Hypovolemic Shock

Annotations:

• Traumatic hemorrhage: Long bone/pelvic fx, solid organ rupture, major vessel disruption, open wounds.  Nontraumatic hemorrhag: GI bleed, ruptured AA, ruptured ectopic pregnancy, epistaxis, OB hemorrhage, DIC

1. ▼ Cardiac output
   1. ▼ Tissue perfusion
      1. Compensatory Mechanisms Activated
         1. Epi/Norepi release
            1. ▲ HR and systemic vascular resistance
         2. Renin-Angiotesin-Aldosterone & ADH release
            1. Intracellular fluid shift to intravascular space
               1. ▲ Blood volume
                  1. ▲ Cardiac output
                     1. Compensatory Mechanisms Fail
                        1. ▼▼ Cardiac output
                           1. ▼▼▼ Blood pressure
                              1. ▼▼▼ Vital organ perfusion
                                 1. Multisystem Organ Failure
2. Remember ABCs. O2 via NRB if conscious, ET if unconscious. Sp02 and ABG. Stop bleeding (pressure, dressing, splints, OR etc.). 2 large bore IV with isotonic crystalloids (LR/NS) - warm to prevent hypothermia and metabolic acidosis. Draw labs, including type/crossmatch. NG, foley, monitors.