Hemmorage Hypovolemia CPG Flashcards
Care objectives
- To identify and control heamorage
- To maintain vital organ perfusion while minimising cogulopthy, hypothermic and acidosis
- To transport rapidly to a facility capable of definitive care
What may be accepted to reduce the amount of fluids given before control of a haemorrhage?
- accepting a degree of hypotension and tachycardia
If a patient has a BP of less than 70mmHg what would you expect?
Difficult/unable to ascertain their blood pressure
Loss of radial pulse
If a patient has BP of 70mmHg or above and an altered conscious state what should be considered?
Other causes- Hypoglycaemia, TBI, Dementia, OD, ETOH
What is the preferred fluid to be given?
Blood products rather than normal saline
What could be an indication of a tension pneumothorax?
A patient with a chest injury with persistence IPPV or hypotension despite fluid administration
What should you consider when thinking of transporting and managing a patient who may be in shock?
Do not delay transport for things such as IV therapy where possible. Consider concurrent treatment and transport.
Who does this CPG apply to?
Suspected ruptured AAA, massive GI bleed and pregnant major trauma patients
Who does this CPG not apply to?
Isolated SCI, PPH or TBI
What do you do if a patient has a blood pressure above 70?
- Tolerate hypotension without fluid replacement for up to 2 hours
- Prepare for deterioration
- Consult with clinical or hospital if prolonged extraction, long transport time or elderly/frail
What can potentially mimic hypovolemia?
TPT
Extreme pain
Heat exposure (hot or cold)
What do you do if a patient has a blood pressure of below 70
- Prioritise immediate transport
- Normal saline 250ml IV to a max of 2000ml IV titrating to a blood pressure of 70mmHg or above
- Consult for further fluids if management unsuccessful
- Consider the use of blood products if available
