Treatment
Treatment of the patient in hemorrhagic shock should be focused on preventing and mitigating the deleterious effects of the lethal trauma triad. EMS providers should focus on the following actions:
- Controlling all sources of external hemorrhage;
- Keeping the patient warm at all costs;
- Allowing a permissive state of hypotension to exist, and
- Replacing the oxygen and oxygen-carrying capacity lost due to hemorrhage once hemorrhage is controlled.
Above all else, providers need to focus on controlling bleeding. Every intervention performed before adequate hemorrhage control is maintained will be ineffective because the patient will continue to lose oxygen and oxygen-carrying capacity through the bleed. Prehospital trauma management courses often indicate that hemorrhage should be controlled before airway interventions are initiated. This is true in a single-provider situation, but when enough resources are on scene to assist with management of the patient, airway control and hemorrhage control interventions should take place simultaneously. A patent airway is critical to restore normal oxygen content and reserves for the patient in shock.
