WSES Indicators for Hemodynamic Instability

Patient selection: trauma

Clinical indicators associated with hemodynamic instability:

(1) admission systolic blood pressure < 90 mm Hg

(2) signs of vasoconstriction (cool and clammy skin; decreased capillary refill)

(3) altered level of consciousness AND/OR shortness of breath

(4) requires bolus infusion OR vasopressor drugs to maintain blood pressure

(5) admission base excess < -5 mmol/L (acidosis)

(6) shock index > 1

(7) transfusion requirements >= 6 units of packed RBCs in the first 24 hours