What are the main measures for treating traumatic shock?

In general, the management of traumatic shock should follow the principle of "saving life before treating injury." The core measures mainly include immediate hemostasis and source control, rapid fluid resuscitation, correction of acid-base and electrolyte imbalances, active treatment of underlying conditions, and enhanced life support and monitoring. A detailed analysis is as follows:

1. Immediate Hemostasis and Source Control: Traumatic bleeding is the primary cause of shock. Rapid hemostasis using methods such as compression or ligation is essential. Tourniquets can be used for extremity hemorrhage. Simultaneously, wound contamination must be controlled by covering the wound with sterile dressings to prevent infection from exacerbating shock. This is the first critical step in halting the progression of shock.

2. Rapid Fluid Resuscitation: Prompt intravenous administration of crystalloids and colloids is necessary to restore effective circulating blood volume. Crystalloids are preferred initially, administered at 3–4 times the estimated blood loss. Infusion rates should be adjusted based on blood pressure and urine output, with the goal of maintaining systolic blood pressure ≥90 mmHg and urine output ≥30 ml/h.

3. Correction of Acid-Base and Electrolyte Imbalances: Tissue hypoxia during shock often leads to metabolic acidosis, which requires monitoring via arterial blood gas analysis. Sodium bicarbonate may be administered intravenously when necessary. Serum potassium and sodium levels should also be monitored, with timely electrolyte supplementation to maintain internal stability and support organ function recovery.

4. Active Treatment of Underlying Conditions: While managing shock, early targeted interventions for the trauma itself are crucial—such as temporary immobilization for fractures, emergency surgical repair for ruptured internal organs, and debridement and drainage for extensive soft tissue injuries. Only by promptly eliminating the traumatic stimulus can the deterioration of shock be fundamentally prevented.

5. Enhanced Life Support and Monitoring: Continuous monitoring of heart rate, blood pressure, and oxygen saturation is essential. Oxygen should be delivered via nasal cannula or face mask to maintain arterial oxygen saturation ≥95%. For patients with severe respiratory failure, endotracheal intubation and mechanical ventilation may be required, along with protective measures for liver and kidney function.

The treatment of traumatic shock demands immediate action. In daily work and life, proper safety precautions—such as wearing protective equipment and following traffic regulations—should be taken to reduce the risk of high-energy trauma. Once signs of traumatic shock appear, emergency care must be initiated immediately and the patient transferred promptly to a qualified medical facility.