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is an urgent medical condition in which a rapid decrease of the volume of the intravascular fluid (water, plasma or whole blood due to fluid loss) results in inadequate perfusion of the peripheral tissues and, eventually, in multiple organ failure
CAUSES:
Stage 1
Stage 2
Stage 3
Stage 4
>40% 15-30% 30-40% (>2,000 mL) (750-1,500 (1,500(immediately mL) 2,000 mL) life threatening)
Major GOALS in the treatment of Hypovolemic Shock are to: Restore Intravascular volume Redistribute Fluid Volume Correct Underlying Cause of Fluid Loss as quickly as possible
LIFE THRETHENING:
Chest
Abdomen Thighs
External Bleeding
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CASE:
A 25 y/o male client arrives at ER at around 7:30pm dated November 12, 2013 accompanied by friends due to a motorcycle accident at Bimmaley, Pangasinan
COMPLAINTS:
SUBJECTIVE OBJECTIVE
Abdominal pain with severe affection on Left flank area to Left shoulder (Kehr sign)
Anxious +Alcohol breath Abdominal guarding Pale in appearance Bruising on flank area(turners sign) and in Left extremities Hematemesis Abdominal tenderness HR= 115 RR= 29 Temp.= 36 degrees BP= 90/60mmhg
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PHYSICAL EXAM
PAS T M E D I C AL H I S TO RY:
+smoking +drinking
-drugs
BP- ranging from 110/80- 130/80
FA M I LY H I S T O R Y
+ hypertention
-DM
+stroke
Serum electrolytesSodium155meqs/L (135-144meqs/L) high Potassium3.2mg/100ml (3-4.5 mg/100ml) normal Calcium9.2mg/dl (8.5-10.2 mg/dl) normal Cholesterol289mg/dl (150-200mg/dl) high
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calcified splenic
left lower rib fracture Normal peripherally calcified mass in the left upper quadrant under the diaphragm. The mass represents a hematoma.
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PATHOPHYSIOLOGY:
Vehicular Accident (blunt injury)
Abdominal pain, Kehr sign, Hematemesis
Spleen rupture
HYPOVOLE MIA
(DECREASED BLOOD VOLUME)
SHOCK
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