Arnce Shock Flashcards
How is stroke volume determined?
- Preload
- Myocardial contractility
- Afterload
How is BP calculated?
CO x SVR
How is CO calculated?
HR x SV
What is shock?
Inadequate tissue perfusion to meet metabolic demand and tissue oxygenation
What is compensated shock?
- Reflex compensatory mechanisms are activated and perfusion to vital organs are maintained
- HR is increased as well as contractility and peripheral blood vessels constrict to shunt blood centrally
What is decompensated shock
- Tissue hypo perfusion & onset of worsening circulatory and metabolic derangement including lactic acidosis
- Hypotensioni and metabolic lactic acidosis
What is irreversible shock?
- Organ and tissue injury so severe survival is not possible even with hemodynamic resuscitation
What is distributive shock categorized into?
- Septic
- Non septic
What is cardiogenic shock categorized into?
- Cardiomyopathic
- Arrhythmogenic
- Mechanical
Bad pump (ex cardiomyopathy)
What is hypovolemic shock categorized into?
- Hemorrhagic
- Non hemorrhagic
Decreased intravascular volume (ex hemorrhage or dehydration)
What is obstructive shock categorized into?
- Pulmonary vascular
- Mechanical
Mechanical obstruction of circ system (ex PE, tension pneumothorax)
Describe what happens to CO, SVR , and CVP in cardiogenic shock.
- Decrease CO
- Increase SVR
- Increase CVP
Describe what happens to CO, SVR , and CVP in hypovolemic shock.
- Decrease CO
- Increase SVR (systemic vascular resistance)
- Decrease CVP (central venous pressure)
Describe what happens to CO, SVR , and CVP in distributive septic & anaphalactic shock.
- Increases CO
- Decrease SVR
- Decrease CVP
Describe what happens to CO, SVR , and CVP in Obstructive shock.
- Decreased CO
- Increased SVR
- variable CVP
What is the most common cause of cardiogenic shock?
- Heart muscle problem (cardiomyopathy)
- Ischemic (AMI or CHF)
- Infectious (myocarditis)
- Drugs or toxins
What are the rhytym problems that cause cardiogenic shock?
- HR to fast
- A. fib, A flutter, V. fib, V tachy
- HR to slow
- complete heart block, Type II heart block
What are the examples of what causes the specific subtypes of hypovolemic shock?
- Hemorrhagic: Blood loss
- Non-hemorrhagic: Fluid loss
- Dehydration
- Cirrhosis
- Burns
What are examples of distributive shock in the septic and non septic categories?
- Septic is septic shock
- Non septic:
- Neurogenic: secondary to TBI or spinal injury
- Anaphylactic
- Toxin or med induced
Describe what happens to CO, SVR , and CVP in Neurogenic shock.
- Part of the distributive shock non septic category
- Decreased CO SVR and CVP
What can cause obstructive shock?
- Tension pneumothorax
- Pericardial tamponade
- pulmonary embolism
Signs of shock?
- Hypotensioin
- Tachycardia
- Oliguria
- Abnormal mental status
- Tachypnea
- Cool clammy cyanotic skin
- Metabolic acidosis
- Elevated serum lactate
