Title page for ETD etd-11232011-132542


Document Type Master's Dissertation
Author Zarrabi, Eleonora Natali
Email zarrabin@gmail.com
URN etd-11232011-132542
Document Title Relationship between lactate values and mortality in patients with haemorrhagic shock in an emergency unit
Degree MCur
Department Nursing Science
Supervisor
Advisor Name Title
Prof S P Hattingh Co-Supervisor
Dr T Heyns Supervisor
Keywords
  • haemorrhagic shock
  • end points
  • emergency unit
  • emergency nurse practitioner
  • mortality rate
  • serum blood lactate levels
  • level I hospital
  • triage
  • trauma
Date 2011-09-09
Availability unrestricted
Abstract
Introduction : Trauma is the leading cause of death in patients between the ages of 1-44 years in South Africa. Taking these statistics into consideration it is essential to better resuscitation strategies in order to improve outcome of trauma patients. Compensated and uncompensated haemorrhagic shock is frequently under diagnosed in trauma patients, which has a definitive effect on mortality. Concerns about inadequate monitoring of patients through the use of only physiological end points are raised.

Methods : A comprehensive literature review was conducted on resuscitation strategies for patients presenting with haemorrhagic shock. Physiological and metabolic end points of resuscitation were identified to guide resuscitation strategies. A quantitative, retrospective, non-experimental, descriptive, correlational and crosssectional research design was chosen for this study. Data was collected by using biophysical measures, namely clinical audit checklists.

Results : Lactate was identified as a good indicator to predicting mortality in patients presenting with shock caused by haemorrhage. Special consideration to patientsí age and physiological status should be made during resuscitation. The consequence of delayed resuscitation in haemorrhagic shock patients is associated with an increase in mortality that can be prevented. It is found that serum blood lactate levels taken over time are good predictors of patient survival rates. Patients presenting with a raised serum blood lactate level for more than 24-hours has an increase in mortality rate.

Conclusion : Emergency nurse practitioners are responsible for the monitoring of patients admitted to the emergency unit with haemorrhagic shock. The use of serum lactate levels during the first 24-hours of the resuscitation of patients with haemorrhage can assist with the implementation of strategies to reverse the effect haemorrhagic shock on cellular level in these patients.

© 2011, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.

Please cite as follows:

Zarrabi, EN 2011, Relationship between lactate values and mortality in patients with haemorrhagic shock in an emergency unit, MCur dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd-11232011-132542 / >

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