How To Treat A Hemorrage

Essay Question: Treating a Hemorrhaging Patient

Michael Miller

When a hemorrhaging car accident patient bursts through the ER doors, a doctor must first ignore any possible orthopedic injury (e.g. major ligament tear or a skeletal fracture or break) unless one of those injuries is inhibiting the blood flow of the patient. The cardiovascular system of a patient is more important and more fleeting than a physical injury that later could be corrected.

There are many variables that one encounters in treating the hemorrhage, such as blood pressure, stroke volume, heart rate, and the endocrine system of the patient. Initially, when the patient suffers a major wound in an artery or, to a lesser extent, an arteriole, his blood pressure will drop dramatically. The systolic system is under great pressure and a puncture in that system would result in a drop in blood pressure. That would result in a lack of return to the heart, which would decrease baroreceptor firing and thereby increase sympathetic activity . That increase in sympathetic activity will increase the patient's heart rate, which will expel further blood from the heart . In the case of hemorrhage that blood, which follows the path of least resistance, would exit through the wound. The more blood that exits the wound, the more blood pressure would drop, which would lead the heart to pump more blood to the wound. As this pattern progressed because a lot of blood would not make it back to the heart, stroke volume and cardiac output would drop dramatically.

The body will be, in trying to re-establish homeostasis, doing the opposite. This vicious cycle would continue until not enough blood returned to the heart for the patient to supply enough oxygen to his organs. There is no way of knowing which organ would fail first, but it would be a result of cardiac failure.

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