Hypovolemic shock

[Pippa]

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So I have a case with a patient who was involved in a car accident. CT shows ruptur of the liver. Skin isn't punctured but bruised.
His BP is 90/50, puls 140, respiratory rate of 28 and superficial, SAT 90% and temperature 37.9 C.
Hgb 4,3 mmol/l, Ka 3,7 mmol/l, Na 140 mmol/l, Creatinine 80 umol/l, P-glucose 4,0 mmol/l.

I would expect P-glucose to be high in response to volume loss - why is it so low?
And also is the altered temperature just a natural reaction to trauma or what are the causes?

Thank you

 

[jdh71]

So I have a case with a patient who was involved in a car accident. CT shows ruptur of the liver. Skin isn't punctured but bruised.
His BP is 90/50, puls 140, respiratory rate of 28 and superficial, SAT 90% and temperature 37.9 C.
Hgb 4,3 mmol/l, Ka 3,7 mmol/l, Na 140 mmol/l, Creatinine 80 umol/l, P-glucose 4,0 mmol/l.

I would expect P-glucose to be high in response to volume loss - why is it so low?
And also is the altered temperature just a natural reaction to trauma or what are the causes?

Thank you

The liver makes sugar and it just went tits up.

The temp? Who know. Drugs? Infection? Was it a long extraction and the patient was just sitting in the sun? Any blood in the head?

 

[CCM-MD]

4.0 mmol/L is ~72mg/dL - (Americans use mg/dL for glucose)

Its low but not that low. In addition, this is a case of hemorrhagic shock, its whole blood loss, which has glucose in it. So if you're trying to make a case for volume loss and resultant high glucose concentration, it doesn't really work.

 

[kemper6036]

Although I would hesitate to call 37.9 c hypothermic, hypothermia after trauma is from a variety of mechanisms including ongoing hemorrhage, things we do to patients ( give cold iv fluids, remove clothing) and environmental factors etc