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Clinical consequences of shock Unresuscitatable shock Patients who are in profound shock for a prolonged period of time become ‘unresuscitatable’. Cell death follows from cellu lar ischaemia and the ability of the body to compensate is lost. In the heart ther...

Complications of blood transfusion Complications from blood transfusion can be categorised as those arising from a single transfusion and those related to massive transfusion. - Complications from a single transfusion Complications from a single transfusion in...

Conduct of resuscitation Resuscitation should not be delayed in order to definitively diagnose the source of the shocked state. However, the timing and nature of resuscitation will depend on the type of shock and the timing and severity of the insult. Rapid...

Cross-matching To prevent transfusion reactions, all transfusions are preceded by ABO and rhesus typing of both donor and recipient blood to ensure compatibility . The recipient’s serum is then mixed with the donor’s cells to confirm ABO compatibility and to t...

Damage control resuscitation Damage control resuscitation (DCR), also known as haemo - static resuscitation, is a paradigm that prioritises haemorrhage control in patients who are still actively bleeding. The rationale is that no aspect of the shock state /un...

Degree of haemorrhage and classification The adult human has approximately 5 litres of blood (70 /uni00A0 mL/kg for children and adults, 80 /uni00A0 mL/kg for neonates). Estimation of the amount of blood that has been lost is di ffi cult, inaccurate and usually...

Definitions Revealed and concealed haemorrhage Haemorrhage may be revealed or concealed. Revealed haemorrhage is obvious external haemorrhage, such as exsanguination from an open arterial wound or from massive haematemesis from a duodenal ulcer. Concealed haemo...

End points of resuscitation It is much easier to know when to start resuscitation than when to stop. Traditionally , patients have been resuscitated until they have a normal pulse, blood pressure and urine output. However, these parameters are monitoring organ...

FURTHER READING Cole E, Weaver A, Gall L et al . A decade of damage control resusci - tation: new transfusion practice, new survivors, new directions. Ann Surg 2019; 273 (6): 1215–20. Duchesne JC, McSwain NE Jr, Cotton BA et al. Damage control resuscitation...