C13. Cardiovascular responses to shock

Question 1

what is tissue perfusion

Answer 1

Tissue perfusion refers to the flow of blood through the body’s tissues, delivering oxygen and nutrients while removing waste products.

Question 2

what is shock

Answer 2

Abnormality of circulatory system resulting in inadequate tissue perfusion and oxygenation

Question 3

why is it important to spot shock

Answer 3

people can die from shock and early recognition and intervention helps make a difference

Question 4

shock > inadequate tissue perfusion >…..

Answer 4

inadequate tissue oxygenation> anerobic metabolism > accumulation of waste products > Cellular failure

Question 5

What can cause inadequate tissue perfusion?

Answer 5

▪ Loss of blood volume

▪ Sudden severe impairment of heart function

▪ Physical obstruction to circulation

▪ Excessive vasodilation and abnormal distribution of blood flow

Question 6

name 4 types of shock (relevant for this block)

Answer 6

Hypovolaemic shock
Cardiogenic shock
Obstructive shock
Distributive shock

Question 7

what is hypovolaemic shock

Answer 7

loss of blood volume

Question 8

name the 2 types of hypovolaemic shock

Answer 8

haemorrhagic and non-haemorrhagic

Question 9

what can cause Haemorrhagic hypovolemic shock

Answer 9

trauma, GI bleed, ruptured aneurysm

Question 10

what can cause Non-Haemorrhagic hypovolemic shock

Answer 10

Burns, GI losses, diabetic ketoacidosis

Question 11

what is cardiogenic shock

Answer 11

sustained hypotension due to reduced cardiac function

Question 12

name 4 examples of issues that can cause cardiogenic shock

Answer 12

contractility
mechanical
arrhythmia
cardiotoxicity

Question 13

cardiogenic shock - contractility examples

Answer 13

(MI, myocarditis, cardiomyopathy)

Question 14

cardiogenic shock - mechanical examples

Answer 14

Papillary muscle rupture
severe aortic stenosis

Question 15

cardiogenic shock - arrhythmia examples

Answer 15

Heart block, VT, SVT, AF

Question 16

cardiogenic shock - cardiotoxicity examples

Answer 16

medication overdose

Question 17

what is obstructive shock

Answer 17

physical obstruction of flow outside of the heart

Question 18

what conditions are due to obstructive shock - outflow

Answer 18

massive PE, cardiac tamponade, tension pneumothorax

Question 19

what conditions are due to obstructive shock - venous return

Answer 19

vena cava syndrome
sickle cell splenic sequestration

Question 20

what is distributive shock

Answer 20

abnormal distribution of blood flow

Question 21

what are the 2 types of distributive shock

Answer 21

neurogenic
vasoactive

Question 22

give an example for neurogenic and vasoactive distributive shock

Answer 22

Neurogenic - spinal cord injury
Vasoactive - sepsis

Question 23

what is the management of Shock

Answer 23

1. Call for help
2. Structured approach <C>ABCDE</C>
3. High flow oxygen to keep oxygen sats >94%
4. iv access
5. Fluid resuscitation (most)
6. Specific treatments depending on cause

Question 24

In hypovolemic (haemorrhagic) shock, compensatory mechanisms can maintain blood pressure until about >…% of blood volume is lost

Answer 24

> 30%

Question 25

what does the body do to compensate blood loss and what side effects happen

Answer 25

increase pulse rate and resp rate=
aka increased HR via baroreceptor reflex

side effects of blood loss -
decreased MAP, SV, CO
blood pressure decrease
pulse pressure decrease
urine output decreases
become more anxious and confused