Use of RUSH Protocol in the Differential Diagnosis of the Patient in Shock
DOI:
https://doi.org/10.25751/rspa.16135Keywords:
Aged; Anaphylaxis; Clinical Protocols; Diagnosis, Differential; Geriatric Assessment; Shock/diagnostic imaging; Wounds and InjuriesAbstract
Trauma geriatric patients have become increasingly common and assessment of these patients presents a unique challenge. In trauma, massive hemorrhage is the main cause of preventable death. We describe a case of an unexpected severe anaphylactic shock in a fisherman victim of a shipwreck. The patient presented in the emergency room with his thigh sliced through with a broken wooden oar, hemodynamically stable. In the operating room to avoid the platelet dysfunction induced by aspirin, a platelet concentrate was administered. 30 minutes into surgery the patient became hypotensive and vasopressor support was initiated with transitory response. RUSH examination excluded hypovolemia, cardiac dysfunction or pneumothorax. A generalized erythema was found and treatment for anaphylaxis was initiated. Anaphylactic shock is rare potentially life-threatening reaction and in anesthetized patients
is recognition presents a challenge.Although hemorrhage is the main cause of death in trauma we must be prepared to exclude other causes of shock.
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