Difference between revisions of "Shock"

Latest revision as of 06:11, 13 November 2020

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.

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 * 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 [[Adrenergics|DOPAMINE]] 5 - 20 mcg/kg/minute titrated to systolic BP greater than 90 mm Hg.
+* In non-hemorrhagic shock, if condition worsens despite fluid therapy, administer [[Dopamine|DOPAMINE]] 5 - 20 mcg/kg/minute titrated to systolic BP greater than 90 mm Hg.