[73] Shock Flashcards
What is shock?
Where the circulation is inadequate to meet the metabolic demands of the tissues
Who is shock common in?
Critically ill children
Is shock caused by one thing?
No - there are varied reasons
How does the fluid intake requirement per kg of body weight in children compare to adults?
It is much higher
Why is the fluid intake requirement per kg of body weight in children higher than in adults?
- Higher surface area-to-volume ratio
- Higher basal metabolic rate
What factors may cause a child to become dehydrated?
- Unable to take oral fluids
- Additional loss of fluids
- Loss of fluid retaining mechanisms
What can cause inability to take oral fluids?
- Decreased consciousness
- Vomiting
What can cause additional fluid losses?
- Diarrhoea
- Fever
- Increased sweating
What can cause loss of normal fluid retention mechanisms?
- Burns
- Increased urinary loss
- Capillary leak
How can blood pressure be maintained in early shock?
- Increase HR
- Increased RR
- Diversion of blood flow from non-essential tissues to vital organs
- Redistribution of blood from venous reserve volume
What happens in late shock?
Compensatory mechanisms fail, BP falls and lactic acidosis increases
Why is it important to recognise early compensated shock?
It can be reversible, decompensated shock may not be
What are the different categories of shock?
- Hypovolaemic
- Distributive
- Cardiogenic
- Neurogenic
What can cause hypovolaemic shock?
- Haemorrhage
- Dehydration e.g. vomiting
- Burns
- Diabetic ketoacidosis
- Sepsis
What can cause distributive shock?
- Sepsis
- Anaphylaxis
