticipate shock severity.

Sequence practice (2 puzzles on Quiz Me)

Severe extremity bleeding — Stop the Bleed escalation

Order the recommended steps for severe extremity bleeding.

  1. Apply firm direct pressure with a gloved hand and gauze
  2. Pack the wound and apply a pressure dressing
  3. If bleeding continues, apply a tourniquet 2–3 inches proximal to the wound (not over a joint)
  4. Tighten until bright bleeding stops; note the time on the tourniquet
  5. Rapid transport to definitive care; do not periodically loosen
Hemorrhagic shock — Class I through IV

Order the four ATLS hemorrhage classes from least to most severe.

  1. Class I — up to 15% loss; normal vitals; mild anxiety
  2. Class II — 15–30%; tachycardia, narrowed pulse pressure
  3. Class III — 30–40%; hypotension, mental status changes
  4. Class IV — over 40%; severe hypotension, lethargy, imminent collapse

Quick fire sample (12 of 12 on Quiz Me)

The loss of blood from the circulatory system, internally or externally.
  1. Hemostatic dressing
  2. Capillary bleeding
  3. Hemorrhage
  4. Pressure dressing
Visible blood loss outside the body — controlled with direct pressure, dressings, and as needed, tourniquets.
  1. Arterial bleeding
  2. Direct pressure
  3. Class I–IV hemorrhage
  4. External bleeding
Bleeding into a body cavity or tissue, often without external signs; recognized by mechanism plus signs of shock.
  1. Direct pressure
  2. Internal bleeding
  3. Hemostasis
  4. Class I–IV hemorrhage
Bright red blood under high pressure, often pulsatile or spurting; high-risk for rapid blood loss.
  1. Direct pressure
  2. Capillary bleeding
  3. Venous bleeding
  4. Arterial bleeding
Darker red blood with steady, non-pulsatile flow.
  1. Venous bleeding
  2. Hemostasis
  3. Internal bleeding
  4. Hemorrhage
Slow, even oozing of blood — typical of abrasions; usually self-limiting.
  1. Class I–IV hemorrhage
  2. Pressure dressing
  3. Capillary bleeding
  4. Internal bleeding
The body's natural process of stopping bleeding through vasoconstriction, platelet plug, and clot formation.
  1. Hemostasis
  2. Venous bleeding
  3. Pressure dressing
  4. Arterial bleeding
Firm, continuous compression applied directly over a bleeding wound — the first and most important bleeding-control step.
  1. Arterial bleeding
  2. Hemorrhage
  3. Direct pressure
  4. Pressure dressing
A constricting band applied to a limb proximal to a wound to control life-threatening extremity bleeding when direct pressure fails.
  1. External bleeding
  2. Hemorrhage
  3. Tourniquet
  4. Hemostatic dressing
Gauze impregnated with a clot-promoting agent (e.g., QuikClot, Combat Gauze) used for severe bleeding, especially junctional sites where tourniquets cannot be applied.
  1. Internal bleeding
  2. Hemostatic dressing
  3. External bleeding
  4. Class I–IV hemorrhage
A bandage applied with sufficient force to maintain compression over a wound after initial bleeding control.
  1. Pressure dressing
  2. Class I–IV hemorrhage
  3. Arterial bleeding
  4. Capillary bleeding
ATLS classification of blood loss — Class I (<15%), Class II (15–30%), Class III (30–40%), Class IV (>40%) — used to anticipate shock severity.
  1. Pressure dressing
  2. Direct pressure
  3. External bleeding
  4. Class I–IV hemorrhage

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/26/print/. Answers are not marked on this sheet.