Cardiovascular related SHOCKS

Question 1

Obstruction during pregnancy..

Answer 1

Roll pt on her side

Uterus 30lbs - flat on back - uterus rests on vertebral column and the uterus is the vena cava - becomes compressed

Question 2

Tension Pneumo tx

Answer 2

Chest tube/Needle Decompression

Squeezes the heart

Question 3

Cardiac Tamponade tx

Answer 3

Pericardiocentesis

Fluid collects around heart - blood can’t get in

Question 4

Pulmonary Embolism tx

Answer 4

Thrombolytics

Question 5

Aortic aneurysm tx

Answer 5

Surgical intervention

Question 6

Aortic Stenosis tx

Answer 6

Surgical Intervention

Question 7

Excessive PEEP tx

Answer 7

Re-adjust vent - increase intrathoracic volume (hard to move blood from R to L)

Question 8

Obstructive Shock blood can’t…

Answer 8

get into or out of the heart

Question 9

Hypovolemia is from

Answer 9

blood or plasma lost

Question 10

2 compensatory mechanisms during hypovolemic shock

Answer 10

Can loose 60% of blood and still function due to these

SNS
Aldosterone

Question 11

SNS

Answer 11

Fight or Flight

Adrenergic

Question 12

SNS kicks into play..

Answer 12

Various receptors in the body react

Question 13

3 receptors in the adrenergic system

Answer 13

1. Alpha : Heavily in the walls of blood vessels
2. Beta 1 : Affect heart
3. Beta 2: Affect lungs

Question 14

Alpha receptors when stimulated by the adrenergic system…

Answer 14

Vasoconstrictor

Glycogeonolysis: Glycogen stored in the liver transformed back into glucose - elevate BS

Diaphoretic

Question 15

Systolic is..

Answer 15

the measure of the pressure in the artery at the height of contraction - when the blood is pushed and the artery is as full as it can be

Question 16

Pulse pressure is the

Answer 16

difference between systolic and diastolic

Question 17

Systolic can tell you

Answer 17

How much volume you have
(sterling law)

How affective are my ventricles

Question 18

Diastolic tells you..

Answer 18

Peripheral vascular resistance

Question 19

Diastolic can tell you

Answer 19

Vasoconstriction or Vasodilation (If you have the same amount of blood but narrow your pressure will be higher)

Question 20

BP on scene 138/72 = 66
BP on scene 118/80 = 38
Post arrival 102/90 = 12

Answer 20

NARROW PULSE PRESSURE

Diastolic - vasoconstriction = going up! (alpha stimulation)
..what should happen to systolic? It should go up…

Systolic - Pt is loosing blood faster than they can vasoconstriction

Question 21

What is beta 2 meant for in SNS stimulation?

Answer 21

Improve gas exchange

Question 22

What is another name for parasympathetic

Answer 22

Cholinergic

Question 23

What kicks in after shock?

Answer 23

Parasympathetic

Question 24

agonist

Answer 24

increases response

Question 25

antagonist

Answer 25

decreases response

Question 26

Alpha adrenergic agonist affect BP?

Answer 26

Increase

Question 27

Anticholinergic affect pulse rate

Answer 27

Increase

Question 28

How would a Beta Blocker affect RR

Answer 28

Dec RR

Question 29

Pericardial Tamponade

Answer 29

accumulation of fluid in the pericardial sac (average 20 - 40 ml of fluid) MAX 100 ml

Question 30

Pericardial Tamponade SA

Answer 30

CP - like a bruised heart

Blood can’t get in or out of the heart = Hypotension

SNS Stimulation

Inc Lactic Levels

Question 31

What is electrical alternans

Answer 31

Alternating amplitude of QRS complexes

Different filling pressures

Question 32

Cardiac Tamponade can cause what rhythm

Answer 32

PEA

Question 33

How to test the blood from a cardiac tamponade?

Answer 33

Put it in a basin

If it CLOTS - probably from the ventricle

If it does not - probably pericardial blood (platelet poor)

OR CBC - Lower than venous would be sac