Hypovolemic Shock Management

Abstract

Hypovolemic shock as a result of blood loss was once viewed as a death sentence. Today, as a result of numerous advancements in medicine, it is considered a treatable condition, to an extent. In regards to traumatic mortality, hemorrhage causes thirty to forty percent of deaths. (Kauvar, Lefering, and Wade, 2006). This shows that pre-hospital management of both hemorrhage and the resulting shock are crucial for positive patient outcome. The question becomes, how can providers provide the best chance for good patient outcome? New bleeding control techniques such as tourniquets and haemostatic agents are now being seen as the best methods for bleeding control and information showing a change to shock management with regards to fluid

The specific skills behind controlling a hemorrhage have been largely unchanged for hundreds of years. Since the first century A.D., techniques such as compression, styptics (i.e., hemostatic agents), and torsion/tourniquets have been utilized. ( Kabaroff, 2013). Since then, medicine has strived to develop the best way to improve these methods. Even through hundreds of years of research and trials, it is often found that the simplest, earliest methods remain the standard. Shock treatment has also made strides throughout time and, like bleeding control, is constantly changing as new information. Much of the information that is gathered is done so from warzones as they typically see extensive trauma and blood loss on a daily basis. Understanding what the body does in attempt to self-control bleeding and what would cause it to become ineffective are critical to understanding why our interventions work well. Discussing tourniquets and their advantages and disadvantages as well as understanding when and why shock would become irreversible are questions that will be answered as

The development of compartment syndrome is a risk associated with the prolonged use of a tourniquet over a muscle body. Toxic buildup, similar to crush syndrome, is another risk that occurs from the area distal to the tourniquet not being able to adequately return blood for filtering. Finally, limb necrosis has long been the main fear of tourniquet use. This can occur due to the lack of oxygenated blood cells entering the area distal to the tourniquet. (McEwen,