Clinical Case: HemaShock Use in an Elderly Woman in Severe Hemorrhagic Shock

An elderly woman was brought into the ED after being found down in bed by a relative. She had been complaining of stomach pain for several hours.

Paramedics found her to be unresponsive with BP less than 40 systolic, pale and ashen, with fixed dilated pupils. They assisted breathing and started lines, and transported her to the ED. Her abdomen was noted to be distended and firm.

Fluids were continued and blood brought rapidly to the ED. She was given 2 units of O negative cells, followed by three units of typed and cross-matched blood. After two liters of crystalloid, a Dopamine pressor drip was started. She had been intubated.

A CT with a contrast of the abdomen showed the abdomen full of blood and the contrast blushed in the area of the splenic artery suggesting a rupture. Thrombocytopenia was noted and she was given two platelet packs as well.

During this resuscitation, the systolic pressure was never able to get above 60mm.

At that point, the physician elected to try the HemaShock®. After rolling one device on each leg, the pressure immediately rose to 100 systolic. The dopamine was turned off and the patient was transferred to interventional radiology, where attempts to plug an aneurysm for two hours were unsuccessful.

At one time, the BP systolic went up to 140 and the tourniquets were rolled down to above the knees. The BP immediately dropped to 50 systolic, and the tourniquets were rolled back up, restoring the BP.

The patient was then taken to the OR where successful splenectomy and ligation of vessels performed.Total tourniquet time was four and one-half hours on both legs. The patient survived and was discharged from the hospital 5 days later. She had a foot drop nerve injury in one leg that was likely a complication of the HemaShock® compression.

Related Posts

Is MAST a Must?

Noam Gavriely MD, DSc[Janna: Link to the pdf document “is mast a must?” ] The Pneumatic Anti-Shock Garment (PASG), also called Medical (Military) Anti-Shock Trousers

Read More »