Publicação

Use of RUSH Protocol in the Differential Diagnosis of the Patient in Shock

Detalhes bibliográficos
Resumo:	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.
Autores principais:	de Sousa, Joana Fernandes
Outros Autores:	Duarte, Tiago; Almeida, Gonçalo; Pereira, Maria
Assunto:	Case Report
Ano:	2019
País:	Portugal
Tipo de documento:	artigo
Tipo de acesso:	acesso aberto
Instituição associada:	Sociedade Portuguesa de Anestesiologia
Idioma:	inglês
Origem:	Revista da Sociedade Portuguesa de Anestesiologia

Descrição
Resumo:	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.