Hemorrhagic shock
| Hemorrhagic shock | |
|---|---|
| Video explanation of shock | |
 | |
| Specialty | Emergency medicine |
| Symptoms | Fast heart rate, narrowing pulse pressure, anxiety, cool arms and legs, decreased consciousness, low blood pressure[1][2] |
| Causes | Trauma, gastrointestinal bleeding, childbirth, ectopic pregnancy, underlying blood vessel problems[2][3] |
| Diagnostic method | Based on examination and medical imaging[2] |
| Differential diagnosis | Other types of circulatory shock[1] |
| Treatment | Direct pressure, tourniquet use, tranexamic acid, blood products, temperature management, surgery[1][2] |
| Prognosis | Variable[2] |
| Frequency | Relatively common[3] |
Hemorrhagic shock is a type of hypovolemic shock that occurs due to blood loss.[2] Early symptoms may include a fast heart rate and narrowing pulse pressure.[1][2] With further blood loss anxiety, cool arms and legs, decreased consciousness, and low blood pressure may occur.[1] Complications may include hypothermia, blood clotting problems, and multiple organ dysfunction syndrome.[4]
The cause of blood loss may include trauma, gastrointestinal bleeding, childbirth, ectopic pregnancy, and underlying blood vessel problems.[2][3] Bleeding may occur within the body or externally.[2] Significant blood loss can occur within the abdomen, chest, and retroperitoneum.[2] The underlying mechanism involves not enough blood flow to body tissues.[1] A shock index (heart rate/systolic blood pressure) of greater than 1 can indicate who is likely to need blood transfusions.[1] Ultrasound, in the emergency department, may be useful in determining the location of the blood loss.[2]
The initial management is based on ATLS.[1] The primary treatment is stopping the source of bleeding.[2] This may include direct pressure or tourniquet use.[1] Other measures may include tranexamic acid, blood products, and temperature management.[1] In those without a head injury, the blood pressure may be permitted to remain relatively low until surgery can be performed.[2] Hemorrhagic shock is relatively common.[3] About half of deaths due to trauma are due to bleeding and bleeding remains the primary preventable cause of trauma related death.[2][1] The risk of death or poor outcomes is high.[1]
References
- 1 2 3 4 5 6 7 8 9 10 11 12 Pitotti, C; David, J (November 2020). "An evidence-based approach to nonoperative management of traumatic hemorrhagic shock in the emergency department". Emergency medicine practice. 22 (11): 1–24. PMID 33105073.
- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Hooper, N; Armstrong, TJ (January 2020). "Hemorrhagic Shock". PMID 29262047.
{{cite journal}}: Cite journal requires|journal=(help) - 1 2 3 4 Taghavi, S; Askari, R (January 2020). "Hypovolemic Shock". PMID 30020669.
{{cite journal}}: Cite journal requires|journal=(help) - ↑ "Hemorrhagic Shock". fpnotebook.com. Archived from the original on 1 December 2020. Retrieved 4 January 2021.