As the myocardium receives less perfusion, heart pumps less.
Because less blood perfuses the brain, level of consciousness drops.
Shock and Urinary Output
Average adult urinary output is 0.5 to 1.0 ml/kg/hr. Less than 35 ml/hour reflects decreased renal blood flow. Acute renal failurecan result.
Shock and Respiration
As blood flow to lungs decreases, less gas exchange will occur.
When tissues receive less oxygen, they produce more lactate and metabolic acidosis sets in. Metabolic acidosis increases risk of cardiac arrhythmias.
For a client in shock, body cells receive less oxygen and nutrients. Thus treatment aims at increasing both available oxygen and volume of blood in vessels (unless the heart has failed).
Medications can improve tone of blood vessels (inotropes) or treat the cause of shock (corticosteroids, antibiotics).
When treating a trauma client, you must quickly assess ABCs. After you know the client is breathing and has a pulse, vital signs can wait while you stop any bleeding and start other interventions (such as starting IVS). Don't rely only on the vital sign numbers.
Head and Spine Injury
If client has head injury, the most important assessment is level of consciousness; next is pupil response to light. Changes in vitals are very late sign.
With trauma clients, assume spine is injured until proven otherwise. While you open the airway, you must keep cervical spine immobile.