- Women's Health»
Causes and Management of Shock
Causes of Shock
Shock may occur as a result of early pregnancy bleeding-may be as result of abortion, molar or ectopic pregnancy or late pregnancy bleeding or labor-may be due to placenta praeviaor abruption or ruptured uterus. on the other hand, postpartum bleeding-may be caused by ruptured uterus, vaginal tears, uterine atony, retained placentaor its remnants.
Infection-possibly due to unsafe or septic abortion, amnionitis, metritis, or pyelonephritis may also reult to bleeding. lastly, trauma-uteral injury or bowel, uterine rupture, or vaginal tears may also be the cause.
Clinical Features of Shock
with regard to the patient's signs and symptoms, pulse will be Fast and weak in this case =>110 beats per minute; their will be a reduced blood pressure that is systolic <90 mmHg. in addition the patient will presents with pallor; coldness and clamminess of the skin or sweatiness; rapid breathing in this case =>30 breaths per minute; confusion, anxiety, or unconsciousness; and Reduced urine output (<30 ml per hour).
Initial management of Shock
The initial management of the patient will entail, Calling for help, taking care of the vital signs (pulse, respiration, blood pressure, temperature), turning the patient onto her right side in a bid to minimize the aspiration risk as well as ensure that an airway is open. in addition, the healthcare provider will be required to ensure that the mother is warm and do not overheat and elevate the lower limbs-this is to increase venous blood return to the heart.
Definitive Management of Shock
The healthcare provider will be required to start the patient on an Intravenous fluids infusion with a large-bore (gauge-16 or larger) cannula/needle. This will be after taking sample blood for blood typing-hemoglobin level, cross-match as well as bedside clotting. note: this is before infusion. However, the IV Infusion fluids should run rapidly, in this case Ringer’s lactate or normal saline rate 1 l in 15 to 20 minutes (initially). *plasma expanders should be avoided for instance dextran.
At least 2 l of infusion should be given in the first one hour. *A more rapid infusion rate is recommended for shock management secondary to bleeding. in this case 2–3 times replacement is needed of the calculated fluid loss.
Precaution: Per oral fluid is not advised. in cases of peripheral vein missing, a venous cut should be performed.
Monitoring of vital signs should be every 15 minutes, catheterization of bladder in the aim of monitoring fluid input and output is required and lastly oxygenation (6 to 8 l per minute) by nasal cannulae or mask recommended.