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Table 4-4.Correlation of magnitude of volume deficit and clinical presentation

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Table 4-4.—Correlation of magnitude of volume deficit and clinical presentation Approximate Decrease in Degree Signs Deficit (ml) Blood Volume % 0-500 0-10 None None 500-1200 10-25 Mild Slight tachycardia Postural changes in blood pressure Mild peripheral vasoconstriction Thready pulse 100-120 Systolic blood pressure 90-100 1200-1800 Moderate Marked vasoconstriction Diaphoresis Anxiety/restlessness Decreased urine output Thready pulse >120 Systolic blood pressure <60 1800-2500 35-50 Severe Increased diaphoresis Obtundation No urine output 25-35 The symptoms of shock vary from patient to 2. Eyes may be glassy, dull and have dilated patient and even during the course of illness in pupils (these are also the symptoms of mor- an individual. Evaluation of the whole situation phine use). is more important than one particular sign 3. Breathing may be rapid or labored, often or symptom. Table 4-4 provides a generalized of the gasping “air hunger” type. In the overview of the degrees of shock and their advanced stages of shock, breathing symptoms correlated to the approximate volume becomes shallow and irregular. deficit. 4. The face and skin may be very pale or The essence of shock control and prevention is to recognize the onset of the condition and to start treatment before the symptoms fully develop. The following are general signs and symptoms of the development of shock (see figure 4-51): ashen gray; in the dark complexioned, the mucous membranes may be pale. The lips are often cyanotic. 5. The skin feels cool and is covered with clammy sweat. The coolness is related to a decrease in the peripheral 1. circulation. Restlessness and apprehension are early 6. The pulse tends to become rapid, weak, and symptoms, often followed by apathy. thready. If the blood pressure is severely 4-47



   


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