16 November 2008

Gunshot hypovolemic shock

A gunshot wound and bleeding is sure to cause hypovolemic shock due to blood loss, external and internal (1p756). The body is generating the response as part of a negative feedback system that is attempting to correct the problem (1p756):

- Low systolic blood pressure is due to reduced amount of blood.

- Rapid heart rate is caused by sympathetic increase of blood levels of epinephrine and norepinephrine.

- Weak, rapid pulse is due to reduced amount of blood and cardiac output.

- Reduced blood flow to kidneys causes secretion of antidiuretic hormone that increases water reabsorption and causes blood vessel constriction by secreting renin.

- The thirst is due to loss of extracellular liquid.

- Cool, pale, and clammy skin is due to the sympathetic constriction of blood vessels and stimulation of sweating.

- The confused and disoriented mental state is because of reduced oxygen supply to the brian.

An emergency room will need to stop the bleeding right away and replace loss of blood and fluids.(2) This is in addition to helping whatever other situation the bullet might have caused.


1. Tortora GJ, Derrickson B. Principles of Anatomy and Physiology, 11th ed; 2006. New York: John Wiley & Sons, p756-758.
2. MedlinePlus. Hypovolemic shock. Medical Encyclopedia. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000167.htm.

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