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References
McCance, K.A. & Huether, S.E. (2010). Pathophysiology: The biologic basis for disease in adults and children (6th ed). St. Louis: Mosby.
Module 8 (B)
Hypovolemic shock
Hypovolemic shock is noted by McCance and Huether (2010) to be an emergency condition in which severe fluid and blood loss makes the victim's heart unable to sufficiently pump enough blood to the victim's body. This kind of shock is noted by McCance and Huether (2010) to result in multiple organ failure.
Brief case scenario presenting a patient who has experienced this type of shock
Mrs. Robertson was presented to the hospital with pale skin, was slipping into unconsciousness and sweating very heavily. She had been involved in a motor accident and had suffered massive hemorrhage on her left thigh. Her systolic blood pressure was 92 mmHg, and matched that of aperson suffering from stage 3 hypovolemic shock. Her leg had no pulse and fell unconscious after hemorrhaging profusely from the left thing. Her Cardiac output could not be maintained by arterial constriction. She had increase respiratory rate and increase diastolic pressure. Her pulse rate was to narrow.Afer first aid; she gained consciousness but was restless.
Associated pathophysiology
The condition is characterized by a massive loss in an individual's intravascular volume that subsequently results in a decreased level of preload. Due to the fact that preload is one of the main determinants of stroke volume, the cardiac output automatically falls. The very initial case of hemodynamic abnormality of fluid loss inadvertently activates the rather compulsory mechanism under the control of the neuroendocrine system which maintains an adequate level of central perfusion irrespective of reduced level of cardiac output. Systemic vasoconstriction can however lead to hypoxia, tissue ischemia and ultimately to alteration of cellular function as well as global organ dysfunction in the worst case scenario (Worthley,2000).
Treatment of hypovolemic shock
The management of hypovolemic shock is critical since the condition is...
The tremetment involves seeking medical help while in the meantime, keeping the patients as warm and comfortable as possible (in order to prevent hypothermia). The person should be placed to lai down in a flat position with his or her feet lifted about twelve inches (in order to increase circulation).However, should the individual suffer from a neck, head, leg or back injury, then their position should never be changed since they are in immediate danger. Fluids should never be given by mouth. If the patient has an allergic reaction, then the allergy must first be treated. Should there be a need to move or carry the patient, then they should be kept flat with their head pointed downwards and their feet lifted. Their head and neck should be stabilized prior to moving any patient with a suspected spinal injury. The main goal of any hospital treatment is to effectively replace the lost fluids and blood. An IV line will need to be placed on the victim's arm to allow for blood and any other blood products to be infused.
Pharmacological interventions such as dobutamine, dopamine, norepinephrine as well as epinephrine will then have to be administered to the patient so as to increase their blood pressure as well as the cardiac output. Other techniques like Heart monitoring, Swan-Ganz catheterization as well as Urinary catheter for collecting and monitoring how much urine is produced are also employed in order to manage as well as monitor the patient's response to treatment.
References
McCance, K.A. & Huether, S.E. (2010). Pathophysiology: The biologic basis for disease in adults and children (6th ed). St. Louis: Mosby.
Shires, GT (1979).Management of hypovolemic shock. Bull NY Acad Med. 1979 February; 55(2): 139 -- 149.
Worthley, LIG (2000).Shock: A Review of Pathophysiology and Management. Part I. Critical Care and Resuscitation 2000; 2: 55-65
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