In a trauma patient, who is in shock was given 500ml of normal saline over 5-10 minutes. Blood pressure improved for 15 minutes and again it began to fall. Your inference is
Dynamic fluid response: The shock status can be determined dynamically by the cardiovascular response to the rapid administration of a fluid bolus. In total, 250-500 mL of fluid is rapidly given (over 5-10 minutes) and the cardiovascular responses in terms of hea rate, blood pressure and central venous pressure are observed.Patients can be divided into 'responders', 'transient responders' and 'non-responders'.Responders have an improvement in their cardiovascular status that is sustained. These patients are not actively losing fluid but require filling to a normal volume status.Transient responders have an improvement, but this then reves to the previous state over the next 10-20 minutes. These patients have moderate ongoing fluid losses (either ove haemorrhage or fuher fluid shifts reducing intravascular volume). Non-responders are severely volume depleted and are likely to have major ongoing loss of intravascular volume, usually through persistent uncontrolled haemorrhage.Bailey and love 27e pg: 16
Patient is having moderate ongoing fluid loss
Patient is having major ongoing fluid loss
Patient is not actively loosing fluid but require filling to a normal status
Patient is having fluid overload, which precipitated fuher shock
General surgery