7. PALS Shock Flashcards
shock
inadequate tissue perfusion
all forms of shock produce
tissue hypoxia
common shock symptoms
hypotension
decr CO
vasoconstriction
poor perfusion
vasodilation (sepsis/anaphylaxis)
compensated shock
body mx normal BP and CO despite poor signs of perfusion
compensated BP
> 50th percentile for age
decompensated BP
< 50th percentile for age
decompensated shock
BP remains low despite compensatory efforts from the body
warm shock
caused by vasodilation
low BP
periph BF incr
warm shock S+S
good peripheral pulses
incr CO
wider pulse pressure
warm/flushed skin
cold shock
caused by low CO w/vasoconstriction
periph BF decr
cold shock S+S
pale/mottled skin
cold peripherals
narrow pulse pressure
inaccurate BP readings
cold shock/decompensated shock treatment
fluids
vasopressors
inotropes
warm shock treatment
fluids
vasopressors
compensated shock treatment
fluids
inotropes
vasodilators (cardiogenic shock)
most common shock in kids
hypovolemic shock
2 types of hypovolemic shock
hemorrhageic
non-hemorrhagic
hypovolemic shock S+S
poor perfusion
hTN
tachycardia
incr SVR
vasoconstriction
cold shock
clear breath sound
hypovolemic shock treatment
20 ml/kg fluid bolus
blood
cardiogenic shock
caused by decr contractility and decr EF
pts with cardiogenic shock can develop
pulm edema
vasoconstriction (cold shock)
cardiogenic shock S+S
poor perfusion
hTN
incr SVR
vasoconstriciton
cold shock
rales
cardiogenic shock treatment
smaller 5-10 mL fluid bolus over 20 mins
inotropes
vasodilators
diuretics
how do vasodilators incr CO
decr SVR
when can you consider vasodilators?
if shock is compensated (normotensive)
prearrest ECOM should be considered if
pt has cardiomyopathy
or refractory low CO
dissociative shock
abnormalities in Hb affinity:
CO poisoning
methemoglobinemia
CN poisoning
CO poisoning treatment
supp O2
methemoglobinemia treatment
methylene blue
obstructive shock
shock caused by obstruction to BF
4 types of obstructive shock
pulm embolism
cardiac tamponade
tension pneumothorax
ductal dependent lesion
pulm embolism S+S
poor perfusion
hTN
signs of RHF
resp distress/chest pain
pulm ebolism treatment
20 mL/kg fluid bolus
anticoags (heparin)
thrombolytics (tPA)
expert consult
cardiac tamponade S+S
poor perfusion
hTN
becks triad
pulsus paradoxus
resp distress/chest pain
cardiac tamponade treatment
pericardiocentesis
20 mL/kg fluid bolus