Shock is presumed to be a consequence of hemorrhage until proved otherwise.
Assessment of the circulation consists of:
an early phase, during active hemorrhage
late phase, which begins when hemostasis is achieved and continues until normal physiology is restored.
In the early phase, diagnostic efforts will focus on the five sites of bleeding detailed
they are the only areas in which Exanguinating hemorrhage can occur.
Neurologic examination:
Neurologic examination:
measurement of the Glasco Coma Scale (GCS) score; examination of the pupils for size, reactivity, and symmetry
determination of preserved sensation and motor function in each of the extremities.
In few patients who require operative evacuation of an epidural or subdural hematoma, the timeliness of diagnosis and treatment has a strong influence on outcome.
