T7 Hypovolemic Shock

• What is absolute hypovolemia?

  • External loss of whole blood
  • Loss of other body fluids
• What is relative hypovolemia?

  • Fluid shifts
  • Internal bleeding
  • Massive vasodilation
  • Pooling of blood or fluids
• Before doing fluid resuscitation for hypovolemic shock, what needs to be applied to the patient?

  1 or 2 large bore IV catheters, IO access or central venous catheter.
• How big is a large bore IV catheter?

  14 to 16 gauge.
• What fluids are given for hypovolemic shock?

  Normal saline or lactated ringers.
• What is given for volume loss due to bleeding?

  RBCs.
• What does a passive leg raise challenge do?

  Assesses fluid responsiveness by increasing fluid volume by 150 - 500 mL.
• What are problems that may happen with large volumes of fluid replacement?

  Hypothermia and Coagulopathy.
• What may be needed if hypotension is still present after adequate fluids?

  Vasopressors.
• What do you monitor for when doing fluid resuscitation?

  Hypocalcemia and DIC.