- Vaginal/gastrointestinal bleeding
- Cardiac ischemia (MI/CHF)
- Allergic reaction
- History of poor oral intake
- Weak, rapid pulse
- Pale, cool, clammy skin
- Delayed capillary refill
- Coffee-ground emesis
- Tarry stools
- Ectopic pregnancy
- Pulmonary embolus
- Tension pneumothorax
- Medication effect/overdose
- Physiologic (pregnancy)
- Pulmonary edema (CHF)
Hypotension due to cardiogenic shock (tachycardia) ?
Non-trauma Non-cardiac (Possible Sepsis/Neurogenic)?
- OLMC: Request Additional Fluid
- Notify receiving facility or contact
- Medical Control
Hypotension due to bradycardia ?
- Consider all possible causes of shock and treat per appropriate protocol.
- In the presence of cardiogenic shock and pulmonary edema/respiratory distress, fluid should be withheld in favor of giving pressers.
- Hypotension can be defined as a systolic blood pressure of less than 90, however, shock is often present with a normal blood pressure and tachycardia may be the only manifestation.
- Assess lung sounds frequently.
- Push Dose Epi: Mix 1 ml of Epi 1:10,000 with 9 ml NS=Epi 1:100,000. Admin 1-2 ml (10-20 mcg) every 3-5 minutes for hypotension.