Hypovolaemic Shock — Uganda (General Adult population)
General Measures (All Classes)
Control obvious bleeding with pressure. Keep patient lying down with raised legs. Do not use glucose solution or plain water as replacement fluids.
Class 2 and Above
Set 2 large bore IV lines. Give IV Ringer's Lactate (or Normal Saline 0.9%) 20–30 ml/kg over 60 minutes. Warm fluid if possible. Start rapidly, monitor BP. Assess response: BP, HR, RR, capillary refill, consciousness, urine output.
If Internal or External Haemorrhage
Consider blood transfusion (see section 11.2).
Rapid Improvement and Stable (blood loss <20%, not progressing)
Slow IV fluids to maintenance levels. No immediate transfusion but cross-match blood. Regular reassessment. Detailed examination and definitive treatment of cause.
Transient Improvement (blood loss 20–40% or ongoing bleeding)
Rapid IV fluid administration. Initiate blood transfusion. Regular reassessment. Detailed examination and early surgery.
No Improvement
Vigorous fluid administration. Urgent blood transfusion. Immediate surgery.
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