After a car accident, John comes into the ER with an elevated heart rate and low...
After a car accident, John comes into the ER with an elevated heart rate and low blood pressure. He has a hemorrhagic shock from blood loss.
What i.v. would you administer and why? How will this IV change ventricular pressure/volume dynamics for John?
Homework Answers
Ans)The primary treatment of hemorrhagic shock is to control the source of bleeding as soon as possible and to replace fluid.
- In controlled hemorrhagic shock (CHS), where the source of bleeding has been occluded, fluid replacement is aimed toward normalization of hemodynamic parameters.
- In uncontrolled hemorrhagic shock (UCHS), 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 resuscitation).
- The resuscitation should occur before, or concurrently with, any diagnostic studies. Crystalloid is the first fluid 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.
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