NREMT EMT 8: Psychomotor Skills Stations - Bleeding Control, Shock Management, Tourniquet, Wound Packing, Pressure Dressing, Pelvic Binder Application, MAST/PASG Where Applicable

Bleeding Control / Shock Management Study Guide

What This Is

Bleeding control and shock management are emergency skills used to save lives by stopping severe bleeding and preventing shock. Imagine someone is cut badly in a car accident – if you can stop the bleeding, you can buy them precious time until help arrives.

Key Steps / Core Facts

• Tourniquet application: A tourniquet is a device that stops blood flow to a limb. Apply it above the wound, but not too tight (at least 2 inches above). Use a tourniquet if the bleeding is severe and you can't stop it with a pressure dressing. (CATS: Control, Apply, Tighten, Secure)
• Wound packing: Packing a wound means filling it with gauze to stop bleeding. Use a generous amount of gauze, but don't pack it too tight. (ABCs: Airway, Breathing, Circulation)
• Pressure dressing: A pressure dressing is a bandage that applies pressure to stop bleeding. Use a dressing that's at least 2 inches wide and apply it firmly. (OPQRSTI: Onset, Provocation, Quality, Region, Radiation, Severity, Time, Injuries)
• Pelvic binder application: A pelvic binder is a device that stabilizes the pelvis in case of a severe injury. Apply it if you suspect a pelvic fracture. (C-spine immobilization: Keep the neck straight and stable)
• MAST/PASG application: MAST (Military Anti-Shock Trousers) and PASG (Prehospital Airway Support Girdle) are devices that help control bleeding and prevent shock. Use them if you're trained and the situation is severe. (1:10 ratio: 1 liter of IV fluid for every 10 kg of body weight)
• Shock management: Shock is a life-threatening condition that occurs when the body doesn't get enough blood flow. Look for signs of shock: pale skin, weak pulse, and shallow breathing. (AVPU: Alert, Verbal, Pain, Unresponsive)
• CPR compression depth: CPR (Cardiopulmonary Resuscitation) is a lifesaving skill that involves compressing the chest to keep blood flowing. Use a depth of at least 2 inches (like pushing down a soda can). (30:2 ratio: 30 chest compressions followed by 2 breaths)
• CPR rate: The rate for CPR is 100-120 compressions per minute (like a metronome). (CPR sequence: Compression, Ventilation, Repeat)
• CPR duration: CPR should continue until help arrives or the person starts showing signs of recovery. (CPR duration: Continue until help arrives or the person wakes up)

What Laypeople Can Do

• If someone is bleeding severely, apply a tourniquet or pressure dressing above the wound.
• If someone is showing signs of shock, call 911 and try to keep them calm and comfortable.
• If someone is unresponsive, start CPR (30:2 ratio, 100-120 compressions per minute).
• If you're unsure what to do, call 911 and follow their instructions.

Common Mistakes

• Mistake: Applying a tourniquet too tight or too low.
• Fix: Apply it above the wound, but not too tight (at least 2 inches above).
• Mistake: Not using a pressure dressing when the bleeding is severe.
• Fix: Use a dressing that's at least 2 inches wide and apply it firmly.
• Mistake: Not calling 911 in case of a severe injury.
• Fix: Call 911 immediately and follow their instructions.

Quick Practice Scenarios

• A person is cut badly in a car accident and is bleeding severely. What should you do first?
• Apply a tourniquet above the wound.
• A person is unresponsive and not breathing. What should you do first?
• Start CPR (30:2 ratio, 100-120 compressions per minute).
• A person is showing signs of shock (pale skin, weak pulse, shallow breathing). What should you do first?
• Call 911 and try to keep them calm and comfortable.

Last-Minute Exam Cram

• Agonal breathing is NOT normal breathing – start CPR.
• Normal blood pressure range: 90-120 mmHg.
• Normal heart rate range: 60-100 beats per minute.
• Normal respiratory rate range: 12-20 breaths per minute.
• CPR sequence: Compression, Ventilation, Repeat.
• 1:10 ratio: 1 liter of IV fluid for every 10 kg of body weight.
• MAST/PASG application: Use if trained and the situation is severe.
• Pelvic binder application: Use if you suspect a pelvic fracture.
• Tourniquet application: Use above the wound, but not too tight (at least 2 inches above).
• Wound packing: Use a generous amount of gauze, but don't pack it too tight.