7-14
Primitive: When IV fluids cannot be administered to restore intravascular volume, rehydrate orally. Start with
small volumes and increase as tolerated (see Table 7-1).
Patient Education
General: Activity: Bedrest
Diet: If surgery is imminent, keep patient NPO but clear liquids as tolerated is appropriate in most
circumstances
Prevention and Hygiene: If cause is penetrating injury emphasize importance of use of body armor when
patient recovers.
No Improvement/Deterioration: Search for other causes of symptoms. Evacuate for surgery if cause is
on-going, uncontrollable, hemorrhagic
Wound Care: Patients in shock are more susceptible to infection than those with normal perfusion. Keep
wounds as clean as possible and watch closely for developing infection
Evacuation/Consultation Criteria: Uncontrollable hemorrhage requires rapid evacuation to a general
surgeon
Shock: Fluid Resuscitation
This text accompanies Table 7-1 on the next page.- Maintenance rate calculation when NPO: (Weight in Kg) + 40 = ml per hour of infusion rate
- End Points of resuscitation:
a. Controlled hemorrhage, dehydration, burns: Normal BP, pulse, urine output (0.5-1 ml/Kg/Hr), normal
capillary refill, good mentation.
b. Uncontrolled hemorrhage of the trunk: Accept lower BP. Begin fluids if radial pulse not palpable, or
pulse is > 120. Run ASAP. Stop when radial pulse palpable < 120. Monitor. May need to restart.