Trauma hypovolemic shock

Although other types of shock may be present in the trauma patient, such as cardiogenic and neurologic, hypovolemic shock is the most common. Management... 

Although the basic pathophysiology is similar for the various causes of hypovolemic shock, there are unique considerations relative to each. For example, whereas isolated head injuries associated with trauma typically do not result in substantial blood loss or shock, pelvic fractures may sequester several liters of blood as hematoma formation. Patients with traumatic or thermal injuries, as well as postoperative patients, may have substantial fluid accumulation in sites where it cannot be readily transferred back into blood vessels (i.e., third-spaced fluid) for maintaining pressure. With these types of injuries, prompt control of compressible bleeding sources with rapid patient transfer to the hospital for definitive treatment may preclude the cascade of events leading to shock. Indeed, with trauma patients, a scoop and run approach is used in most urban hospitals that places a priority on rapid transport to a hospital. ... 

Millikan JS, Cain TL et al. (1984) Rapid volume replacement for hypovolemic shock a comparison of techniques and equipment. J Trauma Injury Infect Crit Care 24 428-431... 

Plasma protein fractions are used to treat hypovolemic (low blood volume) shock that occurs as the result of bums, trauma, surgery, and infections, or in conditions where shock is not currently present but likely to occur. Plasma protein fractions are also used to treat hypoproteinemia (a deficiency of protein in the blood), as might be seen in patients with nephrotic syndrome and hepatic cirrhosis, as well as other diseases or disorders. As with human pooled plasma, blood type and crossmatch is not needed when plasma protein fractions are given. 

Siegel, J.H. Fabian, M. Smith, J.A. Costantino, D. Use of recombinant hemoglobin solution in reversing lethal hemorrhagic hypovolemic oxygen debt shock. J. Trauma... 

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