During one year, one trauma center reported 62.2% of massive transfusions occur in the setting of trauma. The preponderance of hemorrhagic shock cases resulting from trauma is high. Of this 40%, the greatest incidence was in the 20 to 24-year-old range. While trauma spans all demographics, it disproportionately affects the young, with 40% of injuries occurring in ages 20 to 39 years by one country’s account. In the United States in 2001, trauma was the third leading cause of death overall and the leading cause of death in those aged 1 to 44. Trauma remains a leading cause of death worldwide, with approximately half of these attributed to hemorrhage. Localizing and controlling the source of bleeding is of utmost importance to the treatment of hemorrhagic shock but beyond the scope of this article. The thigh itself can hold up to 1 L to 2 L of blood.
![trauma triad of death trauma triad of death](https://i0.wp.com/rushemergencymedicine.org/wp-content/uploads/2019/04/trauma-lethal-triad.jpg)
A substantial amount of blood loss to the point of hemodynamic compromise may occur in the chest, abdomen, or retroperitoneum. Bleeding may be either external or internal. Obstetrical, vascular, iatrogenic, and even urological sources have all been described. Blunt or penetrating trauma is the most common cause, followed by upper and lower gastrointestinal sources. Though most commonly thought of in the setting of trauma, there are numerous causes of hemorrhagic shock that span many systems. The pathophysiology, diagnosis, and treatment of hemorrhagic shock, a subset of hypovolemic shock, will be explored in this article. The hypovolemic shock could be due to severe dehydration through a variety of mechanisms or from blood loss. Hypovolemic shock occurs when there is decreased intravascular volume to the point of cardiovascular compromise. Classically, there are four categories of shock: hypovolemic, cardiogenic, obstructive, and distributive shock. Shock refers to the inadequate perfusion of tissues due to the imbalance between the oxygen demand of tissues and the body’s ability to supply it. Identify some interprofessional team strategies for improving care and communication to improve patient outcomes in patients with hemorrhagic shock.Outline management options available for the treatment of hemorrhagic shock.Summarize the evaluation of hemorrhagic shock.It reviews the role of the interprofessional team in evaluating and treating patients with this condition. The pathophysiology, diagnosis, and treatment of hemorrhagic shock, a subset of hypovolemic shock, will be explored in this activity.
![trauma triad of death trauma triad of death](https://kundaliniandcelltowers.com/prometheus_chained_by_nathan_rosario.jpg)
Hypovolemic shock occurs when there is a decreased intravascular volume to the point of cardiovascular compromise. Such an increase in acidity damages the tissues and organs of the body and can reduce myocardial performance, further reducing the oxygen delivery.Shock refers to the inadequate perfusion of tissues due to the imbalance between oxygen demand of tissues and the body’s ability to supply it. In the absence of blood-bound oxygen and nutrients ( hypoperfusion), the body's cells burn glucose anaerobically for energy, causing the release of lactic acid, ketone bodies, and other acidic compounds into the blood stream, which lower the blood's pH, leading to metabolic acidosis. This in turn can halt the coagulation cascade, preventing blood from clotting. Severe haemorrhage in trauma diminishes oxygen delivery, and may lead to hypothermia. The three conditions share a complex relationship each factor can compound the others, resulting in high mortality if the cycle continues uninterrupted. Commonly when someone presents with these signs damage control surgery is employed to reverse the effects. This combination is commonly seen in patients who have sustained severe traumatic injuries and results in a significant rise in the mortality rate. The trauma triad of death is a medical term describing the combination of hypothermia, acidosis and coagulopathy.