Shock in Trauma: What Paramedics Need To Recognize

Episode overview

About This Episode

A trauma patient is hypotensive. Is it hemorrhage? Tension pneumothorax? Cardiac injury? Neurogenic shock? In the first few minutes, the differential can get wide fast, but some causes need to stay at the very top of the list.

Recorded at UNC Chapel Hill’s May Day Trauma Conference, Will talks with emergency physician Dr. Maglin Halsey-Nichols about a principle-driven approach to shock in trauma. She explains why hemorrhage should be assumed early, how shock can continue to worsen even after bleeding begins to be controlled, and why trauma resuscitation has to account for more than just blood pressure.

This episode also covers manual blood pressure, shock index, whole blood, minimizing crystalloid, permissive hypotension, TXA, pelvic binding, and the less common causes of traumatic shock that can look very different at the bedside.

In this episode, you’ll learn:

• Why shock index may help identify a patient who needs early blood transfusion before hypotension develops

• How hypothermia, acidosis, coagulopathy, and hypocalcemia can keep hemorrhagic shock spiraling 

• Why neurogenic shock may look different from most other trauma shock states, including relative bradycardia 

• Why asking how the trauma happened can uncover an underlying medical emergency such as sepsis or seizure

 

Resources:

Want more? Sign up for our weekly newsletter, The Confidence Dispatch.

Want individualized coaching and mentorship? Check out The Loud & Clear Fellowship.

Just have a question and want some personalized help? Book a free coaching call with us.

Episode 139: When You Can’t Stop the Bleeding: Inside a Massive Trauma Case

Guests:

Dr. Maglin Halsey-Nichols, Emergency Medicine Physician and Assistant Director of the Emergency Medicine Residency at UNC