John Tristan Pahuyo, Staff Nurse
ACCU-Barts Heart Centre
Hypovolemia is generally defined as having a significant amount of blood volume loss. Shock, on the other hand, is a medical emergency characterized by inadequate blood flow to organs and tissues thus reducing oxygen delivery that leads to organ dysfunction. Hypovolemic shock is described as a loss of greater than 15% of the intravascular volume. It is caused by an excessive fluid loss such as bleeding(external and/or internal) and burns or could be either due to insufficient fluid intake such as dehydration. The most common cause of hypovolemic shock in the current clinical setup is internal bleeding postoperatively. Central venous pressure monitoring and vital signs, in general, is paramount to determine the need for fluid resuscitation. Clinical history as well is vital on the amount of fluid that needs to be replaced. It is also a good practice to determine the patients' ventricular function prior to giving fluid to know the baseline capacity and how much fluid can you give. Physical signs should also be considered in determining hypovolemia. A cold and clammy skin would indicate poor peripheral perfusion secondary to inadequate blood volume. Tachycardia will be expected to compensate for the lowering blood pressure with a narrowing pulse pressure. A decrease in urine output would also be …show more content…
Fluid therapy/fluid resuscitation is the practice of administering fluid intravenously to top up the fluid loss, it includes a broad range of fluids and aims to expand intravascular volume. In the unit, fluid is delivered through a large bore peripheral line 14g or through the central venous catheter. The two most common types of fluids that are used in hypovolemic shock are colloids and