Hypovolaemia

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.


Anaphylaxis

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

(C) 2001 Crown. All rights reserved