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Sun Feb 24 13:25:59 GMT 2008

SUB: Cause of hypotension in MVA patient.

Hellow,

i am a Gen.Surg resident and in 2 years of i have seen 2 pts coming to trauma, in shock,25yr male,Unconscious(intubated),BP not recordable,peripheral pulse absent, Pupils B/L dilated and fixed,chest-B/L breath sound +,CVS-audible heart sounds. Abdomen Soft/lax/Bowel sound+
aftr resuusitation with 2 Lit RL and 2 U PRBC, BP  came to 110/70,pulse110
CXR no pneumo/hemo
Pelvic xray-no #
USG abdomen- no free fluid
we decide to shift the pt to CT with the above vitals-as the pt is shifted to CT table, pt. arrest , CPR done 40mins 
but pt declared dead.

my question here is, what could be cause of shock if we excluded hemorhage, as there was no bleeding in the chest/abdomen/
pelvic/no long bone fractures.

the only thing was the pupils B/L Dilated and fixed !
now is there any cause in the Head which can cause this?
i mean after excluding Hemorrhagic cause, if we label   Neurogenic shock, the pt should be Hypertensive and Bradycardic.
please give your expert opinions.
Thanks

Dr.Asif.H.Ansari;MBBS, MRCS (Std)
King Khalid Hospital
Saudi Arabia

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cause of hypotension