Essential laboratory tests

00000000In assessing the patient, the following tests are recommended:

• Serum electrolyte and blood gas studies.
  
• Liver function tests: serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), and serum proteins.
  
• Platelet count, prothrombin time, partial thromboplastin time, and thrombin time.
  

Evaluation of patient's condition

00000000Frequent recording of vital signs and haematocrit determinations are important in evaluating the results of treatment. If patients show ant signs denoting secondary shock, vigorous anti-shock therapy should be instituted promptly. Patients should be under constant and careful observation until there is a reasonable certainty that danger has passed.

In Practice:

• The Pulse, the blood pressure, the respiratory rate and the temperature should be taken every 30 minutes or more often, until shock is overcome.
  
• Haematocrit (or haemoglobin) levels should be determined every two hours for the first six hours, then every four hours thereafter, until stable.
  
• A fluid balance sheet should be dept, recording the type of fluid given, the rte and amount, to evaluate the adequacy of replacement and correction of fluid and electrolytes. The frequency and volume of urine output should be recorded.
  
• During rapid administration of fluid, it is especially important to watch for the following signs of fluid overload/cardiac failure: respiratory distress (with or without crepitation), puffy eyes, sudden increase in the size of the liver, rapid pulse and restlessness.