GIVE high concentration oxygen by mask

OBTAIN intravenous access x 2

SEND blood for cross-match


When haemorrhage severe ask for TYPE SPECIFIC blood


When haemorrhage life-threatening ask for up to 4 units O NEGATIVE

START warm Hartmannís solution 1 litre x 2


With non-compressible haemorrhage (chest, abdomen) resuscitate to maintain a systolic BP not greater than 100mmHg.
Aggressive resuscitation is harmful.


DO NOT DELAY surgery for those poorly/incompletely responsive to fluid.


GIVE high concentration oxygen

GIVE adrenaline 0.5mg IM (0.5ml 1:1,000), repeated every 5 mins as required

If life-threatening, give adrenaline 0.5mg IV (5ml 1:10,000), give slowly with extreme care

GIVE chlorpheniramine 10-20mg slow IV / IM

GIVE hydrocortisone 100-500mg slow IV / IM

If shock does not respond, GIVE 1-2L crystalloid IV stat

Patients on Beta-blockers may not respond to adrenaline and require salbutamol infusion +/- glucagon infusion

Septic shock

Support ABCís and optimise oxygenation

Vasopressor support as determined by intensivist

Antibiotics determined by likely cause of sepsis

For other cause of shock see hypotension

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