A case about hemorrhagic shock.

1. MULTIPLE INJURED
PATIENT
Presented by:
Arwa H. Al-Onayzan.
ID: 215007943

2. LEARNING OBJECTIVES
 What is the patient’s primary problem?
 List all of the evidence you can that supports the
diagnosis?

3. WHAT IS THE PATIENT PRIMARY
PROBLEM?
 He had multiple abrasions over his chin, neck, anterior thorax, and
abdomen.
 A large wound over his left anterior groin and upper thigh which was
bleeding profusely.
This patient has lost a significant
volume of blood
Due to a laceration of his right
femoral artery.
He is in danger of developing
hypovolemic- hemorrhagic shock.

4. EVIDENCE THAT SUPPORT THE
DIAGNOSIS
 The history of a fall from 9 meters to the ground.
 The appearance of a blood-soaked.
 Left thigh tourniquet overlying the laceration in the left groin suggest that
this patient lacerated left femoral artery.
 HR= 116 (supine) and 132 (sitting).
 BP= 108/60 (supine) and 92/52 (sitting).
 Carotid, radial, left femoral and dorsalis pedis pulses are weak.

5. EVIDENCE THAT SUPPORT THE
DIAGNOSIS
 Hemorrhagic shock has several physiologic consequences:
Orthostatic hypotension.
Elevated creatinine (1.9 mg/dl) and BUN (27 mg/dl).
Elevated SGOT (48 IU/L) and SGPT (41 IU/L).
Pale nail beds and mucous membranes.
Disorientation and lethargy.
Decreased central venous pressure (1-3 cm) (5.5-13 cm
H2O through cardiac cycle).
ST-segment depression.

6. ANY QUESTION?

7. REFERENCE