Hemorrhagic shock: Difference between revisions

Revision as of 07:24, 18 February 2015

Cardiogenic
- Acute valvular Regurgitation/VSD
- CHF
- Dysrhythmia
- ACS
- Myocardial Contusion
- Myocarditis
Obstructive
- Air embolism
- Aortic Stenosis
- Cardiac Tamponade
- PE
- Tension pneumothorax
Distributive
- Adrenal Crisis
- Anaphylaxis
- Neurogenic Shock
- Sepsis
- Toxicologic
Hypovolemic
- Severe dehydration
- Hemorrhagic shock (traumatic and non-traumatic)

Class	I	II	III	IV
Blood Loss (mL)	< 750	750-1000	1500-2000	>2000
Blood Loss (%)	< 15	15-30	30-40	>40
Pulse rate (per min)	<100	100-120	120-140	>140
Blood Pressure	Normal	Normal	Decreased	Decreased
Pulse Pressure (mmHg)	Normal or Increased	Decreased	Decreased	Decreased
Respiratory Rate (per min)	14-20	20-30	30-40	>35
Urine Output (mL/hr)	>30	20-30	15-May	Negligble
Mental Status	Slightly Anxious	Mildly Anxious	Anxious, Confused	Confused, Lethargic

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 ==See Also==
+*[[Undifferentiated shock]]
 ==External Links==
@@ Line 17: / Line 18: @@
 ==Sources==
 <references/>
-== Undifferentiated Hypotension Algorithm ==
-Check/manage the following in order:
-*Pulse (assess based on pt's age)
-**Too slow or too fast (to the point where CO is affected)?
-***If so, HR is likely primary etiology of hypotension
-***Pace or cardiovert
-*Volume Status
-**What is the LV end-diastolic volume?
-***Approximated by the [[Ultrasound: IVC|IVC diameter]] or CVP
-***If low:
-****Assess for blood loss versus fluid loss
-*****[[Ultrasound: FAST|FAST]] for intra-abdominal bleed
-*****US for ruptured [[Ultrasound: AAA|AAA]]
-*****Guaiac for GI bleed
-*****CXR for hemothorax
-****Treat with IVF and/or pRBC depending on cause
-*Contractility
-**Is the myocardium severely depressed in its contractile function (cardiogenic shock)?
-***Assess via [[Ultrasound: In Shock and Hypotension|ultrasound]]
-***Treat w/ inotrope
-**Is forward flow occurring?
-***Assess for valvular dysfunction (MR, AR)
-***Assess for obstruction (PE, tamponade)
-*Systemic Vascular Resistance
-**Pathologic vasodilation (decreased SVR) suggested by:
-***Warm extremities
-***Bounding pulse
-**Treated based on likely etiology of distributive shock (see below)
 ==Differential Diagnosis==