cause of hypotension

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What was the trauma?

R. Smith

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Dr.Asif Huda Ansari
Sent: Sunday, February 24, 2008 8:26 AM
To: trauma-list at trauma.org
Subject: cause of hypotension

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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