So as promised, and following on from our previous shock episode, this time we’ve covered the topic of shock in Trauma. It’s a massive topic and one that we all, yet again, can make a huge difference for our patients’ outcomes.
There is some crossover as you’d expect from the concepts and assessment that we covered in our Shock episode, so we’d recommend taking a listen to that one first. Make sure you have a comfy seat and plenty of refreshments to keep you going for this one as we cover the following;
- Definition
- Aetiology
- Hypovolaemic shock
- Neurogenic shock
- Obstructive shock
- Cardiogenic shock
- Physiology; Traumatic coagulopathy
- Other diagnostics
- Controlling external haemorrhage
- Pelvic binders
- REBOA
- Avoiding coagulopathy
- BP targets & permissive hypotension
- Fluid choices & supporting evidence
- TEG/ROTEM
- Calcium
- TXA
- Vasopressors
- Preventing hypothermia
- Relieving obstruction
- Interventional radiology
- Damage control surgery
As always we’d love to hear any thoughts or comments you have on the website and via twitter, and make sure you take a look at the references and guidelines linked below to draw your own conclusions.
Enjoy!
References
External Haemorrhage; The Resus Room podcast
The Pre-hospital Management of Pelvic Fractures: Initial Consensus Statement. I Scott. FPHC. 2012
RePHILL; Birmingham University Trials
Assessment and Treatment of Spinal Cord Injuries and Neurogenic Shock; Fox A. JEMS