Sheila got in while I was typing:
According to my books:
The symptoms of hypovolemic shock (shock from blood loss) depends on a number of things, including the volume and severity of blood volume loss, age and health of the patient and the patient's ability to compensate (muster the body's defenses by increasing heart-rate, and constricting capillaries to force the blood to remain in the center of the body.)
Symptoms at this time will include cold, clammy skin, paleness, thirst, fast heart-rate, fast breathing and possible changes in blood pressure (not a drop in blood pressure necessarily but a narrowing in the difference in the top and bottom numbers), and delayed capillary refill. Also the kidneys begin to slow down. The patient's level of consciousness changes (he becomes confused, restless, anxious.)
As shock progresses lack of oxygen to the body causes the heart rate to increase and become irregular. The kidneys shut down. When the kidneys shut down the lack of oxygen has already caused serious damage to the organs and organs begin to shut down - once this begins it is difficult if not impossible to reverse. There is a 90-100% morality rate when only three body systems fail.
In shock, time is of the essence. It's not called the Golden Hour for nothing.
Now the above is oversimplified. When an EMT or emergency worker comes on the scene - ABCD
Airway (clear airway if necessary, maintaining proper spinal alignment)
Breathing (supplemental oxygen as needed)
Circulation (control bleeding, increase blood volume)
Disability (level of Consciousness)
OR
Defibrillation (in cardiac arrest)
The problems above must be dealt with immediately.
Blood transfusions are NOT a field operation. In the field normal saline, lactated Ringer's or other solutions will be given.
A patient with major blood loss that needs blood quickly will be given O-negative Packed Red Blood Cells (PRBC) until properly typed and matched blood can be found.
(If your local library has is, I suggest Schumancher & Chernecky's 'Critical Care & Emergency Nursing'. Personally, I think this book is a must for anyone writing Action-Adventure or ends up with hurt characters. Me? I collect medical books.)
