Chapter 15 - Shock And Resuscitation Flashcards
What is inadequate volume?
A decrease of blood volume, which will decrease the preload, which will cause the stroke volume and cardiac output to fall, which will cause the systolic blood pressure to fall
What is shock?
Inadequate tissue perfusion
What is inadequate pump function?
When the heart does not generate enough force to move the necessary amount of blood through out the body
What is inadequate vessel tone?
When the vessels size increases because of massive vasodilation, the resistance decreases and the blood pressure and perfusion Olson decrease
What is hypovolemic shock?
Shock that is caused from a low volume of blood
What is the most common cause of hypovolemic shock?
Hemorrhage - the loss of whole blood
What is distributive shock?
A decrease in the inter vascular volume caused by massive systemic vasodilation and an increase in capillary permeability
What are the 5 categories of shock?
Hypovolemic, distributive, obstructive, cardiogenic
Metabolic/respiratory
What are the types of hypovolemic shock?
Hemorrhagic
Non hemorrhagic, burn
What are the types of distributive shock?
Septic
Neurogenic
Anaphylactic
What are the types of obstructive shock?
Pulmonic embolism
Pericardial tamponade
Tension pneumothorax
What are the types of cardiogenic shock?
MI, CHF
Beta blockers, calcium channel blockers
Abnormal rhythm
Depressed pump function
What are the types of metabolic/respiratory shock?
CO2, oxygen diffusion
What is cardiogenic shock?
Caused by ineffective pump function, usually when more than 40 percent of the left ventricle has been lost
What is obstructive shock?
Condition when blood is obstructed from moving forward
What is anaphylactic shock?
When chemical mediators are released that cause massive and systemic vasodilation
What is septic shock?
Infection that releases bacteria or toxins in the blood, causing the vessels to dilate and become permeable
What is neurogenic shock?
A spinal cord injury that damages the sympathetic nerve fibers that control the vessel tone
What is cardiogenic shock?
Depressed pumping functions of the heart that reduces the stroke volume, cardiac output, systolic blood pressure and perfusion
What is direct nerve stimulation?
When shock occurs, the sympathetic nervous system is activated and tries to restore normal blood pressure
What is compensatory shock?
When the body is able to adjust and maintain near normal blood pressure and perfusion to vital organs
What is decompensatory shock?
An advanced stage of shock where the body is no longer able to maintain blood pressure and perfusion to vital organs
What is irreversible shock?
The stage at which, regardless of intervention, the patient outcome is death
What is the lower blood pressure limit for a child less than 10 dealing with shock?
Systolic blood pressure of 70 plus two times the age is the lower limit of normal
What does resuscitation mean?
Bringing the patient back from potential or apparent death
What is sudden death?
When the patient dies within 1 hour of the onset of the signs and symptoms
How long before the brain has irreversible changes due to cardiac arrest?
4 to 6 minutes
What is the electric phase of shock?
Begins immediately upon cardiac arrest thru 4 minutes, the heart still has a good supply of oxygen and glucose and aerobic metabolism is maintained
What is circulatory phase of shock?
From 4 to 10 minutes after onset, oxygen stores have been depleted and the body shifts to anaerobic metabolism
What is the metabolic phase of shock?
After 10 minutes of onset, the heart is starved of oxygen and the body has a huge buildup of acid. Chances of survival drop dramatically
What is downtime?
The time the patient goes into cardiac arrest until CPR is performed
What is total downtime?
The total time from onset of cardiac arrest until the patient is delivered to the ER
What is ROSC?
Return of spontaneous circulation
What is considered survival?
When a cardiac arrest patient is able to leave the hospital
What is the adult chain of survival?
Immediate recognition and activation Early CPR Rapid defibrillation Effective advanced life support Integrated post cardiac arrest care
What is the compression rate during CPR?
100 per minute
30 compressions to 2 ventilations
What is ventricular fibrillation?
Disorganized cardiac rhythm that produce no pulse or cardiac output
What is ventricular tachycardia?
A very fast heart rhythm that is generated in the ventricle instead of the sinoatrial node in the atrium
What is asystole?
The absence of electrical activity and pumping action in the heart
aka - flat line
What is PEA?
Pulseless electrical activity, the heart has an organized rhythm but the heart does not respond or there is nothing to pump
