ATLS | Shock

🚑 Trauma Shock & Thorax Emergencies

I) 🩸 Hemorrhagic (Hypovolemic) Shock

Patho: Acute blood loss ↓preload → ↓SV/CO; early tachycardia + vasoconstriction; prolonged hypoperfusion → lactic acidosis; lethal triad = 🧊 hypothermia + 🩸 coagulopathy + acidosis. Fluids/Blood:

• Warm crystalloids (1 L adult, 20 mL/kg peds) → avoid excess; consider permissive hypotension.
• MTP: pRBCs/Plasma/Plts (warm). O neg for childbearing-age females; AB plasma if unknown type.
• TXA: within 3 hrs (bolus then 8-hr infuse).
• Calcium: guide by ionized Ca²⁺. No vasopressors first-line. Team: MD leads definitive bleed control (OR/angio); RN gets 2 large-bore IVs/IO, gives warmed fluids/blood ...