Approach to Shock Flashcards
What is shock?
Oxygen delivery is inadequate to oxygen demand
What is the difference between compensated and uncompensated shock?
Compensated = normalish BP, but inadequate perfusion Uncompensated = low BP
What are the classic causes of hypovolemic shock?
Hemorrhage or fluid loss
What are the classic causes of cardiogenic shock?
ACS
Valve failure
Dysrhythmia
What are the classic causes of distributive shock?
Sepsis
Anaphylaxis
Neurogenic
What are the classic causes of obstructive shock?
PE
Tension pneumo
Tamponade
What is the shock index?
HR/ SBP
What is the normal range of the shock index, and what are the significance of each end?
0.5-0.7. If over 1.0, then decreased LV function and are associated with higher mortality
Why should an INR be ordered in pts with shock?
To see if hypocoagulability is a cause
Why should a BUN/Cr and LFTs be ordered in pts with shock?
Assess their function
Why should a CXR and EKG be ordered in pts with shock?
search for obstructive/cardiogenic causes
Why should a lactate be ordered in pts with shock?
To gauge hypoperfusion
What happens to the following in cardiogenic shock:
- HR
- CVP
- CO
- SVR
- HR = Increased
- CVP = Increased
- CO = Decreased
- SVR = Increased
What happens to the following in hypovolemic shock:
- HR
- CVP
- CO
- SVR
- HR = Increased
- CVP = decreased
- CO = Increased
- SVR = Increased
What happens to the following in distributive shock:
- HR
- CVP
- CO
- SVR
- HR = Increased
- CVP = Decreased
- CO = + / -
- SVR = Decreased
