Hemorrhagic Shock Treatment & Management

Etiopathology: Due to whole blood loss like.

Surgical: During and following any major surgery especially cardiopulmonary bypass, pelvic surgery or major abdominal surgery.
Traumatic: As a result of any type of major accident,warfare injuries, homicidal or following suicidal injury as by knife, bullet, etc.
GI bleeding: Bleeding from peptic ulcer, perforation of intestine, bleeding from esophageal varices, etc.
Obstructive bleeding: Incomplete abortion, placenta previa, etc.

“Impact Of Hemorrhagic Shock On Daily Life”

Hemorrhagic Shock Clinical Features

Hemorrhagic Shock Treatment And Management

“Causes Of Hemorrhagic Shock”

Hemorrhagic Shock Management of Hemorrhage Shock

The primary treatment of hemorrhagic shock is to control the source of bleeding as soon as possible and to replace flid.
In controlled hemorrhagic shock, where the source of bleeding has been occluded, fluid replacement is aimed toward normalization of hemodynamic parameters.
In uncontrolled haemorrhagic shock, in which the bleeding has temporarily stopped because of hypotension, vasoconstriction, and clot formation, fluid treatment is aimed at restoration of radial pulse or restoration of sensorium or obtaining a blood pressure of 80 mm Hg by aliquots of 250 mL of lactated Ringer’s solution (hypotensive re-suscitation).
When evacuation time is shorter than 1 hour (usually ur-ban trauma), immediate evacuation to a surgical facility is indicated after airway and breathing have been secured.
When expected evacuation time exceeds 1 hour, an intra-venous line is introduced and flid treatment is started before evacuation.
The resuscitation should occur before or concurrently with, any diagnostic studies.
Crystalloid is the fist flid of choice for resuscitation.
Immediately administer 2 L of isotonic sodium chloride solution or lactated Ringer’s solution in response to shock from blood loss.

“Symptoms Of Hemorrhagic Shock”

Fluid administration should continue until the patient’s hemodynamics become stabilized.
Because crystalloids quickly leak from the vascular space,each liter of flid expands the blood volume by 20–30%; therefore, 3 L of flid need to be administered to raise the intravascular volume by 1 L.
Alternatively, colloids restore volume in a 1:1 ratio. Currently available colloids include human albumin, hydroxyethyl starch products (mixed in either 0.9% isotonic sodium chloride solution or lactated Ringer’s solution), or hypertonic saline-dextran combinations.
Packed red blood cells (PRBCs) should be transfused if the patient remains unstable after 2000 mL of crystalloid resuscitation.
For acute situations, O-negative noncross-matched blood should be administered.
Administer 2 U rapidly, and note the response.
For patients with active bleeding, several units of blood may be necessary.

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