Bleeding and Shock Flashcards
Define shock
A life-threatening, generalised form of acute circulatory failure with inadequate oxygen delivery and utilisation by cells
4 different types of shock
Distributive
Obstructive
Hypovolemic
Cardiogenic
Distributive shock
Failure of vasoregulation (blood vessels dilated and leaky, blood volume and pumping normal but problems with distribution
Due to: sepsis, anaphylaxis, neurogenic
Obstructive shock
Barriers to blood flow and delivering of oxygen to organs
Hypovolemic shock
Loss of intravascular volume: severe blood or other fluid loss makes heart unable to pump enough blood to body
Due to: haemorrhage, burns, diabetic ketoacidosis, severe vomiting or diarrhea
Cardiogenic shock
Reduced activity of the heart
E.g. myocardial infarction, arrhythmias, mechanical failure
Physiological changes in shock/ how it is recognised
Clinical parameters: cardiovascular status (BP, HR), RR, GCS, biochemical markers, specific symptoms
Treatment of distributive shock
Fluid, vasopressors, antibiotics
Treatment of Hypovolaemic shock
Fluid, blood, stop losses
Treatment of Cardiogenic shock
Balance of various things, needs a specialist
Treatment of Obstructive shock
Remove obstruction, use needle or thrombolysis
Results of blood loss
Intravascular volume lost –> decreased cardiac output –>impaired tissue oxygenation –> end-organ dysfunction –> death
Haemorrhagic shock compensation
Cardiac contraction rate increases to compensate for lack of volumeso maintains adequate output (CO = HR x SV)
Blood directed to visceral organs to provide heart with enough blood to perfuse vital organs
Left long enough, kidney, liver and bowel begin to fail due to lack of blood
Circulation and haemorrhage control (6)
Find where blood is coming from
Large peripheral IV access
Stop bleeding (pressure, elevate, tourniquet, pelvic binder, surgical, medical)
Give blood
Major haemorrhage protocol, Tranexamic acid (stops breakdown of clot)
5 types of wound
Abraision, laceration, incised, degloving, bites
