Case study hypovolemic shock
From: Nate S.
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Patient is a 54 year old male who presented at the ER complaining of abdominal pain for the past two days. He admitted to the consumption of a 12 pack of beer four to five nights a week for the past two weeks. He began vomiting during the morning of his admittance, and the vomit turned bloody as he was waiting in the ER. Patient was awake and alert but complained of light headedness and had no chest pain. His stool was dark colored and had no blood in it. Respiration rate and temperature were normal.
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When the cardiopulmonary system can no longer adequately supply the mitochondria with glucose and oxygen to create adenosine triphosphate ATP , a shock state has developed. Because of the decreased glucose or oxygen delivery to the peripheral tissues, the patient can develop central nervous system injury , respiratory failure , renal or hepatic dysfunction , and gastrointestinal ischemia. If left untreated, shock can be fatal in children. Shock in children can be considered as one of the most common presentations that are life-threatening to the emergency pediatric department. Mortality increases significantly in children who present with shock compared to those who have the same disease but present without shock. The most common cause of shock in children is sepsis, followed by hypovolemic shock, distributive shock and, finally, cardiogenic shock.
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People with hypovolemic shock have severe hypovolemia with decreased blood flow to extremities and non-vital organs. If left untreated, the lack of blood flow can cause ischemic injury to vital organs , leading to multi-system organ failure. In treating hypovolemic shock, a primary consideration is whether it has resulted from hemorrhage or fluid losses.
Since June , several case reports and series have been published reporting a similar multisystem inflammatory syndrome in adults MIS-A. Cases reported to CDC and published case reports and series identify MIS-A in adults, who usually require intensive care and can have fatal outcomes. Further research is needed to understand the pathogenesis and long-term effects of this condition. Clinical features in children have varied but predominantly include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-reactive protein CRP , ferritin, D-dimer, and interleukin-6 1. Since June , several case reports have described a similar syndrome in adults; this review describes in detail nine patients reported to CDC, seven from published case reports, and summarizes the findings in 11 patients described in three case series in peer-reviewed journals 4 — 6.
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