Advanced Trauma Life Support ATLS Student Course Manual 2018

CHAPTER 3 Outline
Objectives
iNtroduction
Shock Pathophysiology
• Basic Cardiac Physiology
• Blood Loss Pathophysiology
Initial Patient Assessment
• Recognition of Shock
• Clinical Differentiation of Cause
of Shock
Hemorrhagic Shock
• Definition of Hemorrhage
• Physiologic Classification
• Confounding Factors
• Fluid Changes Secondary to
Soft-Tissue Injury
Initial Management of
Hemorrhagic Shock
• Physical Examination
• Vascular Access
• Initial Fluid Therapy
Blood Replacement
• Crossmatched, Type-Specific,
and Type O Blood
• Prevent Hypothermia
• Autotransfusion
• Massive Transfusion
• Coagulopathy
• Calcium Administration
Special ConsideRAtions
• Equating Blood Pressure to
Cardiac Output
• Advanced Age
• Athletes
• Pregnancy
• Medications
• Hypothermia
• Presence of Pacemaker or Implantable
Cardioverter-Defibrillator
Reassessing Patient Response and
Avoiding Complications
• Continued Hemorrhage
• Monitoring
• Recognition of Other Problems
Teamwork
Chapter Summary
Additional Resources
BibliogRAphy
OBJECTIVES
After reading this chapter and comprehending the knowledge
components of the ATLS provider course, you will be able to:
1. Define shock.
2. Describe the likely causes of shock in trauma patients.
3. Describe the clinical signs of shock and relate them
to the degree of blood loss.
4. Explain the importance of rapidly identifying and
controlling the source of hemorrhage in trauma
patients.
5. Describe the proper initial management of
hemorrhagic shock in trauma patients.
6. Describe the rationale for ongoing evaluation of
fluid resuscitation, organ perfusion, and tissue
oxygenation in trauma patients.
7. Explain the role of blood replacement in
managing shock.
8. Describe special considerations in diagnosing and
treating shock related to advanced age, athleticism,
pregnancy, medications, hypothermia, and presence of
pacemakers and implantable cardioverter-defibrillators.
n BACK TO TABLE OF CONTENTS
43