Shock as an inadequate tissue perfusion is one of the frequent causes of death in trauma patients. In this context, there are various reasons for hemodynamic instability and shock including hypovolemic (hemorrhagic), obstructive (cardiac tamponade, tension pneumothorax), cardiogenic, neurogenic, and rarely septic. In the present report, a 30-year-old trauma patient with full clinical signs and ...

Rectus sheath hematoma (RSH) is an uncommon clinical event usually associated with trauma or coagulation disorders. It can also occur spontaneously. RSH usually runs a benign course but it can present with hypovolemic shock. When conservative management fails, surgical exploration becomes mandatory. We propose a technique of emergency ligation of the inferior epigastric artery. This is a simple...

Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. The diagnosis and treatment of cesarean scar pregnancy (CSP) is challenging. The authors reported here a case of cesarean scar pregnancy (CSP) with hypovolemic shock that underwent emergency laparotomy with resection of ectopic mass. The patient was discharged from t...

1. Describe the basic pathophysiology of shock. 2. Characterize the various causes of shock and recognize their clinical presentations. 3. Discuss the importance of early, goal-directed treatment of shock. 4. Know the guidelines for the type and volume of fluid to be infused initially in hypovolemic or septic shock. 5. Choose the correct drug for the initial management of septic versus cardioge...

Dogs and cats frequently present to veterinarians in hypovolemic shock following trauma. Blunt trauma from motor vehicles is by far the most common cause of trauma, and intravenous fluid therapy is one of the most important modalities of shock management in these patients. This lecture will cover fluid therapy options and their indications in patients presenting with a variety of complications ...

BACKGROUND The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill multiple trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive multiple trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously...

Conventional resuscitation of traumatic hemorrhagic shock involves the intravenous administration of isotonic (normal saline) or slightly hypotonic (lactated Ringer’s, LR) solution beginning in the prehospital setting. Although not conclusive, prior animal and human studies have suggested that alternative resuscitation with hypertonic saline (7.5%) solutions may reduce mortality in these patien...

We report a non-puerperal uterine inversion with nulliparous women caused by huge pedunculated submucosal fibroid. Massive bleeding from protruding mass through vagina brought the heart to stop in 42-year-old nulliparous woman. She became cardiopulmonary resuscitation survivor in emergency room and then underwent laparotomy which ended in successful myomectomy rather than hysterectomy consideri...

was erosion of the patient’s nasogastric tube through the anterior esophageal wall into the trachea. The finding that the defect was larger on the esophageal side than on the tracheal side makes bronchoscopy an unlikely cause. None of the other common causes of TEF in adults (radiation therapy, trauma, corrosive burn, malignancy, congenital defect, or tuberculosis) apply to this patient. There ...

Introduction. Circulatory failure secondary to hypovolemia is a common situation in critical care patients. Volume replacement is the first option for the treatment of hypovolemia. A possible complication of volume loading is pulmonary edema, quantified at the bedside by the measurement of extravascular lung water index (ELWI). ELWI predicts progression to acute lung injury (ALI) in patients wi...