cause of hypotension

[Anthony Caruso]

Dr. My 1st guess would be that he suffered some type of spinal cord trauma.  The brain signals were blocked because of some type of cord compromise. Causing the peripheral vasculature to vasodialate.  Usually, these patients wouldn't be unresponsive, however he may have suffered some type of brain trauma concurrently post MVC.  Although, his heart rate was elevated.  What was he doing prior to the crash? (I.E. poly substance abuse of some sort) Which may explain the pupils being dilated. Definitely an interesting case.  Keep us informed as to what the results were post mortem.  Anyone else care to add, please do so. Ron, Pret, Tim?  
 
 Anthony Caruso. EMT-P> Date: Sun, 24 Feb 2008 05:25:59 -0800> From: asifhansari at yahoo.com> To: trauma-list at trauma.org> Subject: cause of hypotension> > SUB: Cause of hypotension in MVA patient.> > Hellow,> > i am a Gen.Surg resident and in 2 years of i have seen 2 pts coming to trauma, in shock,25yr male,Unconscious(intubated),BP not recordable,peripheral pulse absent, Pupils B/L dilated and fixed,chest-B/L breath sound +,CVS-audible heart sounds. Abdomen Soft/lax/Bowel sound+> aftr resuusitation with 2 Lit RL and 2 U PRBC, BP came to 110/70,pulse110> CXR no pneumo/hemo> Pelvic xray-no #> USG abdomen- no free fluid> we decide to shift the pt to CT with the above vitals-as the pt is shifted to CT table, pt. arrest , CPR done 40mins > but pt declared dead.> > my question here is, what could be cause of shock if we excluded hemorhage, as there was no bleeding in the chest/abdomen/> pelvic/no long bone fractures.> > the only thing was the pupils B/L Dilated and fixed !> now is there any cause in the Head which can cause this?> i mean after excluding Hemorrhagic cause, if we label Neurogenic shock, the pt should be Hypertensive and Bradycardic.> please give your expert opinions.> Thanks> > Dr.Asif.H.Ansari;MBBS, MRCS (Std)> King Khalid Hospital> Saudi Arabia> > > ---------------------------------> Never miss a thing. Make Yahoo your homepage.> --> trauma-list : TRAUMA.ORG> To change your settings or unsubscribe visit:> http://www.trauma.org/index.php?/community/
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