Section 3 - Hemorrhage and Shock Part 2

Hemorrhage can occur from external or internal causes. Internal bleeding can be challenging to detect and must be suspected by the EMT-I through signs, symptoms, the mechanism of injury (in traumatic cases) and sometimes the patient’s past medical history (hypertension, GI bleeds, pregnancy, or aneurisms). Signs and symptoms of internal bleeding include abdomen pain, blood in the urine (hematuria) or feces, bloody vomit, weakness, dizziness and syncope.

The average adult patient has 6 liters of blood circulating in their body. A loss of 1 liter of fluid (via hemorrhage or other causes of fluid loss) will cause the body to compensate for the deficit in a variety of ways. First, when the brain detects a drop in pressure (via baroreceptors) stores of Epinephrine are released constricting vessels and speeding up the heart (tachycardia) thereby moving what blood is left around the body more quickly. A side-effect of Epinephrine when constricting the blood vessels is pallor and sweating. With a drop in the arterial pO2, the brain will stimulate the lungs and related respiratory muscles to work more quickly (tachypnea). In the event of hemorrhage (internal or external) the body will also attempt to slow the bleeding by constricting broken vessels and rushing platelets to the site in attempt to plug the hole with a clot.

With the above information, answer the following questions based on the prior activity (Richard the assistant manager of the hardware store complaining of abdomen pain).