Integumentary Disorders Q 47

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Which of the following is the initial intervention for a male client with external bleeding?

  

    A. Elevation of the extremity

    B. Pressure point control

    C. Direct pressure

    D. Application of a tourniquet

    

    

Correct Answer: C. Direct pressure

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Applying direct pressure to an injury is the initial step in controlling bleeding. For severe or arterial bleeding, pressure point control can be used. Control the external source of bleeding by applying direct pressure to the bleeding site. External bleeding is controlled with firm, direct pressure on the bleeding site, using a thick dry dressing material. Prompt, effective treatment is needed to preserve vital organ function and life.

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Option A: Elevation reduces the force of flow, but direct pressure is the first step. If trauma has occurred, evaluate and document the extent of the client’s injuries; use a primary survey (or another consistent survey method) or ABCs: airway with cervical spine control, breathing, and circulation.

Option B: Pressure points are those areas where large blood vessels can be compressed against bone: femoral, brachial, facial, carotid, and temporal artery sites. Maintaining an adequate circulating blood volume is a priority. The amount of fluid infused is usually more important than the type of fluid (crystalloid, colloid, blood). The amount of volume that can be infused is inversely affected by the length of the IV catheter; it is best to use large-bore catheters.

Option D: A tourniquet may further damage the injured extremity and should be avoided unless all other measures have failed. For trauma victims with internal bleeding (e.g., pelvic fracture), military antishock trousers (MAST) or pneumatic antishock garments (PASGs) may be used. These devices are useful to tamponade bleeding. Hypovolemia from long-bone fractures (e.g., femur or pelvic fractures) may be uncontrolled by splinting with air splints. Hare traction splints or MAST and/or PASG trousers may be used to reduce tissue and vessel damage from the manipulation of unstable fractures.

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