Non-Hemorrhagic Shock: Difference between revisions

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== Section 5 -MEDICAL ==
== Section 5 - MEDICAL ==
=== 5.13 SHOCK ===
=== 5.13 NON-HEMORRHAGIC SHOCK ===
=== HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION SECONDARY TO FLUID LOSS ===
=== 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.
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* 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.
* Consider administration of [[Anti-Fibrinolytic|Tranexamic Acid (TXA)]] if:
** Sustained Systolic Blood Pressure is less than 90 mmHg AND
** Sustained heart rate of 110 beats per minute or higher
* 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.
* 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|DOPAMINE]] 5 - 20 mcg/kg/minute titrated to systolic BP greater than 90 mm Hg.
* In non-hemorrhagic shock, if condition worsens despite fluid therapy, administer [[Adrenergics|DOPAMINE]] 5 - 20 mcg/kg/minute titrated to systolic BP greater than 90 mm Hg.





Latest revision as of 20:02, 22 April 2020

Section 5 - MEDICAL

5.13 NON-HEMORRHAGIC 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.
  • 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.