Blood pressure assessment in the hypovolemic shock patient [Video]

Historically, EMS professionals relied on the vital signs, specifically blood pressure, in conjunction with other physical findings to determine if a patient was in hypovolemic shock. Shock is a state of inadequate tissue perfusion. However, it has become clearer that blood pressure and heart rate may not be a good early indicator of a hypovolemic shock state and may actually mislead the EMS practitioner when considering a differential diagnosis.

Alteration in vital signs primarily results from both a reduction in blood volume and a cascade of neural and hormonal responses in an attempt to increase blood pressure and conserve body fluid. We have always looked for profound changes in blood pressure to assist in making a differential diagnosis of shock.

For example, a drop in the systolic blood pressure to 90 mmHg is an indication that the shock state deteriorated from a compensatory stage to a decompensatory, or progressive stage. This dramatic drop, which is a clear but …