Case-3: Patient History P.W. is 23 years old. He was the victim of a hit-and-run
ID: 91788 • Letter: C
Question
Case-3: Patient History
P.W. is 23 years old. He was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of his left thigh. He was discovered approximately 2 hours after the incident and is now in the emergency department. P.W.’s vital signs and hematocrit suggest that he has had a blood loss of about 2500 ml. A urinary catheter is inserted to monitor urine output, and fluid resuscitation is initiated while his wounds are cleaned and sutured. The urine output is averaging 15 ml/hr, with a high urine osmolality and low urine sodium.
Analyze this case study and answer the next four questions that follow.
Case-3: Question-2
Based on your answer for the previous question, what is the best therapy for preventing this from occurring? (select all that apply)
A) Dialysis should be initiated immediately.Explanation / Answer
The patient is suffering from hypovolemic shock as a result of loss of 2500 ml of blood. The kidneys are functional but at a sub optimal range due to low perfusion pressure. In order to overcome this condition, adequate extracellular volume replacement with blood or isotonic fluids to ensure adequate circulating blood volume and perfusion pressure to the kidney is essential (option c).