Morera HH

Language: Spanish
References: 12
Page: 545-550
PDF size: 167.23 Kb.

ABSTRACT

The primary treatment of hemorrhagic shock is control of the source of bleeding as soon as possible and fluid replacement. In controlled hemorrhagic shock (CHS) where the source of bleeding has been occluded fluid replacement is aimed toward normalization of hemodynamic parameters. In uncontrolled hemorrhagic shock (UCHS) in which bleeding has temporarily stopped because of hypotension, vasoconstriction, and clot formation, fluid treatment is aimed at restoration of radial pulse, or restoration of sensorium or obtaining an optimal blood pressure by aliquots of lactated Ringer’s solution. When evacuation time is shorter than one hour (usually urban trauma) immediate evacuation to a surgical facility is indicated after airway and breathing (A, B) have been secured. Precious time is not wasted by introducing an intravenous line. Is important to recognize the grades of shock, to give an adequate treatment. Crystalloid solutions and blood transfusion are the mainstays of pre-hospital and in-hospital treatment of hemorrhagic shock. In the pre-hospital setting four types of fluid are presently recommended: crystalloid solutions, colloid solutions, hypertonic saline and oxygencarrying blood substitutes. In unstable or unresponsive hemorrhagic shock surgical treatment is mandatory as soon as possible to control the source of bleeding.

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