14 Shock Flashcards
What is the definition of shock?
failure of the circulation to deliver oxygenated blood to meet tissue requirements
What does a reduction of blood flow to tissues cause?
anaerobic metabolism lactic acid production metabolic acidosis ischaemia necrosis death
How can we measure if oxygen delivery to the tissue is adequate?
serum lactate
urinary catheter
How do we measure oxygen delivery?
DO2 = CO x (Hb x SPO2 x 1.34) + (PaO2 x 0.2)
What are all patients in shock given?
15L high flow oxygen
How can we increase preload?
give patients more fluid, with blood
not too much! after so much fluid, stroke volume decreases
how might we increase heart contractility?
give them adrenaline or something
What might cause preload shock?
haemorrhage - hypovolaemia
What might cause inotropic shock?
something cardiogenic
CHF
ACSDysrhythmia
valve
cardiac tamponade
What might cause afterload shock?
distributive issues
sepsis
thyrotocicosis
anaphylaxis
neurogenic
How might you assess shock patients?
ABCDE
How does the body responsd to acidosis?
H+ detected by central chemoreceptors
increased frequency of impulses to medulla
increased rate and depth of ventilation
increased expiration of CO2
What hormone is released which ulitmately leads to decreased urine output in shock?
renin
How does angiotensin II increase blood volume?
efferent vasoconstriction
increases thirst drive
