Cardiovascular Responses To Shock Flashcards
What is the sequence of shock
Inadequate tissue perfusion Inadequate tissue oxygenation Anaerobic metabolism Accumulation of metabolic waste products Cellular failure and death
What does adequate tissue perfusion/oxygenation depend on
Adequate blood pressure (perfusion) and adequate cardiac output (enough blood to tissue and heart)
What is the sequence of hypovolaemic shock
Loss blood volume Decreased blood volume Decreased venous return Decreased EDV Decreased SV Decreased cardiac output and decrease blood pressure Inadequate tissue perfusion
What is cardiogenic shock
Sustained hypotension caused by decreased cardiac contractility
What is the craduogenic shock sequence
Decreased cardiac contractility
Decreased SV
Decreased cardiac output and decreased blood pressure
Inadequate tissue Perfusion
What is the sequnce of tension pneumothorax- obstructive shock
Increased intra thoracic pressure Decreased venous return Decreased EDV Decreased SV Decreased cardiac output and decreased blood pressure Inadequate tissue perfusion
What is the sequnce of neurogenic shock
Loss of symp tone
Massive venous and arterial vasodilation
Decreased venous return and decreased tpr
Decreased cardiac output and decreased blood pressure
Inadequate tissue perfusion
What is the sequence for vasoactive shock
Release of vasoactive mediators (from infection)
Massive venous and arterial vasodilatation -also increased cap perm
Decreased venous return and decreased tpr
Decreased cardiac output and decreased blood pressure
Inadequate tissue perfusion
What are the outlines of treatment of shock
Abcde
High flow oxygen may help perfusion
Volume replacement at loosing vol fluids expand circ vol
Inotropes- increase contractility of heart for cardiogenic shock
Immediate chest drain for tension pneumothorax
Adrenaline for anaphylactic shock help circ
Vasopressors for septic shock give massive vasodilatation use something to influence vasoconstriction
What are the causes of hypovolaemic shock
Circulatory shock (decrease MaP)
Decrease cardiac output
Decrease blood volume
From haemorrhage and vomit/diarrhoea/excessive sweating
How long can compensatory mechanisms maintain Haemorrhagic shock
Maintain blood pressure until >30% of blood volume is lost
What is shock
An abnormality of circulatory system resulting in inadequate tissue perfusion and oxygenation
