Question

1. Explain why the following may occur in a patient suffering from hemorrhagic trauma
   • Decreased Hct/Hb
   • Increased blood glucose
   • Decreased blood pressure
   • Decreased skin coloring
   • Increased HR
   • Increased respiratory rate
   • Increased acidosis: Their blood pH is typically lower than 7.35
   • Decreased urine output

Answer 1

• Hemorrhagic trauma causes loss of a huge volume of blood, which immediately decrease the fluid volume in the body and also cause loss of red blood cells. Hemoglobin is a component of RBCs, so the loss of RBCs causes decreased hemoglobin percent and decreased hematocrit (due to loss of RBCs)
• Any type of trauma stimulate the sympathetic response, which releases epinephrine and nor epinephrine. These hormones and neurotransmitters increase the release of glucose from the liver (glycogenolysis) and cause arise in blood pressure
• Reduced fluid volume reduce the blood pressure
• Reduced peripheral blood supply (due to reduced fluid volume) and reduced hemoglobin levels, reduce the skin coloring
• The heart rate increases in a reflex manner to increase the cardiac output and blood supply to the organs
• The rate of respiration increases simultaneously with raise in HR in response to the sympathetic stimulation. It is needed to provide adequate oxygen supply to the cells
• Increased acidosis (fall in pH) occur due to increased rate of respiration, and increased metabolic rate (high CO2 production)
• The urine output decreases due to reduced fluid volume and BP. It releases ADH from the hypothalamus, which increase the fluid and electrolyte reabsorption