Hypovolemic Shock

Hypovolemic Shock

1. Fluid loss resulting in decrease of intravascular volume

   • 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
   • ▼ Cardiac output
     • ▼ Tissue perfusion
       • Compensatory Mechanisms Activated
         • Epi/Norepi release
           • ▲ HR and systemic vascular resistance
         • Renin-Angiotesin-Aldosterone & ADH release
           • Intracellular fluid shift to intravascular space
             • ▲ Blood volume
               • ▲ Cardiac output
                 • Compensatory Mechanisms Fail
                   • ▼▼ Cardiac output
                     • ▼▼▼ Blood pressure
                       • ▼▼▼ Vital organ perfusion
                         • Multisystem Organ Failure
   • 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.

2. Classified stages I-IV