Hemorrhage and Shock Chapter 4
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Questions and Answers

What type of agents are Combat hauze, Hemcon dressing, and Celox?

  • Anticoagulant medications
  • Hemostatic agents (correct)
  • Topical antibiotics
  • Analgesic medications
  • At which level of spinal cord injury is neurogenic shock most likely to occur?

  • L1
  • T6 (correct)
  • S1
  • T1
  • What is the typical volume of blood loss that precedes the appearance of shock symptoms?

  • 1.5 L
  • 1 L (correct)
  • 2 L
  • 500 mL
  • What is the first sign of late shock?

    <p>Hypotension</p> Signup and view all the answers

    Why does a neurogenic shock patient often look better than their actual condition?

    <p>Due to the lack of catecholamine release</p> Signup and view all the answers

    Study Notes

    Hemostatic Agents

    • Combat hauze, Hemcon dressing, and Celox are hemostatic agents.

    Neurogenic Shock

    • Typically occurs after an injury to the spinal cord at the sixth thoracic vertebra or above.
    • The SNS is shut down, resulting in no vasoconstriction.
    • Clinical presentation:
      • No pale skin, no tachycardia, and no sweating (due to lack of catecholamine release).
      • Normal or slow heart rate, decreased blood pressure, warm, dry, and pink skin.
      • May have accompanying paralysis.
    • Patients may look better than their actual condition.

    Hypovolemic Shock

    • Can be considered as mechanical shock.
    • Signs of shock appear after losing 1 L of blood.
    • First sign of late shock is hypotension.
    • Clinical presentation:
      • Pale skin, thready pulse (weak radial pulse), flat neck vein, tachycardia, and sweating.

    Obstructive Shock

    • Can be caused by:
      • Tension pneumothorax.
      • Cardiac tamponade.
      • Massive pulmonary embolism.

    Tension Pneumothorax

    • Clinical presentation:
      • Agitated, cyanosis, decreased level of consciousness.
      • Decreased or absent breath sounds on the affected side.
      • Hyper-resonance to percussion.
      • JVD and tracheal deviation (as a late sign).
      • Possible subcutaneous emphysema.
    • Needle decompression is indicated when:
      • Absent radial pulse, cyanosis, and loss of consciousness.

    Cardiac Tamponade

    • Clinical presentation:
      • Trachea midline, normal breath sound.
      • Hypotension, narrow pulse pressure.
      • Beck's triad: JVD, pulses paradoxus, and muffled heart sound.

    TXA

    • Should be given as early as possible.

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    Description

    Important notes on hemorrhage and shock, including hemostatic agents, types of shock, and their signs and symptoms

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