Differential diagnosis of shock in trauma

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Differential diagnosis of shock in trauma

I. Low CVP

A. Hypovolemia

1. Hemorrhage

a. External (compressible)

i. Lacerations

ii. Contusions

iii. Fractures (partly compressible)

b. Internal (noncompressible)

i. Intrathoracic

ii. Intraperitoneal

iii. Retroperitoneal (partly compressible)

c. Fractures (partly compressible)

2. Third spacing (eg, burns)

B. Neurogenic (high cervical cord injury)

II. High CVP

A. Pericardial tamponade

B. Tension pneumothorax

C. Myocardial contusion

III. Other diagnoses to consider

A. Pharmacologic or toxicologic agents

B. Myocardial infarction (severe)

C. Diaphragmatic rupture with herniation

D. Fat or air embolism