THE

CARDIOVASCULAR
SYSTEM
Introduction
• involves the heart and blood vessels
• System keeps body supplied with oxygen &
nutrients.
• Carries away CO2 and waste materials
• System can be disrupted by severe external
or internal bleeding or fluid loss eg in
burns, trauma
• Heart pumps blood rhythmically through a
network of vessels- arteries, veins,
capillaries
• Force exerted by blood flow through the
main arteries is called blood pressure
• Blood supply to the heart muscle is by
coronary arteries
• Heart beat is controlled by electrical impulses
generated in the heart.
• A heart beat has 3 phases- atrial systole,
ventricular systole and complete diastole
• Conductive system; Sinu- atrial node- atrio
ventricular node- bundle of HIS- AV
branches- purkinje fibres
Composition of blood

• About 6 litres in an adult

• 55% of blood is plasma
• 45% cells- Red Blood Cells, platelets, White
Blood Cells.
• RBC contain hemoglobin that carries oxygen
• WBC- defense against infections
• Platelets- help in blood clotting
Bleeding and types of wounds
• When a blood vessel is injured, it constricts ,
a series of reactions occur to form a clot
• If the blood vessel is large, uncontrolled
blood loss may occur before clotting takes
place and shock may develop
Types of bleeding

ARTERIAL BLEEDING
• Blood is bright red in colour.
• Flow is pulsatile
VENOUS BLEEDING
• Blood is dark red in colour
• Steady flow
CAPILLARY BLEEDING
• Red in colour, even flow
EFFECTS OF HAEMORRHAGE

• Lack of oxygen supply to the tissues.

• Decrease in blood volume causes a drop in
blood pressure.
• Heart rate increases
• Shock follows soon
• Bleeding may be external or internal
External bleeding

• Evidence of major external blood loss

presents with signs of shock:
• 1.thirst, blurring of vision, fainting,
• 2.skin is clammy,
• 3. weak pulse, restlessness,
• 4. shallow breathing, unconsciousness
Internal bleeding
• Signs and symptoms of shock
• Blood may appear from the body orifices: nose,
ear, mouth, rectum, urethra, vagina
• Fracture of long bones of the upper arm and the
thigh.
• Swelling of the abdomen.
• Wounds that have penetrated the chest.
• Wounds that have penetrated the skull
.
• Orifice possible cause
• Nose broken nose, fractured skull
• Ear perforated ear drum, skull #
• Mouth jaw #, injury to G.I.T
• Rectum piles, intestines
• Urethra blood in urine kidney, bladder,

• Vagina menstrual flow, abortion

General management
• Place the victim in such a position that he is
least affected by blood loss
• Place the person in a supine position and
elevate the legs in a semi flexed position.
• Control bleeding
• Maintain airway
• Keep person warm and calm.
Major external bleeding
• Apply pressure over the wound until
bleeding stops. this may take up to 30
minutes
• Apply clean dressing over the wound.
• Bandage firmly to control bleeding but not so
tightly to cut off circulation.
• Elevate the bleeding part above the heart.
• pressure points
Pressure points
• Arterial bleeding can be controlled by the
digital thumb or finger pressure at this
points.
• Pressure points are the places over a bone
where arteries are close to the skin.
• Pressure on the artery can control flow of
blood to the injured part.
Main Arteries/Pressure Points

• Arms: Brachial Artery

• Legs: Femoral Artery (use heel of hand)
Applying a tourniquet
• A tourniquet is a device used to control
severe bleeding in the extremities.
• It Can be improvised by the use of a belt,
cloth, and a piece of wood.
• The piece of cloth is twisted around the limb
at a point proximal to the injured site.
Nose bleeding

• Occurs from the vessels inside the nostrils

• Sit the casualty down.
• advice him to breath through the mouth and
pinch the soft part of the nose, and lean
forwards
• Tell him to spit out any blood in the mouth.
• Release the pressure after 10 minutes : reapply
pressure if bleeding persists
• Avoid exercise, blowing the nose,
Dressings and bandages

• Are protective coverings applied to the

wound in order to:
 Control bleeding
 Prevent infection
 Absorb discharge
 Avoid further injury
 Assist in healing
Types of wounds

• Incised wounds- bleeding may be profuse

• Laceration- has less bleeding
• Abrasion
• Contusion
• Stab wound
• Gunshot wounds- has an entry & an exit
• Puncture wound- nail injury
Wounds: AVULSION

Avulsion: a cut in which a portion of skin

or other soft tissue is partially or
completely torn away.
Wounds: CUT

Cut: jagged or smooth edges, commonly

caused by knives, scissors, or broken glass.
Deep cuts can damage nerves, large blood
vessels, and other soft tissues.
Wounds: SCRAPE

Scrape: most
common; skin has
been rubbed or
scraped away.
Scrape exposes
nerve endings.
Easily infected.
Wounds: BRUISE

Bruise: damage to soft tissues and blood

vessels causing bleeding under the skin.
Discoloration and swelling.
Characteristic of dressing materials
• Sterile
• Soft with pores to allow for oozing of
discharge and sweat.
• Large enough to cover the wound.
Types of dressings
• Adhesive dressings
• Adhesive and gauze dressing
• Gauze dressing
• Bandages : triangular and roller bandages
Dressings and bandages
• Dressings and Bandages used on wounds
helps control bleeding, and prevents
infection.
• Dressings: pads placed directly on wound to
soak up blood and keep out germs.
• Bandage: any material used to wrap or cover
any part of the body. Often used to hold
dressings in place, apply pressure that
controls bleeding, and helps support an
injured part of the body.
General rules for dressings
• Wash your hands before dressing
• Clean the wound if bleeding is under control.
• Avoid touching the wound.
• Do not cough on a wound
• Do not remove dressing, apply over the top
of blood soaked dressing.
Bandages
• Are made of cotton , elastic net, or other
materials. they are used to maintain direct
pressure over a dressing
• Control bleeding
• Hold dressings or splint in position
• Restrict movement
• Assist in lifting casualty
Roller Bandage

• Roller Bandage: AKA pressure bandage. Used

to control bleeding.
• Secure dressing with bandage.
• Use overlapping turns to cover the dressing
completely. Extend several inches beyond
dressing. If possible do not cover fingers.
• Tie or tape the bandage in place.
• Check the fingers for warmth, color, and
feeling. (If fingers turn pale or blue, or
become cold…the bandage is too tight.
Loosen it.)
• If blood soaks through bandages put on more
bandages, do not remove blood soaked ones.
• If too tight: restricts blood flow, this causes
tissue damage, and is very painful.
Control Bleeding Practice

• Put gloves on
• Place and hold dressing against wound
• Elevate wound above level of heart if
possible.
• Add bandage dressing, cover bandage with
dressing. Keep starting end loose to tie at
end.
• Secure by taping or tying.
• If blood seeps through dressing, add another.
• If blood continues to seep through, push
artery against bone.
Quick Steps for Controlling Bleeding
• Cover & Press Firmly
• Elevate
• Bandage
• Add Bandage if blood continues
• If bleeding still doesn’t stop, push artery
against bone.
Controlling Bleeding

• Finger Wraps: wrap entire finger, or multiple

fingers. Leave finger tip exposed if possible.
• Eye Injuries: bandage lightly
Controlling Bleeding

• Mouth Injuries
• If you don’t suspect a serious head or spine
injury, place victim in seated position with
head tilted forward to allow blood to drain
out.
• To control bleeding inside cheek, place a
folded dressing inside mouth against
wound.
• To control on the outside, use dressing to
apply pressure.
• If tooth is knocked out, place sterile
dressing directly on space left by tooth.
Tell victim to bite directly on space left by
tooth.
Controlling Bleeding
• Head Injuries
(may also wrap
wound)
Rules
• Do not bandage too tightly as to interfere
with circulation or too loosely as for the
dressing to fall off.
• Apply bandage with casualty sitting or lying
down.
• Cover entire wound
• Expose toes and nails