Syok dapat diklasifikasikan menjadi 4 macam, yaitu:

1) Syok hipovolemik
Syok hipovolemik disebabkan oleh volume darah yang rendah (SV turun) yang
disebabkan oleh perdarahan atau dehidrasi

2) Syok kardiogenik
Syok kardiogenik disebabkan oleh penurunan kontraktilitas jantung (SV turun), yang
biasanya disebabkan oleh infark miokardium (MI) masif

3) Syok distributif
Syok distributive disebabkan oleh hilangnya tonus arteri yang normal (PVR turun)
sehingga darah tidak dapat terdistribusi ke seluruh tubuh (misalnya, sepsis, anafilaksis,
transeksi medulla spinalis, overdosis obat, defisiensi endokrin)

4) Syok obstruktif
Syok obstruktif disebabkan oleh obstruksi sirkulasi sentral (SV turun; misalnya, embolus
paru masif, tamponade perikardium, pneumotoraks tegang, tension pneumothorax, atau
diseksi aorta thorakalis, yang menurunkan SV efektif di sebelah distal tempat diseksi)

Sumber : Bresler, JM. Manual Kedokteran Darurat. Ed. 6. Jakarta: EGC, 2006

Tatalaksana perdarahan internal :
Stabilkan kondisi pasien (ABC-nya distabilkan)
Setelah stabil, periksa dengan benar apakah terdapat perdarahan internal atau
tidak dengan melihat ada atau tidaknya tanda dan gejala dari adanya perdarahan
internal (lakukan juga CT scan untuk memastikan sekali lagi apakah terdapat
perdarahan internal atau tidak)
Setelah mendapat kepastian adanya perdarahan internal, tindakan selanjutnya
adalah operasi. Operasi dilakukan segera atau tidak tergantung dari seberapa
parah perdarahan internal yang diderita korban atau pasien.

Catatan buat Indri : ini kesimpulan yang ak dapat habis baca tentang tatalaksana
internal bleeding di emedicine. Kalo ada kesalahan bisa ditambahkan ini ak
sertakan copas dr webnya. Di bawah catatan ini ni ada tanda dan gejala kalo kena
internal bleeding. Alamat webnya juga udh ak sertakan dibawah maaf
ngerepotin ndri, tapi ini yang ak sampaikan di dk kmrn :)
Abdominal pain and/or swelling can be caused by Internal bleeding from trauma in
the liver or spleen. These symptoms get worse as the bleeding continues.
Light-headedness, dizziness, or fainting can result from any source of internal bleeding once
enough blood is lost.
A large area of deeply purple skin (called ecchymosis) can result from bleeding into the skin and
soft tissues.
Swelling, tightness, and pain in the leg can result from internal bleeding in the thigh. Most often,
this is caused by a fracture of the thighbone.
Headache and loss of consciousness could be the result of Internal bleeding in thebrain.
Treatments for Internal Bleeding Due to Trauma
Internal bleeding damages the body both from the loss of blood and from the pressure the
misplaced blood puts on other organs and tissues. Treatment usually takes place in a hospital's
emergency department.
Intravenous fluids and blood transfusions may be given to prevent or correct an unsafe drop
in blood pressure.
Imaging tests (usually an ultrasound, CT scan, or both) can identify whether internal bleeding is
present. Doctors consider the amount of internal bleeding along with the injured person's blood
pressure and severity of injuries to decide on the best initial treatment -- surgery or observation.
When internal bleeding is slower or delayed, observation may be appropriate at first. Often,
internal bleeding from trauma stops on its own.
Ongoing or severe internal bleeding due to trauma requires surgery to correct the problem. When
internal bleeding is severe, emergency surgery may take place within minutes after arrival at the
hospital.
The type of surgery used will depend on the location of the injury and bleeding:
Exploratory laparotomy: A surgeon makes a large incision in the skin of theabdomen and
carefully explores the abdomen. The surgeon will seal the ends of any leaking blood vessels with
a heat probe or suture material.
Thoracotomy: For bleeding around the heart or lungs, a surgeon makes an incision along the rib
cage or the breastbone. Gaining access to the chest, the surgeon can identify and stop the
bleeding and protect the heart and lungs from pressure caused by excess blood.
Craniotomy: For bleeding due to traumatic brain injuries, a surgeon may create a hole in the
skull. This can relieve pressure and reducing further injury to the brain.
Fasciotomy: Internal bleeding into an area such as the thigh can create high pressure and prevent
blood flow to the rest of the leg. A surgeon can cut deeply into the thigh to relieve pressure and
gain access to stop the bleeding.
Some people have additional risk factors for internal bleeding due to trauma. These include:
Use of "blood thinner" medications, such as clopidogrel (Plavix), warfarin(Coumadin), and
dabigatran (Pradaxa)
Severe liver disease or cirrhosis
Inherited conditions that interfere with blood clotting ability, such as von Willebrand's disease
or hemophilia
People with internal bleeding due to trauma who have these risk factors may receive additional
treatments to help their blood clot properly.

Medical Treatment
Initial treatment of internal bleeding will include stabilizing the patient, meaning that the ABCs
of resuscitation take priority for the care provider.
A: Airway. Patients with altered or decreased mental status may not be awake enough to
breathe on their own.
B: Breathing. Even if the airway is open, the lungs may not adequately be functioning and
may need assistive care to allow oxygen to be transferred from the lung to the bloodstream.
C: Circulation. The body requires blood to circulate to all its cells to provide oxygen and
nutrients and to remove waste products. Treatment is aimed to maintain blood pressure and
circulation. Often intravenous fluids only are required. Sometimes blood transfusion is
needed. A few patients will require immediate transfusions with universal donor blood (type
"O negative" blood).
Specific treatment for internal bleeding depends upon the source of the bleeding. The common
goal for treatment is to find the source of bleeding and stop it. At the same time, treatment will
be directed to repair or stabilize any damage that the bleeding caused.
Once the acute situation has resolved, treatment will try to correct the underlying cause of
bleeding to prevent future episodes.
Sumber:
http://www.emedicinehealth.com/internal_bleeding/page8_em.htm#medical_treatment

Darurat adalah suatu keadaan yang tidak terduga yang mana membutuhkan pertolongan segera
Sumber : KBBI
Tanda dan gejala fraktur tulang :
Riwayat trauma
Adanya nyeri lokal dan semakin bertambah dengan adanya gerakan
Hilangnya fungsi anggota gerak dan persendian yang terdekat
Terdapat perubahan bentuk (deformitas)
Adanya nyeri tekan, nyeri ketok, atau nyeri sumbu
Gerakan abnormal
Pemeriksaan keadaan neurovascular di bagian distal dan garis fraktur


Stadium shock :

Stadium Plasma yang hilang Gejala
Presyok (compensated) 10-15% 750 mL Pusing, takikardia ringan
sistolik 90-100 mmHg
Ringan (compensated) 20-25% 1000-1200 mL Gelisah, keringat dingin, haus,
diuresis berkurang, takikardia
> 100/menit sistolik 80-90
mmHg
Sedang (reversibel) 30-35% 1500-1750 mL Gelisah, pucat, dingin, oliguri
takikardia > 100/menit sistolik
70-80 mmHg
Berat (ireversibel) 35-50% 1750-2250 mL Pucat, sianotik, dingin,
takipnea, anuria, kolaps
pembuluh darah, takikardia/
tidak teraba lagi sistolik 0-40
mmHg

Sumber buat stadium syok dan tanda dan gejala fraktur : Purwadianto, Agus, Sampurna,
Budi. Kedaruratan Medik. Edisi revisi. BINARUPA AKSARA Publisher : Tangerang,
2013 (maaf kalo salah, soalnya ak lupa cara buat dapus -,-)