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Non Modifiable Factors Age Gender

Modifiable Factors Vehicle (ten wheeler truck) Environment (South Luzon Express Way, fast moving vehicles)

Right leg physical trauma due to vehicular accident Break in the skin Tissue damage

Bone cannot with hold the outside body force Caused breaking of bones and tearing of tissues and lumens

Nerve fibers that surround the bone becomes irritated Massive bleeding (Internally and Externally) Decreased intravascular volume Decreased cardiac output Pain
Loss of function and loss of blood access of the affected part ( right leg)

Opportunistic Parasite enters the open wounds through a cochliomyia Secondary screw worm matures

Decrease tissue perfusion

Impaired cellular metabolism Secretion of Catecholamine Produce myiasis Tissue necrosis

Secretion of ADH and Aldosterone

Shift of interstitial fluid

Increase fluid volume

Increased Heart rate and force of contraction

Increased systemic vascular resistance

Above knee amputation done

Increased cardiac output Continued volume loss Decrease Cardiac output Decrease systemic pressure Decrease pulmonary pressure

Compensatory mechanism begin to fail

HYPOVOLEMIC SHOCK

Perocho, Irene Ann L.