 Hi, welcome to nursing school explain in this video on acute blood loss anemia. While most anemias actually have chronic causes that will develop symptoms over time, acute blood loss anemia is just that. So there can be certain things that cause this acute blood loss and they could be trauma, surgery and an aortic dissection. So the trauma can be minimal or or small, let's say from a car accident where they seat belt compresses the internal organs and causes some tear of a mesenteric artery or it can be severe where the patient has a accident with a chainsaw and cuts a major blood vessel and has acute blood loss there. So think about the different stages of trauma we could have and and so this acute blood loss leads to hypervolemia and again the degree of injury depends on how much blood loss the patient will have and how symptomatic they'll be. If it is slower, so if it's not a major blood vessel that is injured that causes this acute blood loss, the red blood cells will get lower over time and I'm not meaning over months, I mean more about hours or days, which is why it's so important to keep a very, very close eye on any of patients that come from surgery or trauma victims or had an aortic dissection because these symptoms might develop over time. So keeping an eye on their CBC is going to be key. And so the signs and symptoms that the patient might have depend on the volume that they lost. So it can be anything from a small blood loss that might be positive for orthostatics. If there's more blood loss they might show tachycardia and hypotension and that's again is why we're trending vital signs and many times in the trauma room the patient's vital signs are taken every two minutes every five minutes because we want to keep an eye on their vitals and trend them and make sure that we're not missing anything. If the blood loss is more severe they might even be short of breath because now they've lost that oxygen carrying capacity of the red cells they might also start to get diaphoresic and have altered level of consciousness because now only the important organs are being perfused and the skin is not an important organ in a case of acute blood loss and the patient might also exhibit these altered level of consciousness as their brain gets less perfused. And then eventually the more severe symptoms can lead to shock so hypovolemic shock and then eventually the patient will die because they just don't have enough blood volume in their system and symptoms here are listed from less to more or most severe. And then as in terms for diagnostic tests we certainly want to check a CBC and for this particular anemia of blood loss there RBC and H hemoglobin and hematocrit will be low. We also want to check coagulation studies because we know that with this acute blood loss not only are they losing red cells they're also losing platelets coagulation factors white cells clotting factors all these things we want to make sure we check that and then in anticipation we should be typing and crossing the patient because we know most likely they are going to need a blood transfusion. So the goal is to replace the volume that is lost and while the blood bank may be processing the typing and screening or that all negative blood becomes available we might give the patient some isotonic fluids just to give them some volume to keep the blood pressure up. Colloids might even be required and then packed red blood cells to replenish those packed those red blood cells that the patient has lost but like I mentioned with acute blood loss you don't only use red blood cells you also lose all these other things so we might have to think about replacing those and they can be platelets plasma clotting factors and cryoprecipitate so please watch my video on the different types of blood products to get a better understanding of what that means and what we are trying to accomplish here. And then after the acute phase is done so now the trauma has been contained or the surgical blood loss has been taken care of and eventually over time after this acute phase is done the patient will also need iron supplementation to help the bone marrow produce all these blood cells and produce specifically the red blood cells that can be so detrimental to the patient's health. For nursing care if this is a trauma victim we want to make sure we approach them appropriately and follow the ABCDEFGHI approach and I have a special video that goes over the trauma assessment if this is a post-op patient which is why we're checking vital signs and all those things so frequently on post-op patients because we know they're at high risk for bleeding just in case so we need to check their vital signs again to trend and then check any kinds of tubes drainage tubes they have think about JP drains tubes as well as chest tubes for example and dressing surgical dressings to check if they're saturated or filling up with blood because that also can contribute to blood loss and then also the level of consciousness plays a big role here because we know that eventually the patient will become altered so we also want to check their skin and their level of consciousness to see and maybe detect any kinds of hypovolemia soon enough so that we can intervene and then as talked about over here we need to replace IV fluids and the blood products that we discussed over here to make up for that lost blood and then hypovolemia now I have several videos that pertain to this topic which is mostly the videos in the trauma and emergency care site but there's also critical care videos that go over hypovolemic shock and you might even find the one on fluid volume deficit helpful so I'll make sure to put all the descriptions of the videos and the links in the description below so that you have easy reference thanks for watching see you soon