Resuscitation : equipment, organization, training, and procedures / [the War Office].

Date:
1942
Catalogue details

Licence: Public Domain Mark

Credit: Resuscitation : equipment, organization, training, and procedures / [the War Office]. Source: Wellcome Collection.

    5/62 page 5
    { RESUSCITATION EQUIPMENT, ORGANIZATION, TRAINING AND Since it is the policy of the Army to train a special medical officer at each Military Hospital, General Hospital, Casualty Clearing treatment of Secondary (syn. Traumatic, Hemorrhagic, Wound) Shock, there are in this booklet some recommendations concerning the duties of this officer, the equipment needed, the personnel required to assist him and the organization he should endeavour to establish to enable him to carry out this important work. The duced in co-operation with the Army Medical Service, ‘‘ The Treatment of Wound Shock ”’ (H.M. Stationery Office, London). GENERAL PRINCIPLES The cardinal sign of secondary shock is a sustained or progressive lowering of the systolic blood pressure below 100 mm. Hg. This is exhibited after a period from one hour or longer by nearly all Who suffer wounding in association with a considerable loss of blood. The reduction in blood pressure may be distinguished from that which is also found in primary shock, and which is then due to psychogenic and neurogenic influences, because the blood pressure in secondary shock is not restored by rest in the recumbent head- low position together with warmth and relief of pain by morphine. When casualties are seen soon after wounding, as is usual in air- raids, it is important to apply the simpler remedies first, before resorting to transfusion, unless the nature of the wounds makes it obvious that the patient must have suffered the serious reduction in blood volume which is the cause of the cardinal sign of secondary shock. Occasionally, the cardinal sign of depleted blood-volume, reduced blood-pressure, may not be as definite as would be expected in relation to the probable blood loss estimated from the degree of wounding. Thus, a hypertensive who has suffered gross loss of blood may still exhibit a blood-pressure within the recognized normal limits, whilst young subjects may, for a time, react to their blood loss with vasoconstriction intense enough to maintain a reasonable blood-pressure. These exceptional cases show the necessity for assessing. all clinical features in addition to making blood-pressure observations. Restoration of the blood volume by transfusion is the most important single measure for the treatment of secondary shock; the sooner this restoration is effected the better are the results. In casualties with whom there has been a delay of more than a few hours, a lowered blood pressure always | suggests the necessity for restoring blood volume by the transfusion 1*—1874
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image