Flank ecchymosis may indicate retroperitoneal hemorrhage. Extremities Hemorrhage from extremity injuries may be apparent or tissues may obscure significant bleeding. Femoral fractures may produce significant blood loss. Neurologic Agitation and combativeness may be seen in the initial stages of hemorrhagic shock. This is followed by a progressive decline in level of consciousness due to cerebral hypoperfusion or concomitant head injury.
Laboratory studies are essential in management of many forms of hemorrhagic shock.
Baseline studies are determined frequently, but infrequently change initial management after trauma. Serial determinations can help guide ongoing therapy. Lactate and base deficit are used in some centers. Other x-rays may be indicated for orthopedic injuries. Oral contrast may not increase the diagnostic yield of abdominal CT scan in blunt trauma.