Volume Shock

Tom RaderStaff - June 1, 2021

If we have a history of trauma for this event, and that mechanism is significant, you should consider internal and external bleeding. But the most com
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What do you think about including electrolyte tablets in a FAK to assist with rehydration?

 

Or I see they suggest items like Gatorade, Emergen-C, and Pedialyte in the article on Home medical supplies list.

I propose adding a few examples of electrolyte products in this article also, so readers know what they may want to stock up on.

 

How do you evaluate whether loperamide/diphenhydramine are appropriate? They can stop the loss of fluids, but I imagine that in some cases the body is ejecting fluids in an attempt purge some “bad actor”, in which cases stopping that is perhaps not the right move?

 

Great Q and a good example of the risk vs. reward meta concepts. Those drugs are used to buy time (by delaying fluid loss) so you can resolve the underlying problem. In almost every case, if the body is trying to eject something, it should be allowed to do so. If you’re in a situation where the body can eject fluid but you’re still able to help the patient rehydrate etc, then let it happen according to the diarrhea/vomiting guidelines.

The main context in which I’d imagine deciding “I want to override the body’s desire to expel fluids” is if we’re in a location without water and/or is unsafe. If pausing the fluid ejection makes it easier/faster to get to safety and a source of water, so I have time to help them, treat the water, manage hygiene, etc.

Thinking out loud: Maybe you’re desperate to evacuate the area because of some big threat. You find a helpful person willing to let you and your patient cram into their car to flee. But if the patient is exploding diarrhea in the car, maybe the driver kicks you out. So in that case it might have been better to delay the fluid loss for the big benefit of getting to safety.

 

When would rectal rehydration be advised?

 

Only if the patient can’t take and hold fluids the normal way + you can’t get to professional help.

 

Concerning volume shock and hypothermia – do you always assume hypothermia will set in once you’re sure of shock? And if so would it benefit the patient to keep them warm with an emergency blanket or similar?