Non-Hemorrhagic Shock

From Protocopedia
Jump to navigation Jump to search

Section 5 -MEDICAL

5.13 SHOCK

HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION SECONDARY TO FLUID 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.