Question

A 22 y/o has arrived via the Trauma Room after a prolonged extrication which included the amputation of the patient's left leg at mid-thigh level. Abdomen is noted to be distended and hard to palpation. Data includes the following:

RR: 34 breaths/minute
HR: 132 bpm
BP: 90/68

GCS: 9T
Disposition: Anxious, combative
Jugular Veins: Flat

ABG

pH 7.24
PaCO2 24 mmHg
PaO2 60 mmHg
HCO3 12 mEq/L
BE -5
Anion Gap 20 mEq/L
Lactic Acid: 7 mM

This presentation supports a classification of:
A) Hypovolemic Shock
B) Septic Shock
C) Anaphylactic Shock
D) Cardiogenic Shock

Answer 1

The patient's symptoms and lab findings, such as low blood pressure, rapid heart rate, and high lactic acid level, suggest they are experiencing hypovolemic shock, likely due to blood loss from the traumatic amputation of their limb.

Step-by-step explanation:

The clinical presentation outlined in the question suggests that the 22 year old patient is experiencing a type of circulatory shock due to a traumatic event resulting in the amputation of a limb. The symptoms pointed out, such as the distended and hard abdomen, rapid respiratory rate (RR: 34 breaths/minute), elevated heart rate (HR: 132 bpm), low blood pressure (BP: 90/68), altered mental status (GCS: 9), and lab findings including a low pH (7.24), low bicarbonate (HCO3 of 12 mEq/L), and the elevated lactic acid (7 mM), support a diagnosis of hypovolemic shock. The hypovolemic shock is a type of circulatory shock caused by excessive loss of blood volume, which in this case, could be due to hemorrhage from the traumatic limb amputation. The correct classification for this patient's presentation, considering the provided data, is Hypovolemic Shock (A).