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Management of shock in trauma
Abstract:Shock is defined as failure of the circulatory system resulting in a level of perfusion to tissues, which is inadequate to meet the oxygen demands of cellular metabolism. Haemorrhagic shock is most commonly associated with trauma. Haemorrhage is a leading cause of preventable death in trauma and over the past two decades there has been an increasing understanding of the pathophysiological processes that occur in major haemorrhage associated with trauma. This has been fundamental to the development of the current approach to management of traumatic shock, known as damage control resuscitation (DCR). DCR encompasses three key resuscitative strategies: permissive hypotension, haemostatic resuscitation (the use of blood products as primary resuscitative fluids) and damage control surgery. The implementation of DCR alongside the creation of trauma networks has been revolutionary in the management of the shocked trauma patient.
Keywords:Coagulopathy  haemorrhage  hypovolaemia  lethal triad  massive transfusion  shock  trauma  trauma team
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