ATLS | Shock
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đ Trauma Shock & Thorax Emergencies
I) 𩞠Hemorrhagic (Hypovolemic) Shock
Patho: Acute blood loss âpreload â âSV/CO; early tachycardia + vasoconstriction; prolonged hypoperfusion â lactic acidosis; lethal triad = đ§ hypothermia + 𩞠coagulopathy + acidosis. Fluids/Blood:
- Warm crystalloids (1 L adult, 20 mL/kg peds) â 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 CaÂČâș. No vasopressors first-line. Team: MD leads definitive bleed control (OR/angio); RN gets 2 large-bore IVs/IO, gives warmed fluids/blood ...Â
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