blood loss

[rsdemt]

I thought there was an equation, to figure out about blood lose.
But I can not remember.
I had an incident last night, with a family member having a nose bleed. I told him to place his head fowaeds, and then I placed an ice bag on his nose.
But he lost quite a bit of blood.
I was debating on calling 9-1-1. But he refused.
Then he told me he was feeeling very dizzy, and weak.
So he layed down.
So my real question is, how much blood (approximately) can a 150 pound 6 foot tall man lose before symptoms appear.
I took his pulse, and it was 90 and regular. No other equipment availabe. IE: bp cuff, sthescope.
I watched him for about an hour, no other real signs of further problems.
So did I do right, not calling 9-1-1.
Some basic facts: Was at a hotel room. I am thinking nose bleed was caused by having a bowel movement, and pushed hard enough to cause the blees.
Any suggestions, help, comments?

 

[rmellish]

I used to get frequent, heavy nosebleeds. Can you estimate a volume of blood loss?

Everyone will be different though. Remember some of the dizziness / weakness or nausea could be more psychological in nature. Especially if everyone around the patient is seeming worried or the patient thinks they have lost "too much" blood.

 

[mikie]

I have yet to run a nose bleed, other than some friends...

If O2 is warranted, would a cannula (if the bleeding stops) cause irritation? Is it contraindicated?

 

[rmellish]

From personal experience, most of my nosebleeds occurred because my nasal passages dried out, usually overnight. A cannula would probably do the same to me, maybe causing a repeat.

 

[akflightmedic]

Epistaxis is a true emergency and should not be taken lightly.

Definitely need more facts from you in order to guess at this situation, however the first thing that pops in my head aside from trauma is a hypertensive crisis. Weak, dizzy, nosebleed....he definitely should have been checked out.

You did the right things to stop or slow the bleeding but nothing to fix what originally caused it.

 

[Topher38]

To estimate the volume of blood loss, my EMT instructor told us to take a liter of water and poor it on the ground, although there is a diffrence between water and blood he said you could do that. Haha but I have yet to do it. All I know is stop the bleeding

 

[CFRBryan347768]

I have yet to run a nose bleed, other than some friends...

If O2 is warranted, would a cannula (if the bleeding stops) cause irritation? Is it contraindicated?

I wouldnt use the cannula in fear that it might irritate id probally go for blow by.

 

[rmellish]

If they really needed the O2, I'd do a NRB. If they really only need 2-6L via NC, and then you're doing blow by instead of NC (assuming they have do not have COPD) then maybe they don't really need it.

Very situational though.

 

[CFRBryan347768]

If they really needed the O2, I'd do a NRB. If they really only need 2-6L via NC, and then you're doing blow by instead of NC (assuming they have do not have COPD) then maybe they don't really need it.

Very situational though.

I meant blow by from the start.

 

[Explorer127]

I personally wouldn't have called EMS, unless the pt. was really, really sick. I would probably stop bleeding, and btw, im not saying you're wrong, because ur not, but I've always found that putting ice on the back of the neck instead of on the nose works best. I like to use a piece of gauze w/ pressure on the nose, then put a piece of ice on the back of the neck...it makes things so much easier.
Then, if the patient was near-syncopal or was dizzy, I would have them lie down, and elevate their legs. I would probably then give them a glucose tablet, even if i didn't get a blood sugar level just b/c that helps a lot of people, and it really can't hurt them...
I dont think there is much more u can do just because u have no equipment

 

[CFRBryan347768]

but I've always found that putting ice on the back of the neck instead of on the nose works best.

How come putting ice on the back of the neck works?

 

[Explorer127]

How come putting ice on the back of the neck works?

I was taught to do that...
it somehow constricts the vessels b/c your neck is where all your nerves are, i think that's the reason if i remember correctly.

but it definetly does work, i've done it many times

 

[skyemt]

well, of course, nosebleeds can be minor...

you said you leaned the family member's head forward, but did you have him pinch the fleshy part below the bone? that is the standard of care, in my area anyway.

you didn't have the equipment to get a BP, but nosebleeds can also be caused by Hypertensive crisis... which would put the patient in potential serious risk of imminent stroke.

was that ruled out? how much blood was seen? what were the possible causes of the syncopal episode, which is never normal...

was the pulse fast, very slow? irregular? any new meds?

is the patient prone to nosebleeds? was it very dry? was the patient very dehydrated, etc?

the point of doing a good history and ABC's, is to rule out potential life threatening situations, of which a nosebleed may be a sign.

even if 99 out of 100 nosebleeds were not serious, and not taken seriously,
the crew that responded to the 1 out of 100 better take it seriously, or there next position in EMS will be cashier at Eastern Mountain Sports.

you just never know, i've seen a "simple" nosebleed be a precursor to a major stroke.

 

[CFRBryan347768]

or there next position in EMS will be cashier at Eastern Mountain Sports.

thats pretty funny you make that line up your self?

 

[Airwaygoddess]

Nosebleeds

if the patient is symptomatic, it is best to air on the side of caution, speaking of medications check for anticoagulants, aspirin, and any NSID's

 

[skyemt]

thats pretty funny you make that line up your self?

original material, thank you very much...

i even spelled "their" incorrectly, but i haven't been caught yet... lol

 

[paramedix]

I suffer from nose bleeds... It is nothing for me to have a nose bleed once a day/night... and the problem is it goes on for hours. I cant recall that I have ever had or felt "weird" after or during the nose-bleeds.