ITLS Hemorrhage control and shock

What are the four components of the vascular system needed for normal tissue perfusion?

1. Blood volume 2. Heart function 3. Blood vessel integrity 4. Blood flow

What are the signs and symptoms of compensated shock?

Weakness, pallor, tachycardia, narrowed pulse pressure, thirst, delayed capillary refill.

What is the first sign of decompensated shock?

Hypotension.

List the three common clinical shock syndromes.

Hypovolemic shock, obstructive shock, cardiogenic shock.

What does shock result in at the cellular level?

Cellular hypoxia leading to anaerobic metabolism and increased lactate levels.

What is the pathophysiology of hypovolemic shock?

Loss of blood volume leading to inadequate perfusion and resultant hypoxia.

What is the primary management step for controllable hemorrhage?

Direct pressure to control the bleeding.

What is the indication for using tranexamic acid (TXA) in hemorrhagic shock?

TXA stabilizes fibrin clot after trauma and should be given as early as possible.

What symptoms indicate neurogenic shock?

Hypotension, normal or slow heart rate, warm dry skin, paralysis.

What is the mechanism of mechanical shock?

Obstruction of blood flow to or through the heart, slowing venous return and decreasing cardiac output.

What are the signs of early hypovolemic shock?

Weakness, pallor, tachycardia, diaphoresis, tachypnea.

What is the major risk of treating patients with hemorrhagic shock late after injury?

TXA becomes less effective and may be harmful.

What are the four types of shock?

Hypovolemic, distributive, obstructive, cardiogenic.

What is the importance of monitoring lactate levels in the context of shock?

Lactate levels help monitor shock status in the field.

What is the classic pattern of shock progression?

Decreased red blood cells, inadequate perfusion, worsening hypoxia, increased catecholamines, and cell death.