Wednesday, August 4, 2010

Lack of fluids can cause hypovolemic shock

Hypovolemic shock can happen to anyone including us. But whether the actual conditions that can lead to hypovolemic shock, clinical circumstances that we can experience and how we act to deal with such circumstances. Actually, hypovolemic shock can be caused by bleeding (hemorrhagic shock), for example due to trauma. Conditions such as trauma can occur when people experience the state of the car crash, stabbed with sharp objects, and others. Loss of plasma for example due to burns, peritonitis disease, and so forth can also lead to hypovolemic shock. In addition, hypovolemic shock can be caused by the loss of water and electrolytes, such as in vomiting and diarrhea. The most common cause of hypovolaemic shock is a state of gastrointestinal mucosal bleeding and severe trauma. Hidden among other causes of bleeding trauma with ruptured abdominal aortic aneurysm, ruptured spleen, ileus obstruction and peritonitis.

Signs & Symptoms
Intravascular fluid volume decreases along with decrease in central venous pressure, arterial hypotension and increased systemic vascular resistance. Common form of cardiac response tachycardia. Caused symptoms depend on the level of severity of shock.

What to do
Hypovolaemic shock incident handling must consider several conditions such as acute bleeding or gastrointestinal fluid loss. If an acute hemorrhage that occurred then your doctor will usually recommend to install a 2 lane intravenous infusion. Giving 1-2 liters of crystalloid as 0.9 percent Na Cl or Ringer Lactate (RL), or colloids such as dextran intravenously (iv) within 30-60 minutes can be given to remedy the situation hypovolaemic shock. Monitoring against the possibility of pulmonary edema should be taken carefully. In adults, a balanced salt solution (RL) can be given as much as 2-3 liters during the 20-30 left to restore blood pressure, central venous pressure and diuresis. On acute bleeding can also be given packed red cell (PRC) when needed Ht> 30 percent. Give 1-2 units of fresh frozen plasma (FFP) for every four units of blood. Failure of fluid resuscitation with crystalloid is almost always caused by massive bleeding, because it should be considered to take immediate action with surgical hemostasis.
Meanwhile, when the gastrointestinal fluid loss can be carried out of action by giving 1-2 liter Na Cl 0.9 per cent in 30-60 minutes, then continued with additional fluid, followed by monitoring vital signs, CVP and PCWP. You can check and correct electrolyte abnormalities. Determine the cause of diarrhea and vomiting and then treated if there is an indication of this.

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