Atls (Advanced Trauma Life Support) Teaching Protocol

Recognition of Shock :

• 
  Early: Tachycardia and cutaneous vasoconstriction
  
• 
  Normal heart rate varies with age, tachycardia is present when
  

Infant: >160 BPM

Preschool age child: >140 BPM

School age to puberty: >120 BPM

Adult: >100 BPM

• 
  The elderly patient may not exhibit tachycardia because of the limited cardiac response to catecholamine stimulation / use of medications
  

• 
  Differentiation of shock:
  

• 
  Hemorrhagic shock  hypovolemic shock
  
• 
  Nonhemorrhagic shock:
  

1. 
   Cardiogenic shock: Blunt cardiac injury, cardiac tamponade, air embolus, myocardial infarction.
   
2. 
   Tension pneumothorax
   
3. 
   Neurogenic shock
   
4. 
   Septic shock
   

• 
  The normal blood volume of adult is 7 % of body weight. Whereas that of a child is 8-9% of body weight.
  

• 
  Estimated Fluid and Blood Losses: ( For a 70-kg man )
  

Class I

Class II