As shock progresses, level of consciousness deteriorates due to decreased cerebral perfusion. Mr. Sloane is becoming more restless and agitated, and his GCS score falls to 12. He's now in a Class III shock state. Sp O 2 values, cardiac rhythm and rate, and temperature. The DPL is grossly positive for blood, so you prepare the patient for surgery.
Surgery reveals a liver laceration.
Hypothermia impairs clotting functions and platelet aggregation, and thrombocytopenia can develop. After 6 hours of continuous warm fluid resuscitation, blood product replacement, and external rewarming in the ICU, Mr. Sloane's vital signs stabilize. He returns to the operating room for removal of the liver packing and surgical repair of the laceration. After a week in the ICU, he's transferred to the trauma step-down unit. Septic shock Septic shock is a distributive form of shock resulting from maldistribution of blood volume and decreased oxygen uptake at the cellular level.