Bleeding and shock

Question 1

Define shock

Answer 1

Clinical syndrome in which tissue perfusion and therefore oxygenation is inadequate to maintain normal metabolic function

Question 2

List the types of shock and give a brief description

Answer 2

Hypovolaemic (severe blood or fluid loss due to haemorrhage or GI/Burns)
Spinal/neuro (change/loss of vascular tone which controls blood vessel diameter)
Anaphylactic (in response to allergy, immune system releases chemicals)
Cardiogenic (heart pumping failure)
Septic (damage due to infection - causes low blood pressure)

Question 3

What happens during shock?

Answer 3

During shock, the body will try to maintain blood pressure for as long as possible. This is more difficult in the elderly as they have less physiological reserve.

Question 4

What happens are blood pressure drops due to shock?

Answer 4

As BP drops, organs start to fail.
High Pulse pressure
High respiratory rate
Low urine production as less blood is going to the kidneys
Increase in confusion/anxiety as more blood is lost

Question 5

Describe class I shock ?

Answer 5

Class I:
Up to 15% blood loss
Pulse rate < 100
Blood pressure: normal
Respiratory rate: 14-20
Urine output: >30 mls/hour 
Mental state: normal

Question 6

Describe Class II shock?

Answer 6

Blood loss: 15-30%
Pulse rate: >100
Blood pressure: normal
Respiratory rate: 20-30
Urine output: 20-30 mls/hour
mental state: mild anxiety

Question 7

Describe Class III shock?

Answer 7

Blood loss: 30-40%
Pulse rate: >120
Blood pressure: decreased
Respiratory rate: 30-40
Urine output: 5-15 mls/hour
mental state: anxious

Question 8

Describe Class IV shock

Answer 8

Blood loss: >40%
Pulse rate: >140
Blood pressure: decreased 
Respiratory rate: >40
Urine output: negligible 
mental state: confused

Question 9

What is ABCDE and what is it used for?

Answer 9

Airway with C-spine control
Breathing
Circulation
Disability
Exposure (of body)

Used for management of trauma patients