Bleeding and Shock

Question 1

what is shock?

Answer 1

when tissue perfusion and hence oxygenation is inadequate to maintain normal metabolic

Question 2

what happens during shock?

Answer 2

cardiovascular system fails to deliver enough O2 and nutrients to meet metabolic needs. cells switch from aerobic to anaerobic ATP production and lactic acid builds up.

Question 3

what causes hypvolaemic shock?

Answer 3

-acute sudden haemorrhage
-blood loss may be internal or external
-can also be caused by loss of body fluids via sweating or diahhrea
-excess water loss via urine in diabetes

Question 4

how is hypovolaemic shock managed?

Answer 4

by replacing fluid volume as quickly as possible

Question 5

what happens during class I?

Answer 5

-up to 750ml blood loss
- <100 Pulse rate
-normal BP
-14-20 resp rate
->30mls/hr
-normal mental status

Question 6

what happens during class II?

Answer 6

-750-1500ml blood loss
->100 pulse rate
-normal BP
-20-30 resp rate
-20-30mls/hr urine output
-mild anxiety

Question 7

what happens during class II?

Answer 7

-1500-2000 ml blood loss
->120 BP
-decreased BP
-30-40 resp rate
-5-15ml/hr urine output
-anxious

Question 8

what happens during class IV?

Answer 8

->2000ml blood loss
->140 pulse rate
-decreased BP
->40 resp rate
-negligible urine output
-confused

Question 9

what causes cariogenic shock?

Answer 9

-most commonly a myocardial infection
-poor perfusion of the heart
-heart valve problems
-impaired contractility of muscle fibres
-shock can still occur if BP drops due to a decrease in systematic and vasucalar resistance

Question 10

what happens during cariogenic shock?

Answer 10

heart fails to pump blood adequately

Question 11

what causes septic shock?

Answer 11

combination of cardiac depression and when infection causes inflammatory response around the body, fluid leaks from blood vessels and is unable to circulate

Question 12

what happens during septic shock?

Answer 12

BP drops to a dangerously low level after an infectio, meaning blood doesn’t reach vital organs

Question 13

what is spinal/neuro shock?

Answer 13

vasodilation and hypertension may occur following trauma to the head that causes malfunction to the cardiovascular centre in the medulla. this results in the loss of vascular tone and slowing of heart beat.

Question 14

what is anaphylactic shock?

Answer 14

-due to a severe allergic reaction
-releases histamines and other mediators which cause vasodilation due to IgE
-drives an inappropriate or exaggerated reaction towards a substance that is normally harmless

Question 15

what is distributive shock?

Answer 15

a failure of vasoregulation, or severe peripheral vasodilation (may be due to sepsis, anapylaxis or neurogenic causes)

Question 16

what is obstructive shock?

Answer 16

due to barriers in cardiac flow/filling (such as pulmonary embolism, cardiac tamponade and tension pneumothorax)

Question 17

what is hypovolaemic shock?

Answer 17

loss of intravascular volume (haemorrhage eg trauma or non haemorrhage eg burns)