Non-Hemorrhagic Shock: Difference between revisions
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== Section 5 -MEDICAL == | == Section 5 -MEDICAL == | ||
=== 5.13 SHOCK === | === 5.13 SHOCK === | ||
=== HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION SECONDARY TO | === HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION NOT SECONDARY TO BLOOD LOSS === | ||
INITIAL MEDICAL CARE - Provide OXYGEN or assist ventilations as appropriate for patient condition. | INITIAL MEDICAL CARE - Provide OXYGEN or assist ventilations as appropriate for patient condition. | ||
| Line 7: | Line 7: | ||
* Control any external hemorrhage if present | * Control any external hemorrhage if present | ||
* For spontaneously breathing patients with a systolic blood pressure less than 100 mm Hg and no known contraindications to the device, apply the [[ResQGuard Impedance Threshold Device|ResQGuard impedance threshold device]] with mask or mouth-piece as indicated (procedure 9.31) if available. Monitor systolic Blood pressure every 2-3 minutes. | * For spontaneously breathing patients with a systolic blood pressure less than 100 mm Hg and no known contraindications to the device, apply the [[ResQGuard Impedance Threshold Device|ResQGuard impedance threshold device]] with mask or mouth-piece as indicated (procedure 9.31) if available. Monitor systolic Blood pressure every 2-3 minutes. | ||
* Establish 2 large bore IV lines. Fluid boluses in increments of 200 - 300 ml, to titrate systolic BP greater than 90 mm Hg. Monitor for signs of fluid overload. | * Establish 2 large bore IV lines. Fluid boluses in increments of 200 - 300 ml, to titrate systolic BP greater than 90 mm Hg. Monitor for signs of fluid overload. | ||
* Limit fluid administration to 2000cc due to possibility of DIC. | * Limit fluid administration to 2000cc due to possibility of DIC. | ||
Revision as of 20:28, 1 October 2018
Section 5 -MEDICAL
5.13 SHOCK
HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION NOT SECONDARY TO BLOOD LOSS
INITIAL MEDICAL CARE - Provide OXYGEN or assist ventilations as appropriate for patient condition.
- Place patient in Trendelenburg
- Control any external hemorrhage if present
- For spontaneously breathing patients with a systolic blood pressure less than 100 mm Hg and no known contraindications to the device, apply the ResQGuard impedance threshold device with mask or mouth-piece as indicated (procedure 9.31) if available. Monitor systolic Blood pressure every 2-3 minutes.
- Establish 2 large bore IV lines. Fluid boluses in increments of 200 - 300 ml, to titrate systolic BP greater than 90 mm Hg. Monitor for signs of fluid overload.
- Limit fluid administration to 2000cc due to possibility of DIC.
- If known hemorrhagic shock infuse fluid rapidly until systolic BP greater than 90 mm Hg. Monitor patient for signs of fluid overload.
- In non-hemorrhagic shock, if condition worsens despite fluid therapy, administer DOPAMINE 5 - 20 mcg/kg/minute titrated to systolic BP greater than 90 mm Hg.
ADMINISTRATION OF DOPAMINE TO HYPOVOLEMIC PATIENTS IS CONTRAINDICATED.