3. Shock Flashcards
Features of tamponade
Tachycardia Muffled heart sounds Dilated neck veins Hypotension Non-response to fluids
Class I haemorrhage. Approx amount of blood loss:
15%
Class II haemorrhage. Approx amount of blood loss:
15-30%
Class II haemorrhage. Signs:
15-30% blood loss
Tachycardia.
Reduced pulse pressure.
Reduced base deficit: -2 - -6
Class III haemorrhage. Approx amount of blood loss:
30-40%
Class III haemorrhage. Signs:
30-40%
Tachycardia Blood pressure may drop Pulse pressure down Resp rate up Urine OP down Base deficit down: -6 - -10
Class IV haemorrhage. Approx amount of blood loss:
40% +
Class IV haemorrhage. Signs.
40% + Tachycardia Hypotensive Pulse pressure down Resp rate up Urine OP way down Base deficit -10 or less
Fractured tibia or humerus can result in how much blood loss?
750ml
Fractured femur can result in how much blood loss?
1.5L
Initial fluid therapy: typical volume
1 L for adults
20mL per kg for paediatric pateitns
What are the patterns of fluid responsiveness in trauma patients?
Rapid responders
Transient responders
Minimal/non responders
What does transient response to fluids suggest in a trauma patient?
Ongoing blood loss or inadequate resuscitation.
Typically class II or class III haemorrhage
Action required for transient response to fluid resuscitation?
Rapid surgical intervention
Consider massive transfusion protocol
Action required for no response to fluid resuscitation?
Activation of massive transfusion protocol
Immediate definitive intervention.
Consideration of non-haemorrhagic causes of shock
Definition of massive transfusion
More than 10 units of RBCs within 25 hours
Or MOre than 4 units per hour.
How do you investigate coagulopathy in a trauma patient?
Prothrombin time
Partial thromboplastin time
Plastelet count
